What is a Total Hysterectomy?

A total hysterectomy is a gynecological surgery in which the entire uterus, including the cervix, the lower part of the uterus, is removed. Hysterectomies in general are the most commonly performed gynecological surgery, and this procedure is usually done by a gynecological surgeon who has received special training in how to perform surgeries of this nature. This is a major surgery with serious repercussions for the patient, and in nonemergency situations, patients are usually strongly encouraged to take time to think before consenting to the surgery.

The total hysterectomy is performed on a patient under general anesthesia. In a vaginal hysterectomy, the surgeon accesses the site through the vagina. This procedure is less invasive and does not leave visible scarring, but it may not be an option in all cases. The alternative is an abdominal hysterectomy, in which an incision is made through the abdomen to access the uterus and cervix for removal. This may be performed laparoscopically to minimize scarring and to facilitate a quicker recovery for the patient.

There are a number of reasons why this procedure may be recommended. A total hysterectomy can be used in cancer treatment, treatment of adhesions, pelvic pain, endometriosis, uterine prolapse, and several other conditions. This treatment is usually recommended when other treatment approaches have not been effective. In emergencies, trauma to the uterus may result in a recommendation of a total hysterectomy, as for example if someone has experienced a puncture wound to this area of the body and repair is simply not possible.

Once someone has had a total hysterectomy, it will be impossible to become pregnant. For women who are not interested in having children or who have completed their families, this may be a perfectly acceptable outcome. Women who are planning children or who would like to have more children may experience some emotional distress at the idea of a total hysterectomy, however. One option for such patients is egg harvesting to collect eggs which could later be used in assisted reproduction with the help of a surrogate.

In a total hysterectomy with oophorectomy, the fallopian tubes and ovaries are also removed. This procedure is more invasive, and it also requires supplemental treatment with hormones after surgery to prevent the patient from going into menopause. In cases with a total hysterectomy with oophorectomy is recommended, the patient may be encouraged to meet with an endocrinologist to discus hormone therapies.