Uterine removal (hysterectomy, uterine extirpation) is one of the most common procedures in gynecology. There are alternatives to this operation for some diseases. Uterine cancer , on the other hand, usually requires radical removal of the uterus (womb). Here you will find further information as well as selected specialists and centers for uterine removal.
A hysterectomy is performed for both benign and malignant gynecological diseases. The most common reasons for a hysterectomy are
The frequently occurring uterine fibroids usually only need to be operated on if they cause symptoms. These symptoms include
If there is pain in the pelvis/lower abdomen, the cause must first be clarified. A hysterectomy must also be able to eliminate the cause.
A hysterectomy is not always necessary. In the case of uterine fibroids, for example, uterus-preserving therapies are also available, including
It is not uncommon for women to be faced with the choice of living with mild pain and minor problems or having their uterus removed. Before deciding to have their uterus removed, patients should seek detailed advice from their gynecologist and obstetrician.
The reasons for the hysterectomy will determine which approach is chosen.
If only the body of the uterus is removed during a hysterectomy, this is referred to as a supracervical hysterectomy.
In a complete hysterectomy, the cervix and therefore the entire uterus is also removed. This form of hysterectomy is the most common.
Radical hysterectomy, which is performed for uterine cancer, goes even further. This involves the removal of
In the case of malignant findings, it is often necessary to remove the lymph nodes in the pelvis and along the abdominal aorta. In addition, the ovaries and fallopian tubes often have to be removed. Whether this makes sense in the case of benign diseases must be decided on an individual basis.
There are four different methods of hysterectomy depending on the access route:
Which approach is chosen depends, among other things, on the disease, the size of the uterus and the patient's wishes.
Abdominal hysterectomy is the removal of the uterus via an abdominal incision. The advantage of this approach is
In the past, abdominal hysterectomy was frequently performed. Nowadays, however, attempts are made to avoid an incision by using one of the following methods.
The anatomy of the uterus © bilderzwerg | AdobeStock
In a vaginal hysterectomy, the uterus is removed through the vagina. This is possible if the uterus is not too large. The advantages of this method are
Nowadays, laparoscopically assisted hysterectomy (LAVH ) is being performed more and more frequently for non-malignant diseases. This method combines laparoscopy and a vaginal approach.
Total laparoscopic hysterectomy (TLH) is the removal of the entire uterus via laparoscopy. Another option is laparoscopic supracervical hysterectomy (LASH), in which the cervix remains in the body.
Overall, the proportion of subtotal hysterectomies for benign diseases is increasing worldwide. The disadvantages are that in up to 20% of cases persistent cyclical bleeding and in 2-5% secondary removal of the cervix must be expected.
One advantage is the somewhat faster recovery from the procedure. Occasionally cited advantages such as
have never been proven.
The permanent consequences of hysterectomy primarily include the loss of the ability to bear children. Pregnancy can no longer occur.
If the cervix has been removed in addition to the uterus, menstrual bleeding will no longer occur.
A specialist in gynecology and obstetrics is trained to remove the uterus.
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