Hysterectomy and its indications

Hysterectomy means the surgical removal of the uterus. This is of various types of hysterectomy depending upon what parts of uterus and its attachments to other structures are removed.

Types of hysterectomy

Sub total or partial hysterectomy – In this the uterus is removed leaving the cervix in place.

Total hysterectomy – Removal of entire uterus along with cervix.

Hysterectomy with unilateral salpingoophorectomy – Removal of uterus, cervix and one sided ovary along with fallopian tube.

Hysterectomy with bilateral salpingoophorectomy – Removal of uterus, cervix and both sided ovary along with fallopian tube.

Radical hysterectomy – Radical hysterectomy is usually done for cancers, this is removal of uterus, cervix, ovaries, part of vagina, the support of the uterus and lymph nodes of the area.

Indications of hysterectomy

When a hysterectomy is done to repair the pelvic floor, or tighten the support of the uterus, or to remove prolapse of the uterus along with the cervix, it is done via vaginal route, the surgeon giving a small incision in the vagina. It may involve a small incision, but is still a major surgical procedure and is called a vaginal hysterectomy.

A hysterectomy can be done by giving an incision on the abdominal wall and is called an abdominal hysterectomy. This is one used for most gynecological indications. An abdominal hysterectomy allows better visualization of the pelvic organs and greater operating area.


The indication of doing an abdominal hysterectomy are many, but now a days there are many alternatives, equally beneficial reconstructive surgical procedures, which can be considered for some conditions, for which a hysterectomy was the answer earlier.

Now a days laproscopic hysterectomy is most preferred procedure in which just two hole is made and a camera is inserted into the abdomen and the whole procedure is done by visualizing the internal abdomen in the screen.

The benefit of laproscopic hysterectomy is that the patient may be mobile within 24 hours, bleeding is less, though it may require an expert hand and total time consumed for entire operation may be more. This type of operation is more expensive.

Before undergoing hysterectomy a patient should be aware of some facts, she should know whether the operation is actually necessary or not, whether there is any alternative method, if yes is the alternative method as effective as hysterectomy etc. Please go to awareness about hysterectomy to know what a woman should ask the doctor before undergoing hysterectomy.

Absolute indications of hysterectomy

There are some conditions where there is no alternative treatment to hysterectomy and there is absolute indication for hysterectomy. These conditions are

Pelvic cancer
Uncontrolled bleeding where all other measure fails to control.
Severe fulminating pelvic infections.

There are other conditions where hysterectomy is indicated but there are alternative measures for treatment too and it depends on the condition or situation to choose between alternative treatment or hysterectomy. These conditions are

Dysfunctional uterine bleeding.
Fibroid in uterus in elderly patients
Adenomyosis with severe pelvic endometriosis.
Pelvic inflammatory disease.
Some obstetric conditions like molar pregnancy and hydatidiform mole in elderly woman where the risk of choriocarcinoma is more. Some abortions where there is chances of sepsis and in some cases of post partum hemorrhage where there is life threatening bleeding.

In some conditions like placenta accrete where placenta is completely adhered to uterine wall, hysterectomy is the only choice.

One must see the risk involved in hysterectomy before undergoing this operation and should calculate the risk versus benefit by consulting a gynecologist.

For more details see at Indiastudychannel.