Hysterectomy is the removal of the Uterus. There are different kinds of hysterectomies:

• The total hysterectomy is the removal of the uterus and the cervical stump. It can be done either vaginally or abdominally.
• The panhysterectomy (or total abdominal hysterectomy with bilateral salpingooopherectomy, TAHBSO) is the removal of the uterus, cervix, fallopian tubes, and ovaries. If only the right or left tube and ovary are removed, the operation is known as TAHRSO or TAHLSO, respectively.
• The radical total hysterectomy (Wertheim’s operation) is the removal of the uterus, cervix, fallopian tubes, and ovaries.

Hysterectomy can be performed either through an abdominal incision, or by way of the vagina. There are specific medical reasons why your doctor chooses one or the other. The procedure can be performed using operative laparoscopy (Laparoscopy Assisted Vaginal Hysterectomy, LAVH).

Hysterectomy is an option for the following conditions:

• Menorrhagia (heavy bleeding resulting in anemia)
• Recurrent/Large/Multiple Fibroids
• Pelvic Inflammatory Disease
• Severe Endometriosis
• Adenomyosis
• Pelvic Relaxation (Prolapse) (trouble with bladder control and dropping of uterus)
• Precancerous conditions

Many women want a hysterectomy at menopause. The reason is that they want to use estrogens in regular doses, because they remain “women” with all the normal sexual activity that goes with it. The problem is that estrogen produces vaginal bleeding. When the uterus is amputated (leaving the cervix), the bleeding is eliminated, and the patient can stay on higher estrogen level. This is “comfort surgery” and “anti-aging”.

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