Hysterectomy – Three Questions You Should Ask

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Topics to consider and understand when planning your Hysterectomy.

In our last Healthcast we discussed hysterectomies. We learned there are several types of hysterectomies, we discussed what the procedures are like, and why a woman should discuss them with their doctor to determine the best type for their unique medical situation.

This week we are talking about what is called a Supracervical hysterectomy. This is a hysterectomy that takes out the uterus and the cervix. This used to be the most common type of hysterectomy. Around the year 2000, gynecologists began to study sex and sexual information more rigorously. They learned that if a woman loses her cervix, it will result in her loss of one of the three types of orgasms that women can experience. Not all women have cervical orgasms, but if they do, and if they do not have the other two types of orgasms, they will loose the ability to have a satisfying sexual life once their cervix is removed.

Other benefits of leaving the cervix are, operative time is shorter (it is always a good idea to keep operations as short as possible), another is that the ligaments that hold the cervix in place help prevent having a prolapse. The cervix and its ligaments can help prevent this type of injury to the vagina. If you are not able to keep the cervix you may need to have surgical vaginal repair as you age.

If you have cervical cancer you must take the cervix out. But if it is not cancerous then you can leave it. We now can determine quite early if a woman has cancerous cells because of Pap smears.  Cervical cancer is not as common as it was and it is becoming much more rare that a woman needs to have her cervix out.

The American College of Gynecology does not seem to recognize the importance of satisfying sexual encounters for women, because it does not recommend that the cervix be left if it can be. It is up to the individual doctor to discuss this with their patients and make the decision. It is not a required protocol! Dr. Maupin believes that if it is at all possible the cervix should remain and she wishes that the American College of Gynecology would change their protocols.

If you need to have a hysterectomy you will need to chose among four types (based on your preference, and that of your doctor and based on the medical reasons for the hysterectomy).

  1. Abdominal Hysterectomy
  2. Vaginal Hysterectomy
  3. Laparoscopic Hysterectomy
  4. DaVinci Hysterectomy

Your physician should share your options with you and recommend what they think is the best choice for you.

Indications that you may need a hysterectomy are:

  1. large fibroids that cause pressure pain and or heavy bleeding
  2. Any uterus that bleeds excessively and patients are anemic. A Hysterectomy is done in this case when nothing else works.
  3. Severe pelvic pain
  4. Endometriosis
  5. Uterine, cervical or ovarian cancer
  6. Ovarian masses
  7. When both ovaries are being removed for a reason
  8. Positive family history of ovarian cancer—requires removal of both uterus and ovaries
  9. Adenomyosis with heavy bleeding
  10. Prolapse of the uterus, and or vagina with or without bladder and rectum symptoms
  11. Adhesions from other surgeries
  12. Ovarian torsion, bilateral
  13. Post partum hemorrhaging: Bleeding after a C section or vaginal delivery.

These issues are something you can and should discuss with your doctors. Do not hesitate to get a second opinion if your doctor resists discussing your options with you.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author. www.BioBalanceHealth.com

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