HYSTERECTOMY

A hysterectomy is a surgical procedure whereby the uterus ( womb ) is removed. The most common reason hysterectomy is performed is for uterine fibroids ( also known as uterine leiomyomata ).

Uterine fibroids are benign growths of the uterus, the cause of which is unknown. Although the vast majority are benign, meaning they do not cause or turn into cancer, uterine fibroids can cause medical problems.

Indications for hysterectomy in cases of uterine fibroids are :

• Excessive size ( usually greater than the size of an eight month pregnancy )
• Pressure or pain
• Bleeding severe enough to produce anemia

The next most common reasons are :

• Abnormal uterine bleeding ( vaginal bleeding )
• Cervical dysplasia ( pre–cancerous conditions of the cervix )
• Endometriosis and uterine prolapse ( including pelvic relaxation )

Pelvic relaxation is another condition that can require treatment with a hysterectomy. In this condition, a woman experiences a loosening of the support muscles and tissues in the pelvic area.

Mild relaxation can cause three degree prolapse are :

• First degree prolapse : In which the cervix ( the uterine opening ) is about halfway down into the vagina.
• Second degree prolapse : The cervix or leading edge of the uterus has moved to the vaginal opening.
• Third degree prolapse : The cervix and uterus protrude past the vaginal opening.

Second and third degree uterine prolapse must be treated with hysterectomy.
Only 10% of hysterectomy is performed for cancer. A hysterectomy is also performed to treat uterine cancer or very severe pre–cancers ( called dysplasia, carcinoma in situ, or CIN III, or microinvasive carcinoma of the cervix ). A hysterectomy for endometrial cancer ( uterine lining cancer ) has an obvious purpose, that of removal of the cancer from the body. This procedure is the foundation of treatment for cancer of the uterus.

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