There are different methods of hysterectomy. The operation you have depends on the reason for surgery. You need to consider how much of your womb and reproductive system can safely be left in place.
During a total hysterectomy, your womb and cervix (neck of the womb) is removed. You may be advised to have removal of the cervix means to reduce the risk of you developing cervical cancer at a later date. This is part of your discussion for informed consent if you are at risk of cervical cancer.
Total hysterectomy with bilateral salpingo-oophorectomy
- the fallopian tubes (salpingectomy)
- the ovaries (oophorectomy)
The National Institute for Health and Care Excellence (NICE) recommends that the ovaries should only be removed if there’s a significant risk of further problems – for example, if there’s a family history of ovarian cancer. If there is no determinable risk then you do not need to have your ovaries removed. Keeping the ovaries may boost long-term survival rates for women under age 65.
Ovaries continue to make small amounts of oestrogen for years after menopause. They continue to make significant levels of two other hormones, testosterone and androstenedione, at least until age 80. Muscle and fat cells convert testosterone and androstenedione into more oestrogen, which helps protect against heart disease and osteoporosis. The incidence of heart disease and osteoporosis has been shown to be lower in women who have intact ovaries than women who have had their ovaries removed. While 14,000 women die of ovarian cancer every year, heart disease kills 450,000 women a year, or 30 times more women.
A radical hysterectomy is usually carried out to remove and treat cancer when other treatments, such as chemotherapy and radiotherapy, are not suitable or have not worked. The body of your womb and cervix is removed during surgery, along with:
- your fallopian tubes
- part of your vagina
- lymph glands
- fatty tissue
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