What is a hysterectomy?

Hysterectomy is the removal of the uterus. Several options exist:
– Subtotal hysterectomy, which consists in leaving the cervix in place.
– The total hysterectomy, which also involves removing the cervix along with the uterus.
– Hysterectomy and bilateral salpingo-oophorectomy: this is a total or subtotal hysterectomy associated with the removal of fallopian tubes and ovaries.
– Radical hysterectomy is a broader procedure performed in oncology.

Reasons for hysterectomy

Histerectomy procedure

Video hysterectomy should be the preferred procedure when possible. The procedure may either involve laparoscopy or robotic surgery. It allows a very precise gesture with a minimum of side effects, unlike laparotomy. Indeed, scars are minimal, pain is not very severe and can sometimes even be performed in outpatient surgery.
However, in the event the uterus is too large, adhesions are too many, or in some other situations, laparotomy is necessary, i.e. by opening the abdomen.
Vaginal hysterectomy is a frequent procedure. In this case, a systematic cervical removal (total hysterectomy) is performed. It’s a painless procedure. There are no visible scars.

Psychology and hysterectomy

Removing the uterus has few organic consequences – if not that of no longer being able to carry a child! – Nevertheless, even after menopause this gesture is not innocuous. Even women who no longer wish to have children or who have undergone menopause can have a backlash after a hysterectomy.
The part of femininity that resides in the “organ” is specific to each of us and this aspect should not be neglected in the preparation of a hysterectomy.
This is not a question of hormonal drop because, as mentioned already, it is the ovaries and not the uterus that are responsible for menopause.
Psychological support may be necessary to support a hysterectomy. A good psychological preparation and a good experience of the intervention will have very positive consequences on the hospitalization time and the convalescence.

Are the fallopian tubes removed?

The fallopian tubes are one of the parts of the uterus just like the body or cervix
The CNGOF (French national college of obstetricians and gynecologists), settled in 2015*: there is no scientific argument for the removal of the tubes during an inter-adnexal hysterectomy. Nevertheless, this simple procedure is very often associated with hysterectomy.