ALL YOU NEED TO KNOW ABOUT HYSTERECTOMIES (BUT WERE AFRAID TO ASK)

Real conversation with husband of my patient, after I had performed a hysterectomy:

Me: Your wife’s hysterectomy went well. She is in recovery and you will be able to see her in an hour or so.

Spouse: Great! Did you also take out her uterus?

Me: Um, yeah. That is what a hysterectomy is. Just curious, what did you think we were doing?

Spouse, looking perplexed: Uh, I guess I wasn’t sure what you were doing in there.

I would love to say that he was an outlier, that his male gender made him ignorant of female anatomy, but that is not the case. Hysterectomy is one of the most common major surgeries that is performed in this country and yet there is a lot of misinformation about what exactly it is, the types that are done, and the reasons for hysterectomy.

Did you know that the word “hysterical” comes from the Greek word for uterus, “hystera.” This is because for a long time, it was felt that hysteria was limited to females and the result of a defect in their wombs. I kid you not. And this is also the origin of the word hysterectomy.

What is a partial hysterectomy?

Oh, this is one of the greatest misunderstandings of human kind! First of all, “partial hysterectomy” is not really a medical term. But if it were to be a medical term, it would be the opposite of a total hysterectomy and would mean leaving the cervix behind (or Subtotal Hysterectomy or Supracervical Hysterectomy). So many people–even some non-gyn medical professionals– think that it means leaving the ovaries behind. This is incorrect. Unless you have ovarian cancer or a large cyst or something going on with your ovaries, we will usually leave your ovaries and yet you will still have had a total hysterectomy. Removing the ovaries and fallopian tubes is called a bilateral salpingo-oophorectomy. Say that ten times. Gynos shorten it to BSO.

Why would a woman want to keep her cervix?

Good question. Years ago, there was some data to support that it helped with post-hysterectomy sexual function. Most of that data has been debunked and I usually recommend taking the cervix, unless of course the reason for the hysterectomy is cancer or precancer of the cervix. But imagine, no more pap smears!

There are instances when it is physically very difficult to remove the cervix and safer to leave it in place. For example, if there is a large fibroid or scar tissue. Also sometimes with pelvic prolapse, the cervix is used to anchor the vagina and hold things up. Sorry, I am getting a little technical.

By CYNTHIA MCNALLY, M.D. 6-11-2021