Removal of the uterus (hysterectomy) is advisable in cases of myoma, pelvic pain, uterine prolapse, abnormal uterine bleeding, cancer and diseases with the potential to malignancy. However, in some of these situations, there may be other treatment alternatives that should be evaluated by the gynecologist and discussed with the patient.
One of the main reasons for surgical removal of the uterus is excessive menstrual bleeding in the period before menopause. Abundant uterine bleeding can cause anemia, fatigue, and interfere with a woman's daily activities.
Bleeding that lasts for more than a week or requires the use of more than one absorbent per hour is considered excessive. Another form of abnormal uterine bleeding is the bleeding that occurs outside the menstrual period.
Bleeding can be treated with medications or other types of surgical interventions. If there is no improvement, hysterectomy may be necessary.
In the case of fibroids, it may be advisable to remove the uterus if the woman has irregular and excessive bleeding and does not intend to become pregnant.
O uterine prolapse may occur due to weakening and stretching of the pelvic muscles and ligaments that support the uterus, causing the uterus to fall into the vagina. In these cases, the doctor may choose to remove the uterus without removing the uterine cervix. In addition to hysterectomy, prolapse treatment includes the placement of support screens to prevent further prolapse of the pelvic organs.
Another indication for hysterectomy is endometrial hyperplasia. It is an excessive growth of the tissue that lines the inside of the uterus (endometrium). Endometrial hyperplasia is a benign condition, but there is a risk of developing cancer depending on the type of hyperplasia. Treatment can be done with medications, but there are cases where withdrawal of the uterus is necessary or advisable.
Hysterectomy may also be necessary in cases of cancer of uterus, cervix or ovary.
There are still situations, although rare, where removal of the uterus may be necessary to contain a uncontrollable bleeding postpartum or cesarean section.
Except in emergency situations, as described above, the decision to perform the hysterectomy should be shared between the patient and her gynecologist. Consideration should be given to women's reproductive plans, treatment alternatives to uterus withdrawal, and the risk-benefit of hysterectomy.
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