A woman's reproductive organs include the uterus (womb),
vagina, fallopian tubes, and ovaries. Surgery to remove the uterus is called hysterectomy. Hysterectomy is a common operation for women
in the United States, second only to cesarean section (abdominal
delivery of a pregnancy). Because hysterectomy is major surgery with risks,
alternatives to this treatment may need to be considered along with the benefits
of having a hysterectomy. Women who have a hysterectomy stop having menstrual
periods and cannot become pregnant or give birth. If the tubes and ovaries
are removed along with the uterus (called a hysterectomy with bilateral salpingo-oophorectomy) menopause will occur, regardless of
the patient's age, because of the absence of estrogen produced by the ovaries.
Removing the uterus may speed the onset of menopause by several years. The
March 24/31, 2004, issue of JAMA includes an article
about hysterectomy for abnormal uterine bleeding.
Reasons for having a hysterectomy include abnormal uterine bleeding,
such as menorrhagia (extremely heavy menstrual periods);
uterine fibroids (benign tumors causing heavy or
irregular bleeding or pressure); chronic pelvic pain due to uterine adenomyosis (uterine glands that penetrate into the muscle
of the uterus) or endometriosis (uterine glands that
implant into other pelvic tissues); uterine prolapse (uterus
protruding into the vagina); and cancer of the female reproductive organs.
Supracervical (or subtotal) hysterectomy—most
of the uterus is removed, but the cervix (neck of
the uterus) is not removed.
Total hysterectomy—the entire uterus
is removed, with or without the tubes and ovaries.
Radical hysterectomy—removal of
the uterus and surrounding tissues, including the upper third of the vagina;
this is mainly done, along with removal of pelvic lymph nodes, for treatment
of early cervical cancer.
• Vaginal—the uterus is removed
through the vagina.
• Abdominal—the uterus is removed
through an incision in the woman's abdomen.
• Laparoscopic—the uterus is removed
in sections through small incisions using a laparoscope (a tube with a video camera to view organs).
National Women's Health Information Center 800/994-9662http://www.4woman.gov
American College of Obstetricians and Gynecologistshttp://www.acog.org
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. A Patient Page on laparoscopic surgery was published in the January
16, 2002, issue; one on ovarian cancer was published in the July 17, 2002,
issue; one on endometrial cancer was published in the October 2, 2002, issue;
and one on perimenopause was published in the February 19, 2003, issue.
Sources: National Women's Health Information Center, American College
of Obstetricians and Gynecologists, American Academy of Family Physicians
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
TOPIC: WOMEN'S HEALTH
Torpy JM, Lynm C, Glass RM. Hysterectomy. JAMA. 2004;291(12):1526. doi:10.1001/jama.291.12.1526