The complications associated with a hysterectomy, removal of the uterus, are multiple. Up to 75% of women have negative long term effects after this procedure. Most commonly seen are hormone imbalance (even when ovaries are saved), depression, bladder problems with either incomplete emptying of urine or incontinence, constipation and sexual dysfunction. Short of cancer, and sometimes uterine prolapse, we recommend saving the uterus. If you are having monthly problems……or have been diagnosed with a benign disease like fibroids or adenomyosis, treat the diseases but do NOT remove the uterus, especially as the first line of attack.
Recently we have received many emails regarding ovarian cysts.
If you have a diagnostic ultrasound and a clear fluid cyst is discovered, chances
are there is little to worry about. Women produce cysts monthly as part of
the regular menstrual cycle…the clear fluid cysts, known as functional cysts,
usually contain the egg that is released for conception. These cysts will rupture,
release the egg and often disappear. Of more concern are the cysts that appear septated, complex or blood filled. These require follow-up and may need surgery to be removed.
Many physicians currently advocate hysterectomy as the best form of treatment for
endometriosis. I disagree. Once endometrial cells have implanted within the pelvis,
removing the uterus has no effect on the current condition. Implants need to be destroyed to reduce pain and
cramping…..as long as the patient still has her ovaries, monthly flow of estrogen will fuel
the spread of the existing pelvic implants. Diagnosing and some treatment can be performed via a minimally invasive laparoscope that puts a camera in the abdomen near the belly button. This technique can be effective for treating early stages of Endo. Unfortunately, my practice often sees women with much more severe and advanced cases and the scope has too limited a field of view. An open surgery allows the entire abdomen and pelvis to be examined with laser treatment of all areas, not just those limited with the scope. The best course of treatment in advanced stages is an open surgery, not laparoscopy, with aggressive laser therapy.
Fibroids,also known as myomas or leiomyomas, are noncancerous tumors of the uterus. They are strictly found in and around the uterus, nowhere else in the pelvis. There are several common types based on location: Pedunculated, Subserosal, Submucosal and Intramural. Pedunculated tumors are attached to the uterus with a stalk and free float in the abdomen or the endometrial cavity. They are not within the muscle of the uterus. Subserosal are those tumors just beneath the outer surface of the uterus. Submucosal are tumors deep within the muscular layer of the uterus and often are adjacent to and impinge on the endometrial lining. Finally, Intramural myomas are found deep within any area of the uterine muscle. All can be successfully removed with our surgery.
In my opinion, Hysterectomy, the removal of the uterus, is one of the most overrated surgical procedures in this country. Statistics indicate that we perform over 650,000 annually and 80% of those are for non-cancerous conditions like fibroids, adenomyosis and endometriosis. Many doctors will recommend hysterectomy simply to relieve monthly symptoms: heavy bleeding, pelvic pain, and abdominal bloating and discomfort, without giving consideration to post surgical long term irreversible side effects. Hysterectomy is mandatory for cancer and in some women for Stage 4 uterine prolapse, however we never advocate hysterectomy for benign diseases like fibroid tumors, also known as myomas and leiomyomas. The uterus has many functions and should be considered worth saving for long term health benefits….dont remove it unless you have to!