Hysterectomy means surgical removal of the womb. This is the most commonly performed major gynaecological operation. Every year 90,000 women in UK have a hysterectomy. Women who undergo a hysterectomy will have no more periods and will not be able to bear children.

Hysterectomy is sometimes combined with removal of the ovaries and fallopian tubes. Ovaries store and release eggs as part of the process of reproduction. They also produce important sex hormones and the loss of them is very important. If there is any possibility of one ovary, or even part of an ovary being safely left, you should discuss this with your gynaecologist. If ovaries are removed during a hysterectomy, Hormone replacement therapy (HRT) may be required.

After the menopause, regardless of age, women lose protection against heart disease and are more liable to develop early weakening of your bones (Osteoporosis) Hormone replacement therapy (HRT) becomes an important consideration.

Why it is necessary

Hysterectomy may be necessary for various reasons including:

• some cases of cancer of the cervix
• cancer of the lining of the womb
• large or multiple fibroids (non cancerous growths)
• the invasion of the womb wall and other nearby structures by womb-lining tissue (Endometriosis)
• excessive menstruation (this is rare)
• severe downward displacement of the womb (prolapse)
• excessive pain associated with menstruation

How it is performed

Hysterectomy is performed under a general anaesthetic. Today, some gynaecologists will carry out the operation using combined keyhole (laparoscopic) and vaginal surgery. The operation may be done wholly through the vagina, but more commonly, and more easily, the womb is removed through a conventional approach through the abdomen (tummy). If hysterectomy is carried out to treat cancer of the cervix or body, it is necessary to remove most of the structures connected with the womb.