A Hysterectomy may be needed for two principle reasons:
- Clinical (or practical) reasons, where the woman suffers from uncomfortable symptoms that may impact quality of life, which could be greatly improved after removal of the uterus. Examples of such symptoms are heavy bleeding, chronic pelvic pain, or pressure on adjacent organs such as the bladder (with a constant need to pass urine).
These symptoms can be linked to the following conditions: fibromas (myomas), adenomyosis, precancerous lesions of the endometrial layer, prolapsus of the uterus (where the uterus slips down into the vagina).
A hysterectomy in these situations aims to lessen or eliminate the symptoms that are impacting the woman’s wellbeing and quality of life (such as with chronic pelvic pain, painful periods, heavy menstrual bleeding, bleeding after a period, or organ descent).
Before proceeding with a hysterectomy other medical treatment solutions and less invasive surgical solutions such as an operative hysteroscopy should be attempted or recommended. Non-surgical treatment solutions for these conditions should always be the first course of action to be explored.
- Carcinological reasons: Reasons related to the presence of cancer or precancerous symptoms or lesions: This can be cervical cancer, endometrial cancer, or ovarian cancer.
- Very rarely, hysterectomy is necessary during childbirth following rare complications (for example if the uterus ruptures or if there is uncontrollable bleeding)