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let's clear up some misunderstandings regarding hysterectomy

There seems to be a lot of confusion regarding types of hysterectomies: partial, complete, total, subtotal, with or without ovaries. I will try to clarify:

Total Laparoscopic (or vaginal or abdominal) hysterectomy (TLH) is the medical term for "partial hysterectomy": the removal of only the uterus and cervix...Result: no more periods, no more babies, hopefully no more pain associated with you period. You still have your ovaries; therefore, you will not need to take any hormones as a result of the surgery.

TLH with bilateral salpingo-oophorectomy (BSO) is the medical term for "complete hysterectomy": Removal of uterus, cervix, tubes and ovaries. Result: Same as TLH; however, because your ovaries have been removed, you may need to take some form of hormonal supplementation if you are not already in menopause. Removing the ovaries is not performed as often as it once was. There is some good data that removing the ovaries (while making you surgically menopausal with the associated hot flashes, mood swings etc) may also increase you risk of heart disease. My general recommendation is to leave the ovaries unless they are involved with the disease process that you are treating.

Subtotal or Supracervical hysterectomy: Removes only the uterus, leaving behind the cervix. Pros: quicker surgery, leaves ligaments intact. Cons: an increased potential need to remove the cevix in the future for persistent/recurrent bleeding and pain. Continued risk for cervical cancer and need for annual pap smears. In general, I do not recommend leaving the cervix unless the pathology prevents us from removing it (ie. very large fibroids, scarred pelvis) but this is rare.

This is just a quick overview and each patient's situation is unique. My hope is to clarify the terminology that even many doctors confuse.


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