The uterus isn’t merely a childbearing organ. It has other important functions, including:
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Sexuality- the rhythmic contractions of the uterus during orgasm contribute to sensations of pleasure.
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Hormone production by the ovaries- the ovaries play a major role in maintaining the female hormonal system. Their removal results in menopausal symptoms (within 24 hours, oestrogen levels fall by 50 per cent). Therefore, unless diseased, a woman’s ovaries are not usually removed during hysterectomy.
Apart from the above, for some women, the uterus is of great psychological importance for reasons like fertility, femininity, sexuality and body image.
Hysterectomy is the surgical removal of uterus and is employed as a treatment option in cases of cervical, uterine, or ovarian cancer. An emergency hysterectomy may also be necessary if there’s an uncontrolled uterine hemorrhage or infection.
So how is a typical hysterectomy performed?
Depending on the amount of the uterus removed, hysterectomies are of 3 different types- total (most common), partial (removal of upper portion of the womb) or radical (most often used to treat cervical cancers).
For some women, hysterectomy may be a procedure that liberates them from pain, bleeding, and cancer. Almost half a million hysterectomies are performed annually in the US, i.e., almost one-third of women lose their uterus every year.
But is it really necessary?
The intention isn’t to derogate hysterectomy as a treatment procedure as it is undoubtedly appropriate and beneficial in cases when a woman has uterine or cervical cancer, and no other ‘less invasive’ treatment option could be implemented.
However, many conditions that are, today, treated with a hysterectomy may also be treated in other ways. There are too many women who undergo unnecessary surgery because they are not offered less invasive alternatives. Myomectomy or the surgical removal of fibroids, with reconstruction and repair of the uterus is not a well known option amongst women as the doctors hardly recommend it to them. They mostly advocate the procedure as the safer choice, which is associated with less bleeding. But recent studies dispute all of these claims, and, in fact, claim that there may be less complications during myomectomy than during hysterectomy.
Other uterus-sparing alternatives to hysterectomy, such as uterine lining ablation, uterine artery embolization and hormone therapy are some options which can effectively cure conditions like minor fibroids, endometriosis, cervical dysplasia or uterine prolapse.
The complaint isn’t that why hysterectomy is implemented; the complaint is that even if it’s clear that the patient will benefit from a hysterectomy, the doctors do not offer options such as laparoscopic hysterectomy and/or preservation of the ovaries and cervix. Too many women end up with a large incision and a long recovery when they may well have been candidates for a minimally invasive alternative.
It is critical that women are presented the latest, less-invasive, alternative treatment options in a balanced, objective, and scientific manner, so that they are able to make better choices, and also know what to expect as an outcome of hysterectomy.
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