In years past, a hysterectomy was viewed by many patients and physicians as a sort of “cure-all” for a range of disorders that affected the maturing woman. At the time, it surely was the most effective available treatment for a lot of these conditions. Even as non-surgical intervention and medical treatment advanced, however, many patients still held to the idea of receiving a hysterectomy once they reached a certain age. Early on in my medical training, for instance, I was routinely visited by women in their early to mid 40′s who came to see me because “it was time for [their] hysterectomy.” Their mothers, aunts, and grandmothers all had hysterectomies in their 40s and 50s, so they thought it was just something you did as you aged. Contrary to popular belief, we doctors aren’t anxious to take our patients into the operating room. In fact, that is often our last resort, when all other non-surgical treatments have failed. We spend quite a bit of time educating our patients regarding hysterectomies and the wide range of other options available to them that would let them avoid surgery.
Still, though, there are times when a surgical intervention is necessary. Other treatments may fail, and for some conditions, there may be no option other than surgery. Thankfully, though, surgical technology has advanced far beyond where it was back in the days of the ubiquitous hysterectomy. Traditionally, gynecologic surgeries were open affairs, meaning that they required a large abdominal incision. Now, for many surgical cases, laparoscopic alternatives are available. Laparoscopic surgery uses a tiny incision in the belly button through which a telescoping camera is placed. Then 1-3 more incisions are made usually near the hip bones. The uterus, ovaries or any other abnormal tissue can then be removed through the vagina or through these tiny incisions. Advanced laparoscopy affords patients the opportunity to achieve the same surgical goals with, on average, fewer complications than open surgery. With technology continuing to advance, we are now able to perform most major gynecologic procedures through a few tiny incisions – which means minimal pain, shorter hospital stays, and shorter recovery times. Patients are now able to return to work in 2-3 weeks, as opposed to two months if they were to have an open “traditional” procedure.
So if you have been “living with” a condition that just hasn’t been adequately treated with medication for fear of surgery, remember….this isn’t your mother’s hysterectomy. You very well might be able to have surgery, go home the next day, go back to work in a couple of weeks, and only have a few barely visible scars to show for it.
-Jennifer Freeman, MD