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Reproductive Health

Thinking About A Hysterectomy? Alternative Procedures Are Available

About 600,000 women receive hysterectomies every year in the United States, according to the Center for Disease Control and Prevention (CDC). After a cesarean section, hysterectomy is the second most frequently performed major surgery on women of childbearing age. A hysterectomy is a surgical procedure that involves removing part of a woman’s reproductive system. Hysterectomies can help cure a number of diseases and disorders, including uterine fibroids and endometriosis, both of which cause noncancerous growths. After a hysterectomy, a woman stops menstruating and can no longer bear children. Women often experience adverse symptoms due to changes in hormone levels. Hysterectomies may lead to early menopause and symptoms like depression, anxiety and a loss of sexual pleasure. For some women, alternative procedures can treat a disease while keeping the uterus intact. Here is a guide to a few of the options currently available as alternatives to a hysterectomy:

Myomectomy
Women with uterine fibroids often opt out of treatment, as fibroids tend to shrink during menopause. Occasionally, fibroids can grow excessively large or cause symptoms which warrant treatment. A myomectomy may be performed to remove only the fibroids while preserving the uterus. Because myomectomies leave the uterus intact, fibroids may grow back.

Uterine artery embolization
Doctors inject tiny particles into the uterine artery, blocking blood flow to the fibroids. Without blood, the fibroids will starve and die. Health professionals believe that the normal uterine tissue remains unharmed during the process. Nonetheless, complications may arise, including issues due to radiation exposure and possible pregnancy trouble in the future.

Laparoscopic surgery
Laparoscopic surgeries are minimally invasive procedures that involve small incisions in the abdomen, which allow the surgeon to insert a tiny tube and camera into a woman’s body.  A laprascopy can help diagnose and treat endometriosis, usually with high-energy lasers or heat to cauterize the endometrial growths. Laparoscopies may be used to treat a variety of reproductive problems, such as ovarian cysts or other abnormal pelvic adhesions.

Loop electrosurgical excision procedure (LEEP)
LEEP results in the removal of abnormal cells associated with cervical dysplasia. These abnormal cells are usually detected with pap smears, and left untreated, they can develop into cervical cancer. The doctor inserts an electrically charged wire loop into the cervix, then uses the loop to cut away abnormal cells. The removed tissue is then used in a biopsy to rule out cancer.

Pessary and kegel exercises
These non-chemical treatments can help women experiencing uterine prolapse–a condition which accounts for many hysterectomies a year. Uterine prolapse occurs when the womb falls or slides out of its normal place above the vagina. Kegel exercises may strengthen the pelvic muscles that support the uterus. A small device called a pessary can also help hold the uterus and bladder in place.

Hormone therapy
Hormone-based treatments can help control the imbalances that cause abnormal uterine behavior. Gonadotropin-releasing hormone (GnRH) medications are modified versions of hormones already in your body, and GnRH drugs may help shrink the growths associated with fibroids or endometriosis. Oral contraceptives can also alleviate some symptoms of endometriosis by preventing discomfort associated with ovulation. Hormones can also prevent pain by strengthening and lubricating the uterine muscles.

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