Facts about partial and total hysterectomy procedures
A hysterectomy is the surgical removal of a woman's uterus. The procedure is performed for a variety of reasons: to treat uterine, cervical or ovarian cancer and severe cases of endometriosis, to correct systemic trauma resulting from a complicated pregnancy or birth, and as a means of ensuring permanent female birth control. A partial hysterectomy (or, more rarely, a total hysterectomy) may also be prescribed as a treatment for uterine fibroids.
Both partial and total hysterectomies will render the patient unable to become pregnant, so it is usually considered a last-resort treatment. In addition, hysterectomy side effects are considerable: apart from the risks inherent to any form of surgery, including internal bleeding, infection and the possibility of adverse reactions to anesthetics, hysterectomies also wreak havoc on the patient's hormones, which can cause physical, psychological and emotional complications.
Types of Hysterectomy
While lay people use the terms total hysterectomy and partial hysterectomy, the medical community is more precise about the types of procedures performed. They classify hysterectomies in three different ways:
- Radical hysterectomies. The most extreme procedure available, a radical hysterectomy removes the entire uterus as well as the ovaries, fallopian tubes, lymph nodes, cervix, parametrium and part of the vagina. Radical hysterectomies are used only to treat systemic forms of cancer.
- Total hysterectomies. Anatomically speaking, a total hysterectomy is a procedure in which the uterus and cervix are both completely removed.
- Subtotal hysterectomies. Doctors will preserve as much of the body's internal structure as possible to decrease the risk of hysterectomy side effects. A subtotal or partial hysterectomy is one in which only the patient's uterus is excised.
For many women, intercourse after a hysterectomy is a point of concern. Many patients believe that a partial hysterectomy, in which they retain the cervix, is the key to continuing to enjoy sex after the procedure. However, studies have shown that any sexual dissatisfaction following a total or radical hysterectomy is anecdotal, and that all clinical measures of sexual function point to unimpeded capability.
In addition to altered hormone levels, clinically significant hysterectomy side effects include premature menopause, urinary incontinence, vaginal prolapse and, in partial hysterectomies that leave the ovaries intact, ovarian failure. Patient risk for all of these conditions is elevated, though none of them may occur.