If You Need a Hysterectomy

If You Need a Hysterectomy
The bleeding, pain and inconvenience from your fibroids or endometriosis have simply become too much to bear. Or you've received the terrifying diagnosis of uterine cancer. Or, after several children, your uterus has prolapsed. To resolve your condition, your health care professional suggests it might be time for a hysterectomy.

Hold on. While there's no doubt that removing the uterus is often a necessary operation, it's also one of the most overdone surgeries in the United States. Every 10 minutes, 12 hysterectomies are performed in the United States, nine of which fail to meet guidelines for hysterectomy set by the American College of Obstetricians and Gynecologists.³⁰

So before signing a consent form to have a hysterectomy, get the answers to all your questions, as well as a second opinion, if you think one is necessary. It's also important to learn about the alternatives to hysterectomy. (See "Alternatives to Hysterectomy".)

When Hysterectomy is Recommended
Being told that you need a hysterectomy can come as a shock. That's why it's important to schedule a follow-up visit or phone call with your health care professional to discuss the issue at length. Consider bringing a friend or family member to the follow-up appointment to take notes. Some women actually tape record (with their doctor's permission) the discussion and listen to it later when they can think more clearly.

Another helpful tool is a list of questions, to ask your health care professional. (See list below.)

There's usually no need to rush into this decision. Most hysterectomies are not emergencies, so take the time you need to explore and understand your options.³¹ And remember that most health insurance plans will cover a second opinion. Even if yours doesn't, paying for a second opinion could be money well spent.

Before having the surgery, tell your health care professional everything about your medical history, even things you think aren't relevant, such as a long-ago treatment for an STD. Also share information about all medications and supplements you may be taking, including over-the-counter medications, herbal supplements and vitamins.

Questions to Ask Your Health Care Professional

Why is a hysterectomy recommended?
What alternative treatments are there for my condition?
How will the surgery be performed? (vaginally, laparoscopically, abdominally?)
What are the risks?
Will my ovaries or any reproductive organs other than my uterus be removed?
How long will I be hospitalized?
How long will it take before I can return to my normal activities?
Will I need help at home? For how long?
How will I feel after the operation?
Will having a hysterectomy affect my sex life? If so, for how long?
What will be done exactly?
Will I have a scar? How large and where?
What kind of anesthesia will be used?
How much will my surgery cost? (Check with your insurance provider to find out how much will be covered.)

Choosing a Surgeon
Surgery is serious business. Find a surgeon with whom you feel comfortable and can trust. Get referrals from your health care professional, or from friends or relatives who have had a hysterectomy. The following issues also are important to consider when choosing a surgeon (or any other health care professional):³²

Board certification. Board-certified physicians have extra training after medical school to become specialists in a field of medicine such as obstetrics and gynecology (OB/GYN). You want a surgeon who is either board certified or board eligible in OB/GYN, and who is also credentialed at your hospital to perform the type of surgery you're having.
Communication style. Find a surgeon who listens carefully to your concerns, answers your questions and explains things clearly and fully. Make sure you can understand the health care professional. If English is your second language, you may want to choose a surgeon who is fluent in your native language.
Insurance issues. Find out in advance whether the surgeon accepts the type of health insurance you have.
On call. Find out who covers for your surgeon if she or he is not available and there is an emergency.

Preparing For Surgery
If possible, schedule your hysterectomy two or three months out. This gives you time to prepare mentally. It also allows ample time to arrange time off from work and to change family schedules to accommodate your surgery and recovery.

Another great use of this time is getting your body as healthy as possible. Ask your health care professional if there is anything else you should do to prepare for the surgery. Consider donating your own blood in advance of surgery.