Surgical treatments of endometriosis: hysterectomy

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Surgical treatments of endometriosis: hysterectomy
SURGICAL TREATMENTS OF ENDOMETRIOSIS: HYSTERECTOMY

A hysterectomy for endometriosis is surgery which involves the removal of the uterus and as many remaining endometrial implants and adhesions as possible. It may also involve the removal of one or both ovaries and fallopian tubes.
A hysterectomy is often said to be the only cure for endometriosis apart from the natural menopause. However, it does not always cure endometriosis, especially if the ovaries are not removed.
A hysterectomy in which the uterus and cervix are removed is known as a total abdominal hysterectomy (often abbreviated to a TAH). Sometimes all or part of an ovary and/or fallopian tube will be removed at the same time if they are diseased but at least part of one ovary is always left.
Following a total abdominal hysterectomy a woman will no longer menstruate but she will continue to ovulate until the time of her natural menopause.
A hysterectomy which involves the removal of the uterus and cervix as well as both fallopian tubes and ovaries is known as a total abdominal hysterectomy and bilateral salpingectomy and oophorectomy (often abbreviated to a TAH and BSO). It is also sometimes known as a radical hysterectomy.
Following a radical hysterectomy a woman will no longer menstruate or ovulate and she will undergo the menopause almost immediately.
To simplify matters and avoid confusion we will refer to a total abdominal hysterectomy as a total hysterectomy; and a total abdominal hysterectomy and bilateral salpingectomy and oophorectomy as a radical hysterectomy. We will use the term hysterectomy if we are referring collectively to both types.
Hysterectomy is usually only used as a last resort to treat women whose endometriosis is so chronic and their symptoms so severe that their quality of life is intolerable. The most common reasons that women with endometriosis have a hysterectomy are the persistence of intractable and incapacitating pain or severe and persistent heavy bleeding. It should not be used, except in a few rare life threatening situations, until a range of other hormonal and surgical treatments have been tried without success.

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