hysterectomie

A hysterectomy, or hysterectomie, is a surgical procedure to remove the uterus. Depending on the operation, the cervix, one or both ovaries and fallopian tubes may also be removed. The uterus may be excised through the abdomen, the vagina, or via minimally invasive approaches such as laparoscopy or robotic-assisted techniques.

Indications for hysterectomy include abnormal uterine bleeding, fibroids (leiomyomas), endometriosis, pelvic pain, uterine prolapse, and gynecologic cancers. It is typically considered after non-surgical treatments have failed or when fertility preservation is no longer possible or desired.

Types include total hysterectomy (removal of uterus and cervix), subtotal or supracervical hysterectomy (removal of the uterus while leaving the cervix intact), and radical hysterectomy (often for cancer, with removal of surrounding tissues). When ovaries and fallopian tubes are removed, the procedure is combined with salpingo-oophorectomy; if not, ovaries and tubes may be preserved.

Effects and recovery vary by individual and surgical approach. Infertility is permanent. Removal of the ovaries may trigger menopause if it has not occurred naturally. Recovery typically requires several weeks, with activity restrictions and routine follow-up. Hormonal changes and pelvic floor effects can occur, particularly when the ovaries are removed.

Risks include bleeding, infection, injury to surrounding organs (such as the bladder or bowels), blood clots, and reactions to anesthesia. Alternatives include medical management of symptoms, myomectomy (uterus-sparing fibroid removal), and other procedures when retaining the uterus or fertility is desired.