Several benign conditions may warrant a hysterectomy to alleviate symptoms from heavy menstrual periods or large fibroids. There are considerations you may want to address with your doctor to help you weigh the pros and cons of your hysterectomy.

Pre-Operative Testing

Laparoscopic or robotic-assisted hysterectomies are popular due to their small incisions, lower risk of bleeding and shorter recovery time. During the procedure, the uterus is detached from supporting structures and any adhesions before it is removed through the vagina, instead of a large abdominal incision. You should ask your doctor what is their protocol if your uterus is too large to be removed through the vagina.

A common practice with closed hysterectomies is to morcellate the uterus, which uses a machine to break up the uterus into smaller pieces until it is small enough to be removed through the vagina. You may want to ask your doctor if there are any pre-operative tests or exploratory procedures available to check the uterus for signs of cancer. Unfortunately, some instances of metastatic uterine cancers have been attributed to undetected uterine cancer that was spread during the process of morcellation.

Your Ovaries And Cervix

You may prefer to go through menopause naturally by keeping your ovaries or you may want the opportunity to harvest your eggs and find a surrogate to have children. For some women, it can be a relief to have their ovaries removed during a hysterectomy. You might prefer to go through an abrupt menopause and not allow menopausal symptoms to continue for several years. Furthermore, you may want to eliminate the possibility of ovarian and fallopian tube cancers, especially if you have an elevated risk. You should have a similar discussion about the pros and cons of keeping your cervix.

Gynecological Screenings

You should discuss how the surgery and retaining certain parts of your reproductive organs will affect your future gynecological screenings to ensure you have adequate gynecological care. Some women automatically assume with a hysterectomy, there is little, if any, need for screenings. Even without your uterus, fallopian tubes and cervix, you need screenings to catch cancers that can occur externally, such as vulvar cancer, or cancers inside the vaginal canal. If your cervix remains intact, you will need to follow normal screening guidelines to check for cervical cancer.

The discussion with your doctor should extend beyond whether or not you should have a hysterectomy. A deeper discussion on the procedure and type of hysterectomy you have can improve your satisfaction with the procedure.