5 Gynecology Conditions That May Require a Hysterectomy


5 Conditions That May Require a Hysterectomy

Women experiencing chronic abdominal pain, abdominal or heavy bleeding and pelvic pressure should not ignore these symptoms, as they may have an underlying gynecology condition that requires treatment. These symptoms can be warning signs of several health concerns that affect a woman’s reproductive system and are treated with a hysterectomy or other surgical procedure.

1 – Uterine Fibroids. A gynecology evaluation, including some tests, will determine if the symptoms are caused by uterine fibroids, or myomas. These fibroid growths, most likely caused by dramatic spikes in hormones like estrogen and progesterone, can develop as single tumors or clusters in the muscle tissue of the uterine wall, and are the most common reason for getting a hysterectomy operation—— a surgery that removes part or all of the uterus.

Fibroids are very common and estimated to be present in up to 50% of women. Fibroids vary from pea-sized to grapefruit-sized. More than 99% of fibroids are non-cancerous. However, they can trigger chronic pain, irregular bleeding and frequent urination. An OB/GYN doctor may recommend either a myomectomy or a hysterectomy for fibroid removal to relieve abdominal pain and related symptoms such as uncontrolled bleeding.

Fibroids cause symptoms in 25% – 40% of women, particularly in those aged 30-40. Fibroids are sometimes treated non-surgically with uterine fibroid embolization, or uterine artery embolization (UAE), and even watchful waiting. The UAE procedure involves a radiologist using imaging and a catheter to cut off the blood supply to the uterine tissue in an effort to shrink the fibroids.

In nearly 40% of cases, a hysterectomy is the preferred treatment for uterine fibroid removal. Many doctors recommend laparoscopic hysterectomy or robotic hysterectomy as a minimally invasive option delivering better patient outcomes. Robotic hysterectomy is particularly favored for its shorter recovery times, lower risk of complications, and minimal pain and scarring.

2 – Endometriosis. Sometimes uterine tissue (endometrium) grows outside of the uterus on reproductive structures such as the ovaries or fallopian tubes, causing Endometriosis. This condition is associated with intense pain, heavy bleeding, or even infertility. Conservative treatment approaches include medication or minor surgery. Frequently, robotic surgery can be used to resect the abnormal tissue and keep the reproductive organs intact. However, conservative therapy does not always correct the problem and sometimes a hysterectomy is required.

3 – Abnormal or Heavy Bleeding. Irregular bleeding or heavy menstrual periods (menorrhagia) that are uncontrolled should be evaluated by an OB/GYN to rule out a vaginal or uterine condition. If the symptoms are caused by an underlying health issue, treatment may involve removing fibroid growths or treating the lining of the uterus. For more severe cases, a hysterectomy may be the best way to stop the bleeding and related symptoms.

4 – Chronic Abdominal Pain. Chronic abdominal or pelvic pain also should be evaluated by a gynecology expert to determine if the pain stems from problems in the uterus. While a hysterectomy can relieve pain originating in the uterus, an expert evaluation, and even a second opinion, helps determine if it is caused by something else. If so, a hysterectomy won’t relieve the symptoms.

5 – Pelvic Support Conditions, Such as Uterine Prolapse. Sometimes the ligaments and tissues of the pelvic floor supporting the uterus can weaken, causing it to descend into the vagina. This condition, called Uterine Prolapse, can cause pelvic pressure, urine leakage or bowel incontinence. In many cases, a hysterectomy is necessary to correct uterine prolapse and similar gynecological conditions.

Understanding Hysterectomy and Other Surgical Options

There are several different types of hysterectomy, including total hysterectomy where the entire uterus is removed, and supra-cervical or partial hysterectomy where only the upper part of the uterus is removed (not the cervix). In the rare instances when gynecological cancer is diagnosed, a radical hysterectomy may be recommended, where the entire uterus, cervix and surrounding tissue are removed.

Some types of hysterectomy can only be performed using certain surgical techniques, so it is important to ask a gynecologist or gynecology surgeon about all treatment options. In some cases, either vaginal or open abdominal surgery are recommended, while in other cases the technological advancements of laparoscopic or robotic hysterectomy are recommended, or even required. Most hysterectomies that used to be performed as open surgeries can now be performed as robotic assisted laparoscopic surgery, with greater benefit to the patient.

Robotic hysterectomy is a popular treatment option among patients seeking the shorter healing times, lowered risk for complications, reduced pain and minimal scarring that this surgical advancement provides. A gynecologist can help determine if robotic hysterectomy is the best option in each individual case. The most high-tech robotics equipment available is known as the da Vinci Surgical System. Specialized surgical skills are required for this advanced approach, and it is only offered in a limited number of hospitals and outpatient surgery centers.

This article was medically reviewed by Marc Winter, MD, as part of miVIP’s Healthy Living Recommendations.

If you are experiencing gynecology problems, contact miVIP today at (844) 237-5067 to learn more about minimally invasive gynecologic treatments that can address the underlying condition and help resolve symptoms. Schedule a free consultation with an expert gynecologist at miVIP today.


  • Hysterectomy. Office on Women’s Health, U.S. Department of Health and Human Services.
  • Health Topics: Hysterectomy. MedlinePlus, U.S. National Library of Medicine.
  • Hysterectomy: Frequently Asked Questions. The American College of Obstetricians and Gynecologists (ACOG).
  • Hysterectomy. Hysterectomy Center,
  • Abdominal Hysterectomy. Tests and Procedures, Mayo Clinic.

PUBLISHED 16 Apr, 2018

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