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HysterectomyA hysterectomy is the surgicalremoval of the uterus, usually done by a gynecologist. Hysterectomy may be total (removing the body and cervix of the uterus) or partial (also called supra-cervical). In many cases, surgical removal of the ovaries (oophorectomy) is performed concurrent with a hysterectomy. The surgery is then called "total abdominal hysterectomy with bilateral salpingo-oophorectomy." Women who have total abdominal hysterectomy with bilateral salpingo-oophorectomy surgeries lose most of their ability to produce the female hormones estrogenand progesteroneand subsequently enter what is known as "surgically-induced menopause" (as opposed to normal menopause, which occurs naturally in women as part of the aging process). In women under the age of 50, hormone supplements (usually estrogen) are often prescribed as part of hormone replacement therapy(HRT) to offset the negative effects of sudden hormonal loss (most notably an increased risk for early-onset osteoporosis). This treatment is somewhat controversial due to the known carcinogenicand coagulativeproperties of estrogen; however, many physicians and patients feel the benefits outweigh the risks in women who would otherwise be "too young" to be in full-blown menopause. Although many hysterectomies are performed via a full abdominal incision laparotomy, two common surgical approaches which are less invasive are laparoscopicallyor vaginally. Surgery with ovarian conservation is an option for the pre-menopausalpatient with benign disease (non cancer). Indications for hysterectomy include uterine fibroids, pelvic pain (including endometriosisand adenomyosis), pelvic relaxation (or prolapse), heavy or abnormal menstrual bleeding, and cancer or pre-cancer diseases. Uterine fibroids, although a benign disease, may cause heavy menstrual flow and discomfort to some women. Many treatments are possible: Pharmaceutical(the use of NSAIDsfor the pain or hormones to suppress the menstrual cycle), uterine artery embolization, or surgical. The surgical treatment varies depending on the location of the fibroids. If the fibroids are inside the lining of the uterus, hysteroscopicremoval might be an option. Transsexualsundergoing gender reassignment surgeryas part of a female-to-male(FTM) transition usually have hysterectomies and oophorectomies to remove the primary sources of female hormone production. For health reasons, some FTM have these organs removed prior to full gender reassignment surgery, as it reduces risk for developing Polycystic ovary syndromeand other ovarian and uterine problems due to the higher doses of testosterone being administered as part of the process; some, however, wait to have a hysterectomy and oophorectomy as part of the full gender reassignment surgery procedure to avoid having multiple surgeries over the course of their transitions.[{{fullurl:Template:FULLPAGENAME}}#endnote_Hudson] New treatment options have begun to decrease the number of hysterectomies performed in the United States, Canada, and Britain. Despite the availability of alternative treatments to hysterectomy, many women still have traditional hysterectomy. For some patients, these alternatives are not appropriate, or may have been previously tried and been found unsuccessful. All patients should be counselled on alternative therapies and offered them if appropriate. Notes
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it:Isterectomia Categories: Gynecology| Surgery| Surgical removal procedures| Gender transitioning
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