A hysterectomy is a common surgery where the doctor removes a woman’s uterus. It is the second most frequently performed surgery in the United States for women. About 600,000 hysterectomies are completed every year. Roughly 20 million American women have already had a hysterectomy.
Although the surgery is done most commonly with women in their mid to late 40s, hysterectomies can be completed for women well into their 60s. However, there are certain risks to take into consideration. Talking with an experienced doctor can help you find the best option for you.
Different Types of Hysterectomies
There are a few different types of hysterectomies that may be completed:
Vaginal hysterectomy. This is a surgical procedure in which the uterus is removed through the vagina. One or both ovaries and fallopian tubes may also be removed during the procedure.
This surgery is sometimes preferred because there is no scarring. Typically, women recover faster and have less pain after this surgery with fewer complications as compared to other types of hysterectomy. Vaginal hysterectomy is also usually the most affordable option.
Laparoscopic-assisted vaginal hysterectomy. This procedure uses video technology and allows the surgeon to have better visibility as they are removing the uterus through the vagina. Three small incisions are needed for this laparoscopic-assisted approach. One is in the belly button, through which a small video camera is inserted, followed by two other incisions in the lower belly.
This type of hysterectomy may be preferred because of its rapid healing time, less noticeable scars, and reduced pain. However, more time is needed to complete the surgery.
Abdominal hysterectomy. This is the most common type of hysterectomy for removing the uterus and other reproductive organs. Surgeons make one of two types of incisions when performing an abdominal hysterectomy.
The first is a vertical incision that cuts from the belly button to the pubic hairline. The second is a “bikini cut” where a horizontal incision is made directly above the pubic hairline. This type of hysterectomy requires a longer recovery period and produces more noticeable scarring.
Laparoscopic-assisted abdominal hysterectomy. This procedure also uses video technology and allows the surgeon to have better visibility when removing the uterus through the stomach. The laparoscopic-assisted approach entails only one incision. It is used only when a woman’s cervix is healthy and will not be removed.
Robotic-assisted laparoscopic hysterectomy. During this procedure, a surgeon performs the hysterectomy from a remote-control area using video technology. It requires three to four incisions near the belly button. This type of hysterectomy results in smaller scars but it has not been shown to have better surgical outcomes than other options.
When Is a Hysterectomy Performed?
Several medical conditions can be treated or cured with a hysterectomy. The most common medical conditions that may cause a woman to consider a hysterectomy include:
- Fibroids (noncancerous growths inside the uterus)
- Endometriosis (a painful disorder in which tissue similar to normal uterine lining grows outside the uterus)
- Cancer of the uterus, ovaries, fallopian tubes, or cervix
- Pelvic prolapse (tissue and muscles of the pelvic floor no longer support the vagina or uterus)
- Uncontrollable bleeding after childbirth
Risks Associated With Hysterectomy
Complications after having a hysterectomy may include:
- Blood loss during or following surgery
- Damage to internal organs like the bladder or bowel
The seriousness and severity of the complications depend on the individual and the type of hysterectomy completed.
Older women may be less able to adapt to the stress of surgery or the added stress of any potential complication. This greatly increases their risk of post-surgery problems or even premature death. With the right medical guidance, these issues may be avoided.
Is Getting a Hysterectomy After Age 60 Safe?
Hysterectomy is a safe surgical procedure for women of many ages, including those over 60. It is also typically safe for patients 75 and over. The key is that your doctor completes a careful assessment before surgery and follows up with regular monitoring and after-surgery care to ensure the success of the procedure.
As a general rule of thumb, your doctor will talk to you about all of the available options. Sometimes medical conditions like mild abnormal uterine bleeding, fibroids, and low back pain can be fixed with alternative treatments that are less invasive than a hysterectomy.
Fortunately, advances in medical technology, such as sonography, Pap tests, hysteroscopy, endometrial ablation, and laparoscopy make it possible to avoid or delay many hysterectomies. Your doctor may ask you to consider and utilize these techniques before resorting to major surgery.