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Removal of the Uterus: Reasons, Risks, and Side Effects

Krista Giannak

Last updated: November 9, 2016 9:14 pm

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A hysterectomy is a procedure for removal of uterus, and possibly ovaries and fallopian tubes as well. 1 According to the Centers for Disease Control and Prevention (CDC), 500,000 women undergo hysterectomies each year. 2

Reasons for Removal of the Uterus

There are many reasons why a woman might need to have her uterus removed.  Here are some of them:

  1. Uterine Prolapse. Uterine prolapse occurs when the uterus moves into the vagina from its normal place in the abdomen. The condition can occur after multiple births, because of obesity, or following menopause. Uterine prolapse can result in pressure on the pelvis and trouble with urination. 3
  1. Severe bleeding after childbirth. A uterus operation may be performed to control severe bleeding after a woman has a baby. 4 5
  1. Severe or unusual vaginal bleeding. Such bleeding can result from infections, cancer, uterine fibroids or changes in hormonal levels. 6
  1. Endometriosis. This condition occurs when uterine tissue grows on the ovaries or other structures in the pelvis, causing pain and bleeding, even when a woman does not have her period. 7
  1. Adenomyosis. This happens when tissue from the uterine lining grows inside the uterine walls. Like endometriosis, adenomyosis can cause heavy bleeding and severe pain. 8
  1. Various types of cancer. A woman may have her entire uterus removed to treat uterine cancer. She may also have a uterus operation to treat cervical or ovarian cancer. 9 10 The Office on Women’s Health website states that a uterus removal operation “may be the best option if you have cancer in one of these areas.” 11
  1. Uterine fibroids. Fibroids (leiomyoma or myoma) are muscular tumors that are usually benign. They grow in the uterine wall and they vary in size. Fibroids are quite common; estimates vary between one to four women out of five developing fibroids before they turn 50 years old. 12 When fibroids cause symptoms, women may have difficulties with labor or delivery, abdominal or back pain, frequent urination, heavy bleeding (which may cause anemia) and, rarely, infertility. 13

Uterus Removal Side Effects

There are several different types of uterus operations, each with their own risks. Some are vaginal, while others require an abdominal laparotomy, or an incision in the abdomen. 14 15

The traditional uterus removal procedure is the abdominal hysterectomy, usually requiring a vertical incision, though a horizontal or “bikini cut” incision may be used instead. Ovaries and tubes are also removed, if necessary. Risks include potentially longer recovery periods and scarring may be more noticeable. 16

A different hysterectomy procedure, a vaginal hysterectomy, typically has quicker recovery times and fewer risks than other types of hysterectomy surgical approaches. The surgeon removes the uterus, and possibly other organs as well, through the vagina. This procedure can sometimes result in vaginal damage. 17

Some hysterectomies, both vaginal and abdominal, involve laparoscopic surgery. In laparoscopic surgery, small incisions are made near the naval or in the abdomen. Through one incision a small camera known as a laparoscope is inserted so that the surgeon can see inside of the body. 18

One surgical device with significant uterus removal side effects is power morcellation, often used during laparoscopic or robotic surgery. According to the U.S. Food and Drug Administration (FDA), during a uterus removal operation, surgeons have used power morcellators to cut tissue into pieces that are small enough for removal through a laparoscopic incision. 19

In a November 2014 safety communication, the FDA warned against the use of power morcellators in hysterectomy and myomectomy (the removal of uterine fibroids). The communication stated that the use of power morcellators to remove the uterus or uterine fibroids “poses a risk of spreading unsuspected cancerous tissue, notably uterine sarcomas, beyond the uterus.” The communication also stressed “the availability of alternative surgical options for most women.” 20

Because of the risks accompanying use of a power morcellator during hysterectomy or myomectomy and the availability of alternative surgical options, the FDA warned “against the use of laparoscopic power morcellators in the majority of women undergoing myomectomy or hysterectomy for treatment of fibroids.” 21

Risks of Spreading Uterine Cancer with Power Morcellators

According to the FDA safety communication regarding the risks of power morcellators in uterus operations, 1 in 350 women undergoing uterus removal or uterine fibroid removal have an unsuspected uterine sarcoma. Their doctors are unaware of the cancer because according to the FDA, there is “no reliable method” of predicting these cancers. The result of spreading unsuspected cancerous tissue may be “significantly worsening the patient’s long-term survival.” 22

In conclusion, the FDA warns against using laparoscopic power morcellators in the removal of the uterus (hysterectomy) or fibroids (myomectomy) in the vast majority of women. 23 Learn more about using power morcellators for a uterus operation and its risks.

  1. “Hysterectomy,” U.S. Department of Health and Human Services, December 4, 2014. http://www.womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.html. (Accessed December 30, 2015). 

  2. “Number of All-Listed Procedures for Discharges from Short-Stay Hospitals, By Procedure Category and Age: United States, 2010,” Centers for Disease Control and Prevention. http://www.cdc.gov/nchs/data/nhds/4procedures/2010pro4_numberprocedureage.pdf. (Accessed December 30, 2015). 

  3. “Hysterectomy,” U.S. Department of Health and Human Services, December 4, 2014. http://www.womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.html. (Accessed December 30, 2015). 

  4. “Hysterectomy,” MedlinePlus Encyclopedia. https://medlineplus.gov/ency/article/002915.htm. (Accessed December 29, 2015). 

  5. “Hysterectomy – Why It Is Done,” WebMD. http://www.webmd.com/women/tc/hysterectomy-why-it-is-done. (Accessed December 29, 2015). 

  6. “Hysterectomy,” U.S. Department of Health and Human Services, December 4, 2014. http://www.womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.html. (Accessed December 30, 2015). 

  7. “Hysterectomy,” U.S. Department of Health and Human Services, December 4, 2014. http://www.womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.html. (Accessed December 30, 2015). 

  8. “Hysterectomy,” U.S. Department of Health and Human Services, December 4, 2014. http://www.womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.html. (Accessed December 30, 2015). 

  9. “Hysterectomy,” MedlinePlus Encyclopedia. https://www.nlm.nih.gov/medlineplus/ency/article/002915.htm. (Accessed December 29, 2015). 

  10. “Hysterectomy – Why It Is Done,” WebMD. http://www.webmd.com/women/tc/hysterectomy-why-it-is-done. (Accessed December 29, 2015). 

  11. “Hysterectomy,” U.S. Department of Health and Human Services, December 4, 2014. http://www.womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.html. (Accessed December 30, 2015). 

  12. “Uterine Fibroids Fact Sheet,” U.S. Department of Health and Human Services. http://www.womenshealth.gov/publications/our-publications/fact-sheet/uterine-fibroids.html. (Accessed December 30, 2015). 

  13. “Uterine Fibroids Fact Sheet,” U.S. Department of Health and Human Services. http://www.womenshealth.gov/publications/our-publications/fact-sheet/uterine-fibroids.html. (Accessed December 30, 2015). 

  14. “Abdominal Exploration,” MedlinePlus Encyclopedia. April 9, 2014. https://www.nlm.nih.gov/medlineplus/ency/article/002928.htm. (Accessed December 30, 2015). 

  15. “Hysterectomy,” National Women’s Health Network. 2015. https://www.nwhn.org/hysterectomy. (Accessed December 30, 2015). 

  16. “Hysterectomy,” National Women’s Health Network. 2015. https://www.nwhn.org/hysterectomy. (Accessed December 30, 2015). 

  17. “Hysterectomy,” National Women’s Health Network. 2015. https://www.nwhn.org/hysterectomy. (Accessed December 30, 2015). 

  18. “Hysterectomy,” National Women’s Health Network. 2015. https://www.nwhn.org/hysterectomy. (Accessed December 30, 2015). 

  19. “Updated Laparoscopic Uterine Power Morcellation in Hysterectomy and Myomectomy: FDA Safety Communication,” U.S. Food and Drug Administration. November 24, 2014. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm424443.htm. (Accessed December 30, 2015). 

  20. “Updated Laparoscopic Uterine Power Morcellation in Hysterectomy and Myomectomy: FDA Safety Communication,” U.S. Food and Drug Administration. November 24, 2014. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm424443.htm. (Accessed December 30, 2015). 

  21. “Updated Laparoscopic Uterine Power Morcellation in Hysterectomy and Myomectomy: FDA Safety Communication,” U.S. Food and Drug Administration. November 24, 2014. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm424443.htm. (Accessed December 30, 2015). 

  22. “Updated Laparoscopic Uterine Power Morcellation in Hysterectomy and Myomectomy: FDA Safety Communication,” U.S. Food and Drug Administration. November 24, 2014. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm424443.htm. (Accessed December 30, 2015). 

  23. “FDA warns against using laparoscopic power morcellators to treat uterine fibroids: FDA News Release”
    http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm424435.htm. U.S. Food and Drug Administration. November 24, 2014. (Accessed January 25, 2016).