The MenopauseRx Hysterectomy Guide

What is a Hysterectomy?

Image Source: National Cancer Institute

To better define a hysterectomy, a review of the female pelvic anatomy is worthwhile. The female reproductive anatomy consists of the vagina, cervix, uterus, fallopian tubes and ovaries. The uterus is a muscular organ in the pelvis and is the main part of the 'womb'. It consists of a hormonally responsive lining, called the endometrium. When this endometrium sheds each month, it is identified as a 'period' or menses. The cervix is the entry way to the uterus. It is responsible for dilating during labor to allow passage of the fetus.

The remainder of the uterus consists of muscle fibers that can stretch to accommodate a full term pregnancy and that also contract to minimize bleeding during childbirth and during menstrual cycles. At the top of the uterus, a fallopian tube is attached on each side. These muscular tubes are approximately 6 inches long and act to carry sperm from the uterus to meet an egg and allow fertilization to occur. The fallopian tubes drape over each ovary. The ovaries are walnut sized organs responsible for making the majority of the female hormones produced during the reproductive years. Estrogen, progesterone and testosterone are the major hormones produced by the ovaries. The ovaries also contain the eggs that are usually released (ovulated) each month and, when fertilized by sperm in the fallopian tubes, allow pregnancy to occur.

Terms used for Hysterectomy:

There are many terms used in conjunction with hysterectomy. 'Complete' hysterectomy, 'incomplete' hysterectomy, 'partial' hysterectomy, and 'total' hysterectomy terms are used by patients and doctors to describe various aspects of a hysterectomy. Unfortunately, all of these terms frequently lead to confusion between patients and their doctors. 

A complete or total hysterectomy generally involves removing the entire uterus and cervix. An incomplete or partial hysterectomy generally means that only the uterus was removed. Another term commonly used is 'supra-cervical hysterectomy', which means only the uterus is removed... retaining the cervix. Note that none of these terms mention the ovaries. Many patients incorrectly think that a complete or total hysterectomy involves removing the ovaries, and they also think that a partial or incomplete hysterectomy signifies retaining the tubes and ovaries. The term doctors use to signify removal of both the tubes and ovaries is called a 'BSO', which stands for bilateral salpingo-oophorectomy. It is important to review exactly what is being recommended by your doctor.

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