A hysterectomy may help reduce endometriosis pain, but it is also a major surgery that comes with risks and side effects.
A hysterectomy is a surgical procedure to remove the uterus. People may also have an oophorectomy, which removes one or both ovaries.
This article looks at the pros and cons of a hysterectomy for endometriosis, what the procedure involves, and other treatment options.
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There are different types of hysterectomies for endometriosis.
- Partial hysterectomy: This removes the uterus but not the cervix.
- Total hysterectomy: A total hysterectomy removes the uterus and cervix.
- Radical hysterectomy: This removes the uterus, cervix, and upper section of the vagina.
A surgeon may also remove one or both of the ovaries — called an oophorectomy — or fallopian tubes — called a salpingectomy.
A hysterectomy may help significantly reduce pain with endometriosis. According to a
After having a hysterectomy, 28% of participants reported a reduction in pain of any severity, while 76% of participants reported a reduction in severe pain. Overall, 84% of participants reported satisfaction with their hysterectomy results.
There were no significant differences in symptom improvement between those who had both ovaries surgically removed and those who kept their ovaries.
Potential cons of a hysterectomy may include the following:
- endometriosis pain may
recur after a hysterectomy, and people may need further treatment - a hysterectomy is an irreversible procedure
- people will not be able to get pregnant after having a hysterectomy
- people with endometriosis have an increased risk of complications from a hysterectomy and may increase the risk of serious complications as much as
4 times - removal of the ovaries will cause menopause and may increase the risk of osteoporosis
A hysterectomy comes with the risks of surgery, including:
- heavy bleeding
- infection
- injury to surrounding nerves, tissues, organs, or the urinary tract
- blood clots in the leg, which have a risk of traveling to the lungs
- anesthesia risks, which may cause breathing or heart problems
- bowel blockage
Abdominal hysterectomies may have a higher risk of complications than other types of hysterectomies. Some surgical problems may show up days, weeks, or sometimes years after having the procedure.
Learn moreLearn more about a hysterectomy for endometriosis.
A surgeon may carry out a hysterectomy by making incisions through the vagina or abdomen. Sometimes, a surgeon may make these decisions during the procedure.
People may need to stay in the hospital for a few days for monitoring while they recover from a hysterectomy.
Before
Before having a hysterectomy, people will talk with a healthcare team about the best procedure for them, expectations of the surgery, recovery steps, and any medications they are taking.
Before surgery, people will have an anesthetic. According to the American Society of Anesthesiologists, this may include:
- a general anesthetic to make people unconscious, usually for laparoscopic, vaginal, and abdominal hysterectomies
- rarely, neuraxial anesthesia, such as a spinal block or epidural, which is a regional anesthetic to numb the abdominal area and lower body
If people are having a regional anesthetic, they can also have a sedative, so they are unaware of surgery.
During
There are different procedures for a hysterectomy that may depend on a person’s uterus size, overall health, and preference, and the surgeon’s experience.
The different procedures for a hysterectomy include:
- Vaginal hysterectomy: A surgeon makes a small incision at the top of the vagina to remove the uterus with surgical tools.
- Laparoscopic hysterectomy: A surgeon will remove the uterus through an abdominal incision or the vagina, using a laparoscope. A laparoscope is a tube with a light and camera on one end.
- Robotic hysterectomy: A surgeon makes small incisions in the lower abdomen and guides a robotic arm to carry out the surgery.
- Abdominal hysterectomy: A surgeon makes an incision in the lower abdomen to remove the uterus.
After
After surgery, people may need to remain in the hospital for a few days. People should walk around as soon as possible to help prevent blood clots.
Recovery times after a hysterectomy may depend on the type of procedure performed.
A vaginal hysterectomy is the least invasive type of hysterectomy and has the quickest recovery time. It may take longer for people to recover from an abdominal hysterectomy.
People may experience pain for a few days after surgery. A doctor will prescribe pain medication to help with this. People will also have some vaginal bleeding and discharge for several weeks after surgery.
Other side effects people may experience following a hysterectomy include:
- constipation
- urinary problems
- an emotional response to the effects of surgery
Other endometriosis treatments to consider
- pain relievers, either over-the-counter (OTC) or prescription drugs
- hormone therapy, such as oral contraceptives
- surgery, to remove areas of endometriosis
- surgery to cut pelvic nerves to reduce pain
This section answers some frequently asked questions about a hysterectomy for endometriosis.
Does endometriosis come back after hysterectomy?
Endometriosis may return after a hysterectomy, even after removal of the ovaries, and people may need further treatment.
A hysterectomy is not a cure for endometriosis, and pain
What are the downsides of a hysterectomy?
A hysterectomy is a major surgery with risks, such as infection, bleeding, and injury to surrounding tissues or organs.
People will not be able to get pregnant after a hysterectomy, and if it includes removal of the ovaries, it will trigger menopause.
What are the treatments for endometriosis after a hysterectomy?
OTC and prescription pain medications may help. If the ovaries remain, hormone therapy can prevent the ovaries from producing hormones, which
Some people may undergo further surgery for endometriosis after a hysterectomy.
A hysterectomy removes the uterus, and sometimes, the ovaries. A hysterectomy may help reduce endometriosis symptoms and pain.
A hysterectomy is a permanent procedure that may have significant side effects. Other treatment options may include medications and less invasive surgery.