The Hysterectomy Channel
They come in all shapes and sizes, and every woman has one. While they lay silent on a day-to-day basis, they scream for attention once a month, to the bane of their harried owners. When they are gone, they remind us (both men and women) of our mortality, for that which is lost can never be regained. Many decry the fact that our bodies are tombs of the superfluous, hiding from the light of day organs that we can certainly live without, including the appendix, spleen, and gallbladder. Let’s not forget, however, that were they not important, they would not have been designed by the All-Knowing Architect in the first place. Don’t touch that uterus! Don’t place it in the same category as its immediate and distant neighbors. The uterus is the giver of life and home of our future as a species. To evict it by surgeon’s hand from its rightful and preordained place at the center of the realm had better require not only an act of conscience and some soul searching, but also a damn good reason!
Obviously, there appears to be an abundance of the latter, as each year more than 600,000 hysterectomies are performed, making it the second most common surgery among women in the United States (second only to cesarean section delivery). One in three women in the U.S. has had a hysterectomy, and that trend is destined to continue as we use heavy guns to level a terrain fertile to the possibilities of uterine cancer in women enjoying their golden years after menopause.
Don’t ask me to explain it. As a man, how could I possibly know what a woman goes through when making that fateful decision to part with something that has brought her so much joy, tribulation, and zest for life in a day-to-day existence fraught with constant reminders of the finite and potency of youth. This humble writer can only make you, the reader, aware of the reasons why we mortals willingly demolish a structure whose form and function far exceed any man-made marvel of ancient Egypt. What I can tell you is the motivation, good or bad, for performing hysterectomies today. I call them the “Magnificent Seven,” and every woman must be her own judge and jury, to sift through both concrete evidence and medical hearsay in order to reach an informed decision on whether to go under the knife.
Cancers of the uterus, cervix, or ovary, as well as uterine fibroids, are the most well-known motivators for a visit to the operating theater. They are the stuff of talk shows, and, were there a Hysterectomy Channel on cable television, nightly broadcasts would underscore bleeding and painful fibroids as leading the charge for surgical intervention. We must not lose sight of the fact, however, that there are some equally compelling reasons for intervention by “old sawbones.” Endometriosis, uterine prolapse, persistent vaginal bleeding, chronic pelvic pain, and labor- and delivery-related emergencies round out our seven, with recourse to either abdominal hysterectomy, mandating a recovery period of four to eight weeks with gradual return to normal activity, or vaginal or laparoscopic hysterectomy, whose beauty (if there is one) lies in an accelerated return to normal activity, often in one to two weeks.
We have been schooled since childhood that nothing in this life is without its risks. So, too, with hysterectomy. Whether one opts for complete or total hysterectomy (removal of both cervix and uterus, the most common procedure), a partial or subtotal procedure (evicting the upper portion of the uterus while leaving the cervix at home), or radical intervention (extirpation of uterus, cervix, and upper part of vagina), operative and postoperative complications can and do occur. They run the gamut from heavy blood loss, bladder and bowel injury, anesthesia problems, and incision and wound infections to lowered sexual desire and decreased pleasure and orgasm postop. Fret not, however! Most women “duck these bullets” during or after surgery.
With cancer, we are left with little choice but to operate in most cases. Fibroids, uterine prolapse, and endometriosis, on the other hand, extend our options and may even provide a way out, via nonsurgical treatments such as drug therapy, endometrial ablation, uterine artery embolization, myomectomy, and vaginal pessary. Those are just fancy words for a lot less pain, aggravation, and emotional upheaval. You, with the help and advice of your doctor, must once again be the judge of their utility.
Finally, while periodic Pap smears may not be a necessity after hysterectomy, regular gynecologic examinations are. Don’t believe everything you see in print or on television, unless, of course, you have access to a real Hysterectomy Channel. For more information on hysterectomy, contact the National Women’s Health Information Center (NWHIC) at 1-800-994-9662.
© 2007, Albert M. Balesh, M.D. All rights reserved.
Obviously, there appears to be an abundance of the latter, as each year more than 600,000 hysterectomies are performed, making it the second most common surgery among women in the United States (second only to cesarean section delivery). One in three women in the U.S. has had a hysterectomy, and that trend is destined to continue as we use heavy guns to level a terrain fertile to the possibilities of uterine cancer in women enjoying their golden years after menopause.
Don’t ask me to explain it. As a man, how could I possibly know what a woman goes through when making that fateful decision to part with something that has brought her so much joy, tribulation, and zest for life in a day-to-day existence fraught with constant reminders of the finite and potency of youth. This humble writer can only make you, the reader, aware of the reasons why we mortals willingly demolish a structure whose form and function far exceed any man-made marvel of ancient Egypt. What I can tell you is the motivation, good or bad, for performing hysterectomies today. I call them the “Magnificent Seven,” and every woman must be her own judge and jury, to sift through both concrete evidence and medical hearsay in order to reach an informed decision on whether to go under the knife.
Cancers of the uterus, cervix, or ovary, as well as uterine fibroids, are the most well-known motivators for a visit to the operating theater. They are the stuff of talk shows, and, were there a Hysterectomy Channel on cable television, nightly broadcasts would underscore bleeding and painful fibroids as leading the charge for surgical intervention. We must not lose sight of the fact, however, that there are some equally compelling reasons for intervention by “old sawbones.” Endometriosis, uterine prolapse, persistent vaginal bleeding, chronic pelvic pain, and labor- and delivery-related emergencies round out our seven, with recourse to either abdominal hysterectomy, mandating a recovery period of four to eight weeks with gradual return to normal activity, or vaginal or laparoscopic hysterectomy, whose beauty (if there is one) lies in an accelerated return to normal activity, often in one to two weeks.
We have been schooled since childhood that nothing in this life is without its risks. So, too, with hysterectomy. Whether one opts for complete or total hysterectomy (removal of both cervix and uterus, the most common procedure), a partial or subtotal procedure (evicting the upper portion of the uterus while leaving the cervix at home), or radical intervention (extirpation of uterus, cervix, and upper part of vagina), operative and postoperative complications can and do occur. They run the gamut from heavy blood loss, bladder and bowel injury, anesthesia problems, and incision and wound infections to lowered sexual desire and decreased pleasure and orgasm postop. Fret not, however! Most women “duck these bullets” during or after surgery.
With cancer, we are left with little choice but to operate in most cases. Fibroids, uterine prolapse, and endometriosis, on the other hand, extend our options and may even provide a way out, via nonsurgical treatments such as drug therapy, endometrial ablation, uterine artery embolization, myomectomy, and vaginal pessary. Those are just fancy words for a lot less pain, aggravation, and emotional upheaval. You, with the help and advice of your doctor, must once again be the judge of their utility.
Finally, while periodic Pap smears may not be a necessity after hysterectomy, regular gynecologic examinations are. Don’t believe everything you see in print or on television, unless, of course, you have access to a real Hysterectomy Channel. For more information on hysterectomy, contact the National Women’s Health Information Center (NWHIC) at 1-800-994-9662.
© 2007, Albert M. Balesh, M.D. All rights reserved.
posted by Dr. Al at
6/27/2007 03:18:00 PM
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