Our Summary

This study looked at whether having a hysterectomy (surgery to remove the uterus) increases the risk of a condition called pelvic organ prolapse (when one or more of the pelvic organs drop down from their normal position) in women who have never given birth. The research included women born between 1947 to 2000 in Denmark.

The researchers compared women who had a hysterectomy to those who didn’t, and found that those who had the surgery were 60% more likely to need surgery for pelvic organ prolapse. This risk was found even when considering different types of hysterectomies.

The findings suggest that the uterus itself may play a role in preventing pelvic organ prolapse. Therefore, doctors should consider other treatments that don’t involve removing the uterus where possible, and women should be informed of the potential risks before deciding to have a hysterectomy.

FAQs

  1. Does having a hysterectomy increase the risk of pelvic organ prolapse in women who have never given birth?
  2. What did the research find about the likelihood of needing surgery for pelvic organ prolapse in women who had a hysterectomy?
  3. Should doctors consider treatments other than hysterectomy due to the potential risks of pelvic organ prolapse?

Doctor’s Tip

One helpful tip a doctor might tell a patient considering a hysterectomy is to discuss all potential risks and benefits of the surgery, including the increased risk of pelvic organ prolapse. It’s important for patients to make an informed decision and consider other treatment options that may be more suitable for their individual situation. Additionally, patients should be aware of the importance of pelvic floor exercises and other preventive measures to help reduce the risk of pelvic organ prolapse after a hysterectomy.

Suitable For

Patients who are typically recommended hysterectomy include those with:

  1. Uterine fibroids that are causing symptoms such as heavy menstrual bleeding, pelvic pain, or pressure
  2. Endometriosis that is not responding to other treatments
  3. Uterine prolapse (when the uterus slips down into the vagina)
  4. Abnormal uterine bleeding that has not responded to other treatments
  5. Gynecologic cancers such as uterine, ovarian, or cervical cancer
  6. Chronic pelvic pain that is not responding to other treatments

It is important for patients to discuss all treatment options with their healthcare provider and weigh the potential risks and benefits before deciding to undergo a hysterectomy.

Timeline

Before hysterectomy:

  • Patient consults with doctor about symptoms and potential need for surgery
  • Patient undergoes pre-operative testing and evaluations
  • Patient discusses options and risks with doctor and makes decision to proceed with hysterectomy
  • Patient schedules surgery and prepares for procedure, which may include fasting and stopping certain medications

After hysterectomy:

  • Patient stays in hospital for a few days to recover and receive post-operative care
  • Patient may experience pain, discomfort, and bleeding post-surgery
  • Patient follows doctor’s instructions for recovery, including rest, medication, and wound care
  • Patient attends follow-up appointments to monitor healing and address any complications
  • Patient may experience physical and emotional changes due to the removal of the uterus, and may need to adjust to these changes over time.

What to Ask Your Doctor

  1. What are the reasons for recommending a hysterectomy in my case?
  2. Are there any alternative treatments or procedures that could address my condition without needing a hysterectomy?
  3. What are the potential risks and complications associated with a hysterectomy?
  4. How will a hysterectomy impact my overall health and quality of life in the long term?
  5. Will I still be able to have children or experience sexual pleasure after a hysterectomy?
  6. What is the recovery process like after a hysterectomy, and how long will it take to fully recover?
  7. Are there any lifestyle changes or precautions I should take after the surgery to prevent pelvic organ prolapse or other complications?
  8. How often will I need to follow up with my doctor after the procedure?
  9. Are there any specific exercises or physical therapy that could help with pelvic floor strength and prevent pelvic organ prolapse post-hysterectomy?
  10. What are the signs and symptoms of pelvic organ prolapse that I should watch out for after a hysterectomy?

Reference

Authors: Husby KR, Gradel KO, Klarskov N. Journal: Am J Obstet Gynecol. 2022 Mar;226(3):386.e1-386.e9. doi: 10.1016/j.ajog.2021.10.021. Epub 2021 Oct 21. PMID: 34688595