Hysterectomy: this is one of the most common surgical procedures recommended to stop certain types of AUB. About 20 percent of all hysterectomies are performed to stop AUB and it's the only treatment that completely guarantees the bleeding will stop. But, this is a radical surgical intervention that removes your uterus. You will no longer be able to have children after this procedure. Several factors make elective hysterectomy a serious consideration: it is major surgery and includes all the risks associated with any surgical procedure. A lengthy recovery period, often four to six weeks, may be necessary for some women. Fatigue associated with the procedure can last much longer.
Hysterectomy refers to several types of procedures. In a supracervical hysterectomy, the body of your uterus alone is removed above the cervix. A total hysterectomy removes your uterus and cervix. In either of these surgeries, your ovaries and fallopian tubes may be preserved.
The uterus may be removed through either an incision in the abdomen (abdominal hysterectomy), or through an incision in the vagina (vaginal hysterectomy). Another option is the laparoscopically assisted vaginal hysterectomy (LAVH), in which a surgeon uses a laparoscope (a small telescope) inserted through the abdomen to see the entire pelvis. Other tiny incisions are made in the abdomen so the surgeon can perform parts of the hysterectomy there, with the remainder of the procedure completed through the vagina. A LAVH utilizes smaller incisions than abdominal hysterectomy, but is more invasive than a vaginal hysterectomy. The type that makes most sense for you depends, in part, on the size of your uterus, your medical history, and the consultation with your physician and his/her experience with the procedure(s). The risk of ureteral injury (damage to the tube that moves urine from the kidney to the bladder) is, however, increased with LAVH.
When your ovaries are removed, you will undergo surgical menopause and may experience all the symptoms associated with an abrupt decrease in estrogen. To manage symptoms, estrogen therapy is often prescribed following surgery.