DR. ERIC COUGHLIN: Five myths of hysterectomy

Did you know that by age 65, more than one-third of women in the United States have had a hysterectomy? Also, women living in the South or Midwest are more likely to have a hysterectomy.

Hysterectomy is a descriptive term that covers a range of surgical procedures and options. At its most basic, a hysterectomy is surgery to remove a woman's uterus.

Despite hysterectomy ranking as one of the most common surgeries in this nation, many myths or misinformation still surround this procedure.

Myth No. 1:

It's not always major surgery

Surgical and technological advances have transformed many hysterectomies to minimally invasive procedures, with less pain and faster recovery. Even then, physicians will begin with conservative approaches ? such as medication or pelvic floor therapy ? because without a uterus, a woman cannot bear children.

Gynecologists choose the most appropriate surgical approach from a list of options:

Abdominal hysterectomy represents the traditional approach and includes a longer recovery time. The surgeon can make a vertical incision or the so-called "bikini cut" horizontal incision. Abdominal hysterectomy, considered the most invasive hysterectomy, usually is reserved for more difficult cases such as large tumors and fibroids, severe scarring or cancers. The hospital stay is two to three days with return to work in four to six weeks.Vaginal hysterectomy involves removing the uterus ? and possibly ovaries and fallopian tubes ? through the vagina. The surgeon often use this approach for early-stage cancer or pelvic organ prolapse. This method avoids visible scars and leads to a quicker recovery. The hospital stay is overnight in most cases with return to work in three to four weeks.Laparoscopically assisted hysterectomy incorporates small incisions in or near the navel, a video camera and long narrow instruments. Either a vaginal or abdominal hysterectomy can use the laparoscopic approach with shorter recovery times and smaller scars. The hospital stay is usually overnight with return to work in two to three weeks.Robotic hysterectomy uses three or four small incisions to remove the uterus through the vagina. The gynecologist works at a separate console, viewing the internal organs through a 3-D magnifying monitor and operating with remote hand controls. Recovery is an overnight stay in the hospital with rapid return to work, often within two to three weeks.

Myth No. 2:

A hysterectomy is a hysterectomy is a hysterectomy

Different types of hysterectomies involve removal of more or fewer organs.

Partial hysterectomy involves removing only the upper part of the uterus (not including the cervix). This is also called a subtotal or supracervical hysterectomy.Total hysterectomy includes removal of the uterus and cervix.Radical hysterectomy normally is recommended when cancer is suspected. Surgery removes the uterus, cervix, fallopian tubes, portions of the vagina and any lymph glands that might be affected. In some cases, surgery also removes the ovaries.

Myth No. 3:

It's a painful, lengthy recovery

With laparoscopic vaginal and robotic-assisted surgery, patients experience less pain and some go home the next day. Other patients usually go home from the hospital after one to three days. Full recovery can take two to six weeks, but most women feel dramatically better after a couple of days to weeks.

Myth No. 4:

Hysterectomy causes menopause

A woman's uterus and cervix can be removed without triggering menopause. The condition occurs when a woman's ovaries and connected fallopian tubes no longer release eggs and hormones into her body. As long as a woman retains those organs, her body will not automatically give rise to menopause.

Myth No. 5:

Only older women face a hysterectomy

Gynecologists always try to use other treatments until a woman no longer wants children. Younger women suffering from fibroids, abnormal bleeding, endometriosis, pelvic inflammatory disease or pelvic organ prolapse also might face a hysterectomy if other treatments are unsuccessful. Gynecological cancer represents a major health danger and probably will require a hysterectomy.

Relatively recently, gynecologists often will remove the fallopian tubes to reduce but not eliminate the risks of ovarian cancer. Some cases of ovarian cancer actually come from the fallopian tubes.

If the cervix is removed, the risks of cervical cancer are almost eliminated. Total hysterectomy also eliminates the risks of uterine cancer. Removal of the ovaries and fallopian tubes during a hysterectomy dramatically reduces, but does not completely eliminate, the risks of ovarian cancer.

A hysterectomy is a major surgery that can have complications such as bleeding or infection. Most patients have significant and long-term improvements in their health post-hysterectomy and rarely regret having the procedure if medically indicated. This decision should be made in consultation with a gynecologist to understand the surgical options, alternatives and benefits. Each woman's choice depends on her medical history, other health conditions and reasons for the surgery.

Dr. Eric Coughlin received his medical degree from the West Virginia University School of Medicine in Morgantown, West Virginia. He also completed an obstetrics and gynecology residency at the Charleston Area Medical Center in Charleston, West Virginia. Coughlin cares for patients at McLeod Women's Care, located at 101 Johns Street Suite 200, Florence, SC. To schedule an appointment, call 843-777-7518.