What are the side effects of hysterectomy for fibroids? ​ ​

If a patient with uterine fibroids has additionally cancer of the uterus or ovaries diagnosed by biopsy, the ideal treatment for this patient is removal of the uterus (hysterectomy) and/or removal of the ovaries (oophorectomy). If a patient with fibroids has a familial predisposition to ovarian cancer, the ovaries can be removed as a precaution, while additional hysterectomy may or may not be performed. If the possibility of uterine or ovarian cancer is considered very strong in a patient with fibroids as a result of age, symptoms and US+MR findings, hysterectomy and oophorectomy can still be considered. ​ ​

 

However, except for these rare cases, performing hysterectomy in a normal patient with uterine fibroids only to protect the patient from future uterine or ovarian cancer is not accepted as a reasonable scientific approach today. Because the probability of dying from uterine or ovarian cancer during the remaining life of a woman of childbearing age is less than 1%, while the probability of dying from cardiovascular diseases is around 50%. In many studies, it has been shown that cardiovascular diseases increase up to 3 times in patients whose uterus is removed, and this increase is much higher if their ovaries are also removed. Therefore, hysterectomy or oophorectomy performed to protect against uterine and ovarian cancer does not prolong the life of patients, on the contrary, they may shorten the average life span by increasing cardiovascular diseases. In addition, osteoporosis and related fractures, dementia, depression and psychosexual problems are more common in patients whose uterus and/or ovaries are removed.

 

For all these reasons, hysterectomy should be avoided in patients with fibroids, except for a small group of patients who have proven cancer or have a very high risk of cancer. ​ ​

 

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