Prof Saim Yılmaz, MD
"Histerectomy should be regarded as the last resort in fibroids and adenomyosis"
Hysterectomy surgery for fibroids
A hysterectomy is the surgical removal of the uterus. It is usually performed together with removal of the ovaries. This operation is widely applied all over the world in patients with multiple fibroids or adenomyosis who are not suitable for myomectomy, especially in menopausal patients who do not expect pregnancy. Hysterectomy is a relatively easy operation for the practicing doctor, so it is preferred by most obstetricians all around the world. However, it is not an attractive choice for many patients because it is an invasive surgery, results in permenant loss of organs and may cause a severe menopause (surgical menopause), postmenopausal osteoporosis, psychological problems and increased risk of cardiovascular disease.
Although hysterectomy is not desired by patients, it is the mostly applied treatment method for uterine fibroids today. In the United States, 650,000 hysterectomies are performed each year, of which about 90% are performed for "benign" diseases such as fibroids. However, the accuracy of this approach has recently been seriously questioned. In many studies, the risk of coronary heart disease, osteoporosis (bone loss), dementia (early dementia) and depression was found to be higher in patients who underwent hysterectomy. In addition, after hysterectomy, a number of problems that reduce the quality of life may occur such as constipation, urinary incontinence, psychosexual problems and a severe "surgical" menopause. For these reasons, hysterectomy is currently accepted as a method that should be considered as a last resort in patients with fibroids who cannot be treated with embolization or myomectomy.