The surgical removal of a uterus is a medical procedure that is not without some level of controversy. It may be the second most common major surgery conduction in the United States, with 600,000 operations per year, but it is one that has traditionally come at a great cost. The difference is that American women are 2x more likely to have the surgery compared to European women. In France, a laparoscopic hysterectomy is almost never performed.
There are some advantages to have this surgery, but women face a number of disadvantages as well. Each should be carefully considered before deciding that this major procedure is the right course of action to take.
The Pros of a Laparoscopic Hysterectomy
1. A sex life is still very possible.
Most women believe that once they have a hysterectomy, their sex life is never going to be the same. Although it may take up to 4-6 weeks to get back into have sex [and your doctor may want to give you a go-ahead in this area], intercourse can happen once again. If the cervix is removed with the hysterectomy, recovery times may stretch out longer. You will need to speak with a doctor about your specific sexual activities to determine what is safe or unsafe in your situation.
2. Menopause doesn’t always happen.
Although some women do enter menopause after having a laparoscopic hysterectomy, most women rarely have any of the bothersome symptoms that occur. Women don’t have periods after the surgery and won’t be able to get pregnant, but as long as the surgery is limited to just the uterus, the natural timing of menopause usually stays on course.
3. Hormone therapy after the procedure helps the recovery.
Many women benefit from receiving hormone therapies after their laparoscopic hysterectomy. Even if the hormone changes are small, being out of balance can sometimes create bothersome physical symptoms. There are some side effects to hormone therapies, including deep vein blood clots, so always speak with your doctor about all of your options.
4. It is minimally invasive.
The main advantage of a laparoscopic hysterectomy is that it causes less blood loss and only uses small incisions to repair the damage. It is used in nearly half of all surgeries and there are often fewer recovery complications afterward. Recovery times are generally the same for all surgeries, but many women have less pain during their recovery with this procedure.
5. It may help to proactively prevent cancer.
Women who have the BRCA1 or BRCA2 gene defect are at risk of developing certain types of cancer at higher rates than the general population. For example: up to 65% of women with one or both of the gene defects may develop ovarian cancer compared to about 1% of the general population. Having this surgery done could lower a woman’s risk of cancer by up to 80%.
6. It helps to relieve pelvic pain issues.
At the 12 month mark post-operation, many women report that their pelvic pain issues that are not menstrual-related have shown a dramatic improvement. General health reports are usually better at the 1 year mark as well. There are always risks associated with a surgery and pain is generally part of the recovery process, but a majority of women feel like their life is better because of the laparoscopic hysterectomy they had.
7. It is usually covered by health insurance.
Even when this surgery is considered “elective,” a health insurance policy will usually provide coverage for it because of the potential health benefits that arrive afterward. Before scheduling the procedure, however, all women should seek a pre-authorization from their provider just in case there is a conflict in the coverage.
The Cons of a Laparoscopic Hysterectomy
1. It won’t cure endometriosis.
Severe menstrual cramps can be very debilitating. It can lead to painful sexual experiences, chronic ongoing pain, and up to a week every cycle where a woman feels like her body is being crushed. Some doctors have recommended a laparoscopic hysterectomy in the circumstances in an effort to reduce symptoms, but many studies have shown that it rarely, if ever, even improves symptoms, much less cures them.
2. Sometimes the surgery requires ovary removal.
During this procedure, a doctor may need to remove a number of different items depending on a woman’s unique medical needs. One of the options is the removal of the ovaries. These produce female hormones and are essential for bone and sexual health. Although many women won’t enter menopause with a laparoscopic hysterectomy, if both ovaries are removed, it will happen.
3. It doesn’t always need to be performed.
In the United States, women are often advised to receive a laparoscopic hysterectomy when there are fibroids present. There are alternatives that are available instead of the hysterectomy, however, so all procedures should be thoroughly considered. Cutting off the blood supply of the fibroids, removing only the fibroids, or burning and freezing them through ablation can all help to improve health.
4. Not all surgeons provide it.
Women are almost required to ask if a laparoscopic hysterectomy is available from their chosen provider. A doctor may say that a woman needs to have a standard hysterectomy, but that would be because they don’t have the equipment or knowledge to do the minimally invasive procedure. Women should always get at least one second opinion before preceding with a major operation.
5. It could spread cancer cells.
In a laparoscopic hysterectomy that is being done because of cancer, there is the possibility that removing the uterus could unintentionally cause cancer to spread. That’s because a doctor must cut the uterus into small pieces in order to remove it through the smaller incisions. The devices used to cut the uterus have even been recalled due to this risk from at least one manufacturer. Only 27 women out of 10,000 who have a laparoscopic hysterectomy due to cancer are at risk, but it is a risk nonetheless.
6. It is a very emotional experience.
The emotional struggle that comes when a woman realizes she can no longer naturally have children should never be underestimated. It can be an ongoing process that lasts much longer than the physical recovery times from the surgery. This may even lead into depression-like symptoms, including a feeling of hopelessness, problems with eating, and an inability to sleep through the night.
Each Woman Goes Through a Laparoscopic Hysterectomy Differently.
Some women feel empowered and energized by the procedure. Others have long-term emotional pain that requires ongoing counseling. By evaluating all of the advantages and disadvantages of this procedure, each woman can decide with their doctor if it is right for them.