What Makes A Hysterectomy Medically Necessary?
A hysterectomy ranks second on the list of most common major surgeries women undergo in the United States. While in some cases it may be considered an elective procedure, any woman who has suffered extreme pain and bleeding that eliminates any quality of life they had may certainly tell you otherwise. In other situations, a hysterectomy is a life-saving procedure and truly necessary.
When Are They Medically Necessary?
A hysterectomy is considered medically necessary when conditions affecting the uterus or reproductive system become life-threatening, high-risk or unmanageable. Cancer of the uterus, ovaries, cervix or fallopian tubes often can result in a necessary and life-saving removal operation. Extreme bleeding that is unable to be managed by alternative treatments also can necessitate this procedure. An untreatable or consistently recurring pelvic infection that is severe in nature and focused on the uterus also can lead to a hysterectomy.
Severe cases of endometriosis and adenomyosis may leave hysterectomy as the only option when other treatments have failed. Fibroids, which are noncancerous tumors of the uterus, rarely require the surgical removal of the uterus to relieve symptoms. In these situations, total removal of the reproductive system usually is not needed and more partial removals may be considered. Serious uterine prolapse also can lead to partial removal. Uterine rupture can require an immediate emergency hysterectomy if the uterus is unable to be repaired. A ruptured uterus threatens the life of the mother and fetus and must be addressed without delay.
When Are They Recommended Or Elective?
A certain number of performed hysterectomies are not classified as necessary simply because other options exist, even if those options include dealing with unbearable pain. On these occasions, the choice ultimately will be up to you and your doctor. Many physicians are hesitant to perform unnecessary hysterectomies on younger women of childbearing age because they are irreversible. Others will relent only if all other avenues for treatment have been explored and the patient confirms they are not interested in having children.
If your extreme pain, uterine bleeding, or other symptoms are so severe that your quality of life is significantly affected, a hysterectomy may be recommended by your OB/GYN. You will need to personally weigh the pros and cons and determine if the benefits are worth the risk. There is no getting around the fact that this surgery is a major procedure and will change your life afterward. Your doctor and surgeon will be able to address all of your questions and concerns, but the choice will remain up to you.
Of the four types of hysterectomy, all types will remove the uterus, which means pregnancy is no longer possible. This is the most important fact to consider for women opting for an elective, or not medically-necessary, operation. If your ovaries are removed along with your uterus, menopause will be experienced regardless of your age. As mentioned previously, some physicians may be inordinately resistant to elective hysterectomies regardless of the patient’s desires. Seeking a second opinion may help you obtain the treatment you need.
Dr. Jill Gibson is well-versed in hysterectomy procedures and can help you determine if this surgical option is right for you. For a consultation appointment, please contact us here.
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