Hysterectomy
CPT code: 58150

Of the hysterectomies performed each year in the United States, only about 15% are medically necessary. Though fibroids can grow and become troublesome in younger women, this is not an indication that a hysterectomy is the only solution.

Under this category there are three types of procedures - hysterectomy, supercervical hysterectomy, and hysterectomy with oophorectomy. Undergoing any one of them will result in the loss of childbearing ability, and the post-surgery complications and future care vary with each option.

The Procedure

During a total hysterectomy the uterus and cervix are removed. The incision may be vertical or horizontal depending on the individual surgeon and the medical diagnosis.

In a different technique called the laparoscopically assisted vaginal hysterectomy (LAVH), tiny incisions in the abdomen are made to insert a laparascope (a telescope-like instrument) and tools. The uterus is severed and then removed through the vagina. This procedure may pose a higher risk of bladder damage than traditional surgery, and is more time consuming.

After a hysterectomy, some women may find a sense of relief and freedom from the symptoms. Others may experience pelvic relaxation, bladder and bowel disturbances and sexual dysfunction due to the shortening of the vagina. Many women miss the rhythm of their periods and feel like something essential is missing. Some women associate feminity with their uterus, just as men associate their sexual organs with masculinity. The post operative period of adjustment is usually very difficult for most patients. Be sure that you know all of your options, and that your doctor is making a recommendation that is right for you.

Supracervical Hysterectomy
CPT code: 58180

A Supracervical Hysterectomy is the usual treatment for larger or multiple fibroids and in cases of severe endometriosis. In this surgical procedure, the fundus (top of the uterus) is removed by laparotomy or laparoscopy and the cervix, lower part of the uterus fallopian tubes and ovaries are left in place. This shortens operative time, minimizes blood loss and possible infection.

You are less likely to suffer complications that are sometimes associated with a total hysterectomy, such as bladder-bowel injuries. Vaginal prolapse is less common and there are fewer reports of sexual dysfunction due to the shortening of the vagina. After this procedure women do not experience menopause. As with all types of hysterectomy, childbearing ability is lost.

Normal recovery time is two to three weeks.

Hysterectomy and Oophorectomy

Oophorectomy refers to the removal of the ovaries. About half of the women who have hysterectomies have healthy ovaries removed at the same time. Naturally, older women are more likely to have healthy ovaries removed because of the risk of possible risk of ovarian cancer.

It is important to understand the advantages and disadvantages of removing healthy ovaries. If at least one ovary is kept, it will continue to produce estrogen, avoiding premature menopause ( which can lead to early osteoporosis). Important sterioids are produced by the uterus long into menopause.

Advantages & Disadvantages

The advantage of a hysterectomy is that it guarantees no further uterine trouble. A total hysterectomy is required only with cancer or precancerous tumors.

The disadvantages of a hysterectomy are many and complex. they include both early and delayed complications. The procedure is invasive and may cause injury to the bowel, bladder, or adjacent organs. When the ovaries are removed, you experience immediate menopause and require hormome replacement therapy.

Some women experience skin changes, loss of bone mass, loss of sexual drive, and loss of sexual feeling. There is a risk of osteoporosis.

Additional Information

See WebMD's Hysterectomy and Alternatives