Whether it’s an oophorectomy, an endometrial ablation or a myomectomy, you’ve probably never heard of most gynecological surgeries. And that’s okay! Medical terms like these aren’t something you’re supposed to be familiar with. However, more than a million people¹ have a gynecological surgery every year.
Many gynecological surgeries are minor procedures that allow doctors to diagnose potential issues or remove abnormal tissues. And the risks associated with most of these procedures are relatively small. If you’re considering gynecological surgery, or just curious about your reproductive health, here’s some helpful background information.
What is gynecological surgery?
A gynecological surgery is any procedure involving the reproductive organs such as the uterus, cervix and ovaries. Gynecological surgeries often address issues of fertility or medical issues specific to people with uteruses, such as fibroids or cervical cancer.
As with any surgery, procedures involving reproductive organs carry risk. However, most of these risks are minor. Your medical provider should explain them to you thoroughly before any operation.
Types of gynecological surgeries
There are many different types of gynecological surgeries; most are minor though some are more involved. In some cases, there are multiple surgical options doctors might recommend to address the same issue. Read on to learn about some of the more common procedures.
During an oophorectomy, a surgeon removes one (unilateral) or both (bilateral) of your ovaries. It’s commonly done to help lower the risk of cancer in people who are predisposed to breast or ovarian cancer. When done to reduce cancer risk, an oophorectomy is often combined with a salpingectomy, or the removal of the fallopian tubes.
In people with a family history of breast cancer, such as those with a mutation to the BRCA genes, removing the ovaries and fallopian tubes can lower cancer risk by nearly 50 percent.² Doctors might also recommend an oophorectomy to treat conditions like endometriosis or a twisted ovary.
The surgery usually involves a few small incisions to insert surgical tools. An oophorectomy is a relatively major procedure. Removing both ovaries will cause the onset of menopause — no matter what age you are — and permanent infertility. Outside of those major effects, the risks of the surgery aren’t very high. However, you should definitely talk the decision over with your doctor if an oophorectomy is something you may need to think about.
A hysterectomy is a surgery to remove your uterus. It is a major operation that’s usually only performed as a last resort to treat a few different kinds of gynecological issues. After a hysterectomy, you cannot get pregnant and your menstrual periods will stop.
Hysterectomies are sometimes recommended to treat cancers of the reproductive system, fibroids, endometriosis, severe bleeding, and more. There are other options, like endometrial ablations, for treating many of these conditions; therefore a hysterectomy isn’t always necessary.
A hysterectomy can be either total, involving the full removal of your uterus, or partial, leaving your cervix in place. Hysterectomies are also sometimes combined with other surgeries like oophorectomies.
Hysterectomies are relatively safe overall, but risks include excess bleeding, blood clots and infection, as well as damage to your urinary tract, bladder, rectum or other parts of the pelvis.
Fibroid surgeries (myomectomy)
Fibroids are non-cancerous tumors that grow in and around your uterus. They’re quite common. Many people with uteruses will get fibroids at some point in their lives.
But sometimes, fibroids can cause symptoms like painful periods, heavy menstrual bleeding, difficulty urinating and more. In those cases, there are a few minimally invasive myomectomy options.
Read more: What Causes Fibroids?
One noninvasive option is ultrasound, where a surgeon uses sound waves to break down the growths, guided by an MRI machine. Doctors may also use surgical tools to cut out or heat fibroids from inside your uterus to remove them. In more serious cases, a hysterectomy to remove the uterus might be something your doctor recommends — but only as a last resort.
An endometrial ablation is a procedure to remove the endometrium, the lining of the uterus. It’s performed with thin tools inserted into your vagina. There are a few different methods for this procedure.
The most common reason for an endometrial ablation is to treat abnormally heavy bleeding during periods. In some cases, excessive bleeding can even cause anemia.
Because an endometrial ablation removes the lining of the uterus, which is where a fertilized egg implants and grows, pregnancy after the procedure is highly unlikely. Endometrial ablation can be done using a variety of methods, such as using heat, electricity, high-frequency radio waves, or microwaves to destroy the endometrium.
The procedure is not very risky, but watch out for bleeding or infection afterwards. Additionally, you should keep using birth control even after an endometrial ablation: while it’s rare, there is a small chance of pregnancy after the procedure. These pregnancies are much more risky for your health.
A tubal ligation involves cutting, tying, or otherwise blocking the fallopian tubes, preventing eggs from reaching the uterus, or sperm swimming to meet an egg. You might also hear it called “getting your tubes tied.”
A tubal ligation permanently prevents pregnancy. Some people choose to have it done if they don’t want any more children. Evidence from some studies shows it can reduce the risk of ovarian cancer, as well.³
The surgery is done by making one or more small incisions and inserting thin surgical tools to cut or block the fallopian tubes. While the procedure can be reversed, it doesn’t always restore fertility. The chance of getting pregnant after having a tubal ligation undone range from under 50 percent to around 85 percent, with younger people having the best odds.⁴
Other gynecological surgeries and procedures
There are a number of other procedures involving the uterus and related reproductive organs. Many are quick and don’t require any anesthesia.
A colposcopy is an exploratory procedure done with a tool called a colposcope. It’s typically used to follow up on an abnormal Pap smear and the procedure lets your doctor examine your cervix up close to see if any cells might become cancerous.
A cervical biopsy is done to sample cells from the cervix for testing, or to remove tissues that are cancerous or may become cancerous. Your doctor will use a tool to either scrape or cut cells from your cervix during the operation.
A trachelectomy is the removal of the cervix, the opening to your uterus. It’s typically used as an alternative to a hysterectomy in women with cervical cancer, as it can allow them to have children later on.⁵
Removal of ovarian cysts
Ovarian cysts are fluid-filled growths on your ovaries, and they’re not always dangerous. But if cysts cause pain or other issues, your doctor might opt to remove them. This can be done with a laparoscope, a thin tool inserted through a small cut in the abdomen.
Dilation and curettage
This procedure involves dilating the cervix and using a spoon-shaped instrument called a curette to scrape tissues from your uterus. The minimally-invasive procedure can be used to retrieve samples for tests, or to clear the uterus of tissues after a miscarriage or abortion.
This quick surgery uses very cold liquid nitrogen to remove abnormal cells from the cervix.
The more you know
You’re not alone if you don’t know your trachelectomies from your colposcopies. We’re here to help. Check out adyn’s blog, Mind the Gap, for more resources and articles.