Gynecological surgery
Fibroids, ovarian cysts, endometriosis and hysterectomy do not always mean surgery. This page explains when it is considered, what the options are and what recovery is like.
Surgery is not always needed
Many gynecological problems can be managed with monitoring or medicine. Surgery is suggested when symptoms disrupt your life, simpler options have not worked or there is a particular concern. If you plan to have children, say so at the start, because some operations affect pregnancy.
Fibroids
A fibroid is a common non-cancerous growth in or around the uterus. A fibroid with no symptoms usually needs no treatment. If it causes bleeding or pain, medicine is tried first. If that does not help, the fibroid is very large or symptoms get worse, these options are considered:
- Removing the fibroid and keeping the uterus (myomectomy)
- Removing the uterus (hysterectomy)
- Removing the lining of the uterus with heat
- Blocking the fibroid’s blood supply, which is not surgery
Ovarian cysts
Most cysts are normal, cause no symptoms and go away within a few months. Often the doctor simply follows them with ultrasound. A large cyst, one that does not go away or one that looks concerning may need surgery. Most cysts are not cancerous, and the chance of cancer is higher after menopause.
Endometriosis
Here, cells similar to the lining of the uterus grow elsewhere. There is no cure, but pain can be managed with medicine and sometimes surgery. A laparoscopy can both show the disease and remove some of it.
Hysterectomy
This is a major operation with a long recovery, so it is usually suggested after less invasive options have been tried. Afterwards you cannot get pregnant and your periods stop. If the ovaries are also removed, menopause begins at once and you should discuss hormone therapy. You and your doctor decide before surgery whether the cervix and ovaries stay.
It can be done in three ways: by laparoscopy, through the vagina, or through a cut in the abdomen.
What is a laparoscopy?
The surgeon works through small cuts with a camera, under general anaesthetic. Recovery is usually faster than after open surgery. Shoulder pain and bloating are common afterwards.
Risks and recovery
Bleeding, infection, damage to the bladder or bowel and a reaction to the anaesthetic are risks of pelvic surgery. After an abdominal hysterectomy full recovery takes about 6 to 8 weeks, and it is usually shorter after a laparoscopic or vaginal operation. Do not lift anything heavy during this time. Details are in the guide to before and after surgery.
Frequently asked questions
Does fibroid surgery harm a future pregnancy?
It depends on the operation. Some options make pregnancy impossible or raise the risk of problems in pregnancy. If you want children, say so before any decision.
Is an ovarian cyst cancer?
Most cysts are not cancerous. Cancerous cysts are uncommon and are seen more often after menopause.
Will a hysterectomy cause menopause?
If the ovaries are removed, yes, at once. If they stay, menopause may come earlier than usual.
Which operations does the doctor perform personally?
The list of procedures and where they are done will be announced after the doctor confirms it.
To begin: a conversation.
Go to the booking page or talk to the support team. Have the date of your last period and any earlier results ready.