Hysterectomy (from Greek: hyster, "uterus" and temnein, "cut") is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries, fallopian tubes and other surrounding structures. [1] [INTERIOR VIEW] The most common conditions include certain types of cancer, endometriosis [MENSTRUAL MOLIMINA], uterine fibroma, womb pains, abnormal bleedings as well as sex reassignment surgeries. [2] [3]

In Austria, 10.000 hysterectomies are performed annually. [4] In Germany, around 17 per cent of the female population lives without uterus and in the USA every third woman over 60 is affected. [4] [5] Many doctors believe that the uterus in postmenopausal women is a functionless organ and thus quickly opt for a hysterectomy. However, this approach is increasingly criticized by leading experts and new research in modern medicine. [2] [4] [5] [6]

Procedures
There are various procedures to remove the uterus. Vaginal hysterectomy is performed entirely through the vaginal canal and has clear advantages over abdominal surgery such as fewer complications or risks. Laparascopic or abdominal hysterectomy has a strong probability of infections, wound healing disorders as well as heavy pains. [1] [6] [7]

Side effects and risks
In modern medicine, the removal of the uterus is a standard procedure. It's normal to have pains afterwards but they can be treated with pain killers. Other risks include the damage of neighbor organs, wound healing disorders, infections as well as bleedings. [1]

A long-term effect might be a worsening of sexual life. Around 20 per cent of women report a reduced sexual interest and negative effects on their sexual arousal as well as orgasm problems or complications. [2]

On a psychological level, many women experience a traumatic change of their self-concept because the uterus stands for femininity and maternity. Both positive and negative experience and judgment of one's own femininity before the operation plays an important role. [7]

Critcism
Hysterectomies are often performed although there are alternative methods such as the removal of the endometrium by means of electricity, heat or cold in case of an endometriosis. [2] The percentage of unnecessary hysterectomies lies between 40 and 80 percent. [6]

The number of unnecessary procedures could be reduced by pre-operation discussions as well as consultations concerning alternative methods. A second opinion of a medical specialist as well as discussions with other affected women might simplify the decision on the final removal of the uterus. [2] [6] [8] [9]