Disabling pelvic pain and heavy bleeding may force many women into the decision to have a hysterectomy. In fact, about one in three women in the U.S. chooses to have this procedure before age 60. Thankfully, advances in medicine have given women options beyond hysterectomy for symptom treatment. These include endometrial ablation, uterine artery embolization, and several new medications.

For those who still need to pursue hysterectomy, there are many options to consider, including newer, minimally invasive options that help some women recover more quickly than with traditional surgery.

Options for hysterectomies 

There are risks and benefits to all surgical options. The approach you take can be completely personalized to your needs and lifestyle. The medical condition, the size and shape of the uterus, pelvic anatomy, your body type, and prior surgical history all factor into the decision of what type of hysterectomy is most suitable for you.

• Open abdominal surgery: an open approach to hysterectomy through a 6- to 12-inch incision in the abdomen to remove the uterus and cervix. 
• Vaginal hysterectomy: removes the uterus through the vagina without any external incision. This approach often is used with benign (non-cancerous) conditions and when the uterus is of average size and associated with pelvic prolapse.
• Laparoscopic hysterectomy: a minimally invasive approach used to remove the uterus and the cervix with instruments inserted through three to five small incisions in the abdomen. The surgeon inserts a small scope (camera) through one of the small openings, which provides a two-dimensional image of the pelvic area. 
• Robotic hysterectomy: an advanced minimally invasive approach often performed through one or more small incisions. While performing this advanced laparoscopic procedure, the surgeon sits at a console a few feet away from the bedside, controlling the movement of three to four robotic arms over the patient. Unlike traditional laparoscopic surgery, the robotic instruments are precisely tuned to simulate the doctor’s wrist movements. A high-resolution camera gives a magnified three-dimensional view of the abdomen.
  
  This approach to hysterectomy gives the surgeon excellent precision and control, resulting in less pain for the patient, fewer complications, and a quick recovery. Minimally invasive hysterectomies allow most patients to spend only one night in the hospital and, often, they can get back to many of their normal activities in three to five days.

When a hysterectomy is necessary to relieve pain and heavy bleeding, it helps to know you have options and a voice in your treatment.