Common Q & A’s

What do I do if I have a question after hours or on weekends?
Call our office at 252-757-3131 day or night, weekend or weekday. If it is after hours, you will be transferred to our answering service who will page the doctor on call. It may take some time to call you back if the doctor is in a delivery or dealing with an emergency, but they will call you back.

You can always reach a doctor 24 hours a day, 7 days a week.

What are the alternatives to a hysterectomy?
Depending on the reason for your surgery, there may be some alternatives to a full hysterectomy. Below is a list of possible alternatives to hysterectomy:

• Endometrial ablation – Burning the inside of the uterus for heavy bleeding
• Myomectomy – Removal of fibroids while leaving the uterus intact
• Mirena IUD – An intrauterine device inserted in the office that can treat heavy and painful periods
• Uterine artery embolization – A procedure done by radiology that clots off the uterine arteries

If you are interested in or have any questions about alternatives to hysterectomy, mention these to your doctor.

Should I have my ovaries removed as well?
This is a very important question. Usually if a woman is menopausal or very close to it, we recommend removing the ovaries. However, recent studies have shown that prophylactic oophorectomy (removal of the ovaries to prevent ovarian cancer) is not indicated for everyone. In some instances, removing the ovaries at too young of an age may increase the risk of heart disease and early death. However, in some instances, like endometriosis or abnormal ovarian cysts, removing the ovaries is absolutely indicated.

Talk with your doctor about whether or not you should have your ovaries removed during your procedure.

Will I need a bowel prep?
Not necessarily. Some surgeries can be completed without needing a bowel prep. However, in some cases a bowel prep is needed, like in cases of bad endometriosis. Talk with your doctor about whether or not you will need a bowel prep.

Will my cervix be removed?
Removing the uterus but leaving the cervix behind is referred to as a “supracervical hysterectomy.” Most of the concerns about removing the cervix center around sexual function after the surgery. Many different studies have reached the following conclusions:

• There was no difference in the rates of incontinence, constipation or measures of sexual function (sexual satisfaction, dyspareunia)
• Length of surgery and amount of blood lost during surgery were significantly reduced during subtotal hysterectomy compared with total hysterectomy, but there was no difference in the likelihood of transfusion
• Febrile morbidity was less likely and ongoing cyclical vaginal bleeding one year after surgery was more likely (~ 10%) after subtotal hysterectomy

Recovery may be quicker if you choose a supracervical hysterectomy, and the chance of a vaginal cuff dehiscence is eliminated. If you choose to have your cervix left behind, you will still need cervical cancer screening with Pap smears.

Talk with your doctor about which option is best for you.

What can I expect sex to be like after?
Multiple studies have shown that hysterectomy appears to have few, if any, adverse effects on sexual functioning. In fact, some studies have shown an IMPROVEMENT in sexual function, most likely attributable to the fact their abnormal bleeding or pain has finally resolved. However, some women do notice intercourse and orgasm are different, and some women will continue to have problems, especially if other underlying problems aren’t treated like vaginal dryness or pain from pelvic muscles.

You should wait AT LEAST 6 WEEKS before having intercourse after a hysterectomy to prevent a vaginal cuff dehiscence, which was discussed in Risks of Hysterectomy.