Debbie GonzalezDoctor's Corner, Pelvic Health

Will a Hysterectomy solve my Pelvic Floor Problems?

Question: If you had a hysterectomy, wouldn’t that get rid of the issues, if all affected areas were removed?

Answer from Dr. Daniel Gruber, urogynecologist from Sibley Memorial Hospital in Washington D.C., part of John Hopkins medicine.

Well, it can, but it depends on a lot of things. The pelvic area is very complicated. So it depends on what the specific issue is. 

If somebody has heavy bleeding, then removing the uterus with a hysterectomy would definitely get rid of the bleeding, which would be extremely helpful. If you had painful periods, then this could also help and take care of a lot of the pain. If you have pelvic pain that is due to something with the uterus itself, then again, this can be helpful

But just doing a hysterectomy alone wouldn’t help with pelvic organ prolapse, for example. You have to do a suspension procedure at the same time as the hysterectomy. The uterus, in those cases for prolapse, isn’t the cause of the prolapse. Instead, prolapse happens when the ligaments that hold up the vagina are stretched out. 

Sometimes, we do hysterectomy in conjunction with prolapse repairs because they’re often in the way of the actual real prolapse repair. We do that with sutures, biologic grafts, sometimes permanent materials like meshes – there can be lots of different approaches. 

There’s pros and cons to all of those scenarios. So, it gets quite complicated whether a hysterectomy would help or not. Very often it does, but it really depends on what the condition is.