There are a number of conditions for which a hysterectomy may be necessary. However, in almost all cases, other treatment methods will be tried first. hysterectomy is quite often the last resort.
Conditions where hysterectomy may be needed include:

Large or multiple fibroids – Fibroids are non cancerous growths that can cause heavy or painful periods, or sometimes urinary symptoms if they press on the bladder.

Endometriosis – This is a condition where cells similar to the lining of uterus are found in other parts of the pelvis. It can cause painful periods and abdominal pain, and pain during sex.

Very heavy or painful periods – They make daily life difficult or cause anaemia (lack of red blood cells).

Cancer of the cervix, fallopian tubes, uterus or ovaries.

Prolapse – This is when the uterus or part of vaginal wall drops down, due to a weakening of the tissues.

Pelvic inflammatory disease (PID) – This can develop if infections of the uterus or fallopian tubes spread to the pelvic area, and can be very painful.

Before having a hysterectomy, it is very important to discuss the implications with the gynaecologist as well as the partner. It one wants to have a hysterectomy before the menopause, they should think about whether they still want to have children, in which case the surgery may be delayed.

The uterus is removed through an incision that is made in either the abdomen (belly) or the vagina. The type of operation depends on the medical condition being treated.

Abdominal hysterectomy – This is a surgical procedure in which the uterus is removed through an incision in the lower abdomen. One or both ovaries and fallopian tubes may also be removed.

Gaginal hysterectomy – This is a surgical procedure in which the uterus is removed through the vagina. One or both ovaries and fallopian tubes may be removed during the procedure as well. A vaginal approach may be chosen if the uterus is not greatly enlarged, and if the condition prompting the surgery is benign and limited to the uterus. Studies have shown that vaginal hysterectomy has fewer complications, a shorter length of hospitalisation, and faster recovery as compared to removal of the uterus through an abdominal incision (abdominal hysterectomy).
Laparoscopic assisted vaginal hysterectomy – The uterus is removed through the vagina. The surgeon uses tools inserted through small incisions to remove the uterus. This technique allows a shorter stay in the hospital.

Total hysterectomy – This is when the whole of the uterus including the cervix (neck of the womb) is removed. It is the most common type of hysterectomy.

Subtotal hysterectomy – This is when the upper part of the uterus is removed, leaving behind the cervix.
Some women have their ovaries and fallopian tubes removed at the time of hysterectomy. The surgeon may recommend this if they have reached menopause. Removing the ovaries can help prevent problems like ovarian cysts and cancer.

The patient will stay in the hospital for one to two days for post surgical care. Some women may stay in the hospital up to four days.

Abdominal – Complete recovery usually takes four to eight weeks. The patient will gradually be able to increase their activities.

Vaginal or laparoscopic – Most women are able to return to their normal activity in one to two weeks.