Dr. Matthew James Isom, DO, MD, FACOG

For men, the incision is placed between the base of the scrotum and anus. The incision can be made on the abdomen or in the vagina for women. If a surgeon uses a patient's own tissue to form the sling, she will most likely perform the procedure through the abdominal incision. This approach requires a hospital stay of a few days and down time of a few weeks. Surgery to insert synthetic slings is typically done vaginally. It is performed at an outpatient facility, and most normal activities can be resumed within seven to ten days.

Although recovery is shorter with synthetic slings than with slings made from the patient's own tissue, synthetic slings are associated with a complication known as mesh erosion. When synthetic mesh erodes, it pushes through the vaginal wall and sometimes becomes exposed, causing long-term pain and infections. If this complication occurs, the patient may need to have another surgery to remove the mesh.

There are many different ways that the uterine lining can be removed, including radiofrequency, heat, microwaves, and cold. Ablations are usually performed with local anesthetic by an OB/GYN. A probe is inserted into the uterus through the vagina, and the end of the probe is expanded or moved around to access the uterine lining. Cramping and discharge afterwards are normal, but the procedure is not particularly painful.

Endometrial ablation is not for everyone. It shouldn't be done by women who have reached menopause, or women with uterine cancer or uterine infections. It is important to remember that an endometrial ablation does not remove the uterus or ovaries, so regular pelvic exams are still important after this procedure. Women who are considering endometrial ablation should also be done having children. Pregnancy is possible after an endometrial ablation, though not likely. If pregnancy does occur, an ablation increases the risks of miscarriage and other problems, so reliable birth control must be used after endometrial ablation all the way through menopause.

It is important to note that having any of these conditions does not necessarily mean that a hysterectomy is necessary. There are other available treatment options in most cases.

Although the uterus is responsible for a period, it is the ovaries that control the hormonal changes that women go through every month. So if a woman has a hysterectomy but keeps her ovaries, she might still experience hormonal swings every month even if she no longer has a period. Alternately, if a younger woman has a hysterectomy where her ovaries as removed, she will essentially be in immediate menopause.

A hysterectomy can be performed traditionally through one large cut in the abdomen, laparoscopically using tiny incisions and small tools, or through the vagina. Full recovery may take four to six weeks. After a hysterectomy, patients might experience sexual changes such as vaginal dryness or a change in libido. It is common to experience strong emotions after a hysterectomy, including both grief and relief. If a patient's ovaries were removed, they may be at higher risk for certain diseases, such as heart disease and osteoporosis. Taking hormonal birth control might reduce this risk.