We've discussed having this surgery several times, and nobody really knew alot about it. Here's some good info I read in one of my magazines. Most hysterectomies are performed due to fibroids. FIBROIDS These noncancerous tumors in the uterus can cause pain and bleeding to the point of anemia. Their sheer bulk can also lead to backaches, frequent urination or constipation. Medications: Hormone suppressors shrink growths by temporarily interrupting the estrogen supply, pushing the body into menopause. Pros: noninvasive. Cons: Can induce hot flashes and bone loss, fibroids may regrow after drugs are stopped. Uterine Fibroid Embolization: Tiny pellets, inserted via catheter, form artificial clots, which block blood flow to the fribroids. Pros: Symptoms improve in 80-90% of cases. Cons: Involves high levels of radiation. May cause serious infection; rare chance of death. Myolysis: During laparoscopic surgery, fibroids are touched with an electric current, which constricts blood vessels. Pros: Small incision. Cons: Painful adhesions (scar tissue) may result. Most doctors will not perform. Myomectomy: Fibroids are removed through the cervix, via laparoscopy or during open surgery. Pros: Recurrence is unlikely in women over 40. Cons: If open surgery is required, it entails extensive recovery time. Is the newest technique always the best choice? Not necessarily; some approaches are more difficult than others. Depending on a woman's medical situation and her surgeon's skills and preferences, a hysterectomy can be performed through a large abdominal incision or through the vagina. A laparoscope is sometimes used to make abdominal surgery less invasive or to help make vaginal surgery possible. Each method has its pros and cons; you should discuss your case with at least two doctors before deciding who will perform your surgery and which method will be used. Do my ovaries have to be removed: Because of the risk of ovarian cancer, many women undergoing a hysterectoy after 40 have both ovaries removed. Keeping them may avoid instant menopause, but there's a 50/50 chance that they will stop working within 2 years anyway, says Stanley West, M.D. author of "The Hysterectomy Hoax". Other issues that might tip the scale in favor of removal include being at high risk for ovarian cancer, having a large cyst or suffering severe pain from endometriosis.