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Hysterectomy: What Are The Alternatives? - Dr. Ahdoot

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Dr. Ahdoot introduces himself and provides alternatives to the traditional hysterectomy.

Dr. Ahdoot:
Hi, my name is David Ahdoot. I am a board certified OB/GYN, and I work at Saint John’s Hospital, which services the greater Los Angeles area.

We now have a lot of new exciting, different ways of doing a hysterectomy. The whole point of it would be to decrease the invasiveness of the procedure and increase the speed with which the patient recovers.

One alternative, which has been around for many years, is a vaginal hysterectomy. Another alternative is a laparoscopic assisted vaginal hysterectomy where with the assist of a camera, we look from above as we complete the hysterectomy, partially from intra-abdominal approach and partially from vaginal approach.

Another new exciting method is the robotic method of performing hysterectomy, which has adopted similar methods except you literally have a robot assisting or actually performing the surgery. Of course, the main surgeon is in charge, but with a robot you have the ability to use multiple hands, and multiple different techniques are combined within the same procedure, and the idea would be to, again, decrease recovery rate of infection and the speed with which the patient can get back to work.

Depending on the reasons the person’s having the hysterectomy, there is always other alternatives. For example, for those who have abnormal bleeding, an endometrial ablation is a simple vaginal procedure, which is an outpatient procedure, that’s meant to decrease the level of bleeding while evaluating what is the purpose of that bleeding, and if the whole source of the problem is just vaginal bleeding or excess vaginal bleeding with no underlying pathology, the ablation would simply take care of that problem and it’s only an outpatient procedure.

Alternatively, there are women who qualify for embolization of their uterine artery, which is, again, an outpatient or an overnight procedure that avoids the actual hysterectomy procedure and in 50% of the time gives a good outcome.

But in patients who have a prolapsed uterus or severely large fibroids or other underlying pathology where less invasive procedures may not be as effective, there are alternatives to the actual hysterectomy such as a supracervical hysterectomy where the cervix is not removed, which decreases the rate of infection such as laparoscopic assisted vaginal hysterectomy and now the most recent procedure is a robotic hysterectomy.

The idea, again, would be to decrease the time it takes to get back to work and physical activity and also decrease the rate of infection.

About Dr. David Ahdoot, M.D.:
David Ahdoot specializes in Obstetrics and Gynecology at Saint John’s Hospital in Santa Monica, California. He attended medical school at the University of California San Diego Medical Center. Later he went on to do his internship and residency at the University of California Irvine Medical Center. With more than 16 years experience, Dr. Ahdoot is a Diplomat of the American Board of Obstetrics and Gynecology.

Add a Comment5 Comments

I have a questions specifically for Dr. Ahdoot, and I would like him to answer if he would.
How could I have a perfectly normal pap smear, and then a D&C a month later, and then have an abnormal pap smear that may be cancerous?
I am 55 and this is a very frightening situation?
You have never been anyting but upfront and honest woth me and I am very scared. Why did this happen? Is this normal? Is the pain normal ? It is worse than any pain I have ever had from any proceedure before.
I really would hope to hear from you.

August 10, 2010 - 9:31am

If I am already a patient of yours, and you know my medical history, and have done several proceedures on me; would I still need a second opinion?

June 16, 2010 - 12:54pm
HERWriter Guide (reply to DianneWK)

Hi Diane!

That's a great question! I am not a doctor but as a patient advocate I would say it's always ok to get a second opinion - especially when it's to do with surgery or serious treatments.

We can be honest and admit that it might feel awkward. Here you are with your trusted doctor, who has treated you several times (procedures) and the outcome has always been good. So why on earth question him now?

Because you can. And it's ok to. Your doctor may also feel a bit miffed that you go for a second opinion - they are human, after all. But if he/she is confident in his/her work and really does have the best interests at heart for his patients, he/she should certainly encourage you to go ahead and get that opinion. More than likely, you will return to your doctor with that second opinion that says what he/she said was correct to begin with.

It's very understandable to feel a bit weird about it all but in the end, your health is what matters most - and egos and pride need to be put aside.

Here is an interesting article on the subject: http://www.cnn.com/2007/HEALTH/08/30/ep.second.opinion/index.html

Here is another great article, specifically geared to women!

Let me know if this helps and our best to you!


June 16, 2010 - 2:01pm
EmpowHER Guest
Anonymous (reply to Susan Cody)

Thank you for your candor.
I really trust this doctor as he has never don anything that has not been totally explained to me and is always up to my choice and would not do anything that is not needed.
I never felt it would hurt his feelings as much as it really takes a long time to find a health professinoal you trust.
I have only been in LA for 6 years, where I used to live- I had the same doctors for many, many years; and once they get to know you and your body- I have not felt the need to seek other opinions. In other issues I have had in LA- I have had several changes of Doctors who did not take the same care and concern as this Doctor has shown.

June 16, 2010 - 2:44pm
HERWriter Guide (reply to Anonymous)

Hey Anon!

It seems that you have a great doctor then so it's certainly fine to skip the second opinion and go with what you know and trust.


June 16, 2010 - 4:06pm
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