Women’s health and gynaecology
The question is not which hospital. It is whether a hysterectomy is the answer.
Fibroids, endometriosis and heavy bleeding almost always have more than one reasonable route through them. Which route you are offered depends heavily on who you happen to see first.
Most benign gynaecological conditions, fibroids and heavy bleeding among them, can be treated more than one way: medication, a fibroid-sparing procedure, uterine artery embolisation, endometrial ablation, or removal of the uterus. Hysterectomy is often offered first because it is definitive and because a surgeon who operates is, quite reasonably, inclined to offer surgery.
The question worth asking before agreeing to it is whether a treatment that keeps the uterus was ruled out for a real reason, or simply not raised.
Medically reviewed
Reviewed by Dr Gunjan Patel, MBBS, registered with the Gujarat Medical Council (G-65059). Last reviewed 19 September 2026. Reviewed for accuracy only. This page is general information, not advice about your own case, and Dr Gunjan Patel does not diagnose, prescribe or treat.
Where an opinion helps most
Four situations where a second read changes the plan.
These are the cases where we most often find that the first recommendation was one option among several, presented as the only one.
Fibroids, and whether the uterus has to come out
Fibroids are extremely common and rarely dangerous. Depending on their number, size and position, a myomectomy that removes the fibroids alone, or uterine artery embolisation that cuts off their blood supply, can resolve the symptoms without removing the uterus. Whether either is a realistic option for your fibroids is a question a second surgeon, with nothing riding on the answer, can help you weigh.
If you are not planning further pregnancies, that changes which options make sense, and it is worth saying plainly to whoever is advising you rather than assumed either way.
Endometriosis, and who operates on it
Deep endometriosis excision is specialised laparoscopic surgery, and outcomes depend heavily on how much of it a particular surgeon does. A general gynaecologist and a specialist excision surgeon can look, on paper, like the same qualification while being very different in practice for this specific operation.
Peer-reviewed research on this exact operation shows the same pattern, at the level of the hospital and the individual surgeon. 3.6 percent of patients having posterior deep endometriosis excision at French hospitals doing 40 or more of these operations a year had a severe complication, against 5.3 percent at hospitals doing fewer, a gap that held after statistical adjustment in a nationwide analysis of more than 15,000 hospital stays for this surgery in France between 2021 and 2023. 7 to 13 colorectal deep endometriosis excisions a year was the surgeon-level volume below which complication rates began to rise, in a French multicentre study of 1,135 such excisions across 56 hospitals, where volume of activity was the one factor most strongly linked to complication risk in the statistical analysis.
Pivano A, Pauly V, Pirro N, et al., American Journal of Obstetrics and Gynecology, 2026 (published online ahead of print) Checked 2026-09-19.
From a French national hospital-stay database, not the UK’s BSGE registry; no published BSGE analysis comparing outcomes by centre volume could be found. The paper was published online ahead of print in May 2026 and had not accumulated independent citations at the time this was checked. The adjusted odds ratio for the higher-volume centres was 0.83, with a 95 percent confidence interval of 0.70 to 0.99.
Bendifallah S, Roman H, Rubod C, et al., Surgical Endoscopy, 2018;32(4):2003-2011 Checked 2026-09-19.
The same study found a centre-level cutoff of 20 procedures a year, reported with a clearer statistical significance value than the surgeon-level one. The published abstract does not make fully clear whether centre volume and surgeon volume were each confirmed as independent factors separately, or reported together as one measure of activity, so this is best read as a strong association rather than two cleanly separated effects. The median surgeon in the study performed just 5.58 of these excisions a year, below the threshold identified. This is a French study, not the UK’s BSGE registry; no published BSGE analysis stratifying outcomes by surgeon or centre volume could be found.
Heavy or irregular bleeding, before it reaches surgery
Heavy bleeding has medical and minimally invasive options, including endometrial ablation, that are worth exhausting before a hysterectomy is agreed, particularly where no fibroid or other structural cause has been found. Whether those were tried, and why they did or did not work, is the first thing worth establishing.
A gynaecological cancer diagnosis
Where cancer is confirmed, the calculus changes and definitive surgery is often the right call. What is still worth a second read is the extent of the operation proposed, whether fertility-sparing surgery was considered where it applies, and the staging that the treatment plan rests on.
The definitive option
What to ask before agreeing to a hysterectomy.
Not a case against the operation. A great many hysterectomies are the right decision. These are the questions that separate the cases where it clearly is from the cases where something else was never offered.
Worth asking, every time
- What symptom, specifically, is the surgery meant to resolve?
- Which uterus-sparing options were considered, and what ruled each one out for me?
- If I still want children, or might, how does that change what is being offered?
- Is this being proposed by the same person who would perform it?
- What happens to my hormones, and is the plan to remove the ovaries too?
None of this means a hysterectomy was the wrong call. For many diagnoses, and for most gynaecological cancers, it is the established and correct treatment.
What it means is that removal of the uterus is a decision worth reaching on purpose, having heard what the alternative was and why it was set aside, rather than because it was the only option you were told about.
We ask these questions on your behalf, and put the answers in writing so you can compare them side by side rather than from memory in a consultation room.
After you fly home
What has to be settled before you book, not after you land.
This is the part that decides whether travelling was the right call, and it is arranged in advance.
What has to be agreed in advance
- Who reviews your pathology result if a fibroid or growth is sent for testing after surgery
- Who manages hormone changes at home, if the ovaries were removed alongside the uterus
- Who your local team is if bleeding, pain or fever appears after you are back
- For a cancer diagnosis, who delivers ongoing surveillance and any further treatment the pathology calls for
A gynaecological pathology result can change the plan after the operation is already done, and that follow-up has to land with a named clinician at home, not with whoever happens to answer an email.
So we get your own doctor into the conversation before you book anything, not after you land back with a discharge letter and a question nobody local yet owns.
Questions
What people ask about gynaecological surgery abroad.
I have been offered a hysterectomy for fibroids. Should I get a second opinion?
It is one of the situations where a second opinion is most likely to change the plan, because more than one reasonable option usually exists for fibroids and they are not always presented together. That is not a criticism of the surgeon who advised you. It reflects that a surgeon who operates tends to offer surgery.
Does travelling for this mean losing the chance to keep the uterus?
No. If a fibroid-sparing procedure or embolisation is the right option for your case, that is exactly the kind of alternative an independent opinion is meant to surface before any operation is booked, wherever it ends up happening.
Do you cover fertility treatment on this page?
No. IVF and fertility have their own page, governed by separate Indian law. That is covered separately.
What if cancer is found during or after surgery?
Then the plan changes, sometimes to include further surgery, chemotherapy or radiotherapy. Ask before you travel what happens in that situation, who pays for it, and whether the follow-on treatment can be delivered at home. A plan that only describes the expected outcome is not a plan.
Get a second read before you agree to surgery.
Thirty minutes, free. If the plan you have been given is already the right one, that is what you will hear.