Non-emergent Hysterectomy
• Malignant disease of the cervix, uterus, ovaries or fallopian tubes
• Symptomatic uterine fibroids(leiomyomas) that are either:
o causing bladder pressure, pain,fullness, functional disturbance
o bleeding unresponsive to conservative therapy
o showing rapid and progressive enlargement
• Recurrent or persistent uterine bleeding or discharge with failure to respond to conservative management
• Confirmed diagnosis of endometriosis with documented failure of non-surgical management, e.g.use of hormonal therapy (if not contraindicated) and/or low dose contraceptives
• Endometriosis that is unresponsive to conservative management
• Chronic pelvic inflammatory disease unresponsive to conservative management
• Adenomatous endometrial hyperplasia with moderate or sever atypical recurring despite conservative management
• Obstetrical catastrophes, such as uncontrollable post-partum bleeding, uterine rupture, uncontrolled uterine sepsis developing form septic abortion, placenta accretion, etc.
• Septic abortion not responsive to conservative management
• Removal of the uterus in non-=gynecologic pelvic surgery where necessary to encompass disease originating elsewhere, as in uterine involvement in colon cancer or in abscess secondary to diverticulitis
• Symptomatic uterine prolapse or descent resulting in general pelvic relaxation
• Other conditions determined to be medically necessary