An Insightful Book Excerpt on Women’s Pelvic Health

Seat of the Soul

Ask any 10 doctors what to do if the uterus prolapses and 9.7 of them will tell you "Hysterectomy!" This is wrong. If you have uterine prolapse you need the prolapse fixed, not the uterus cut out.

I am a longtime fan of the uterus. I like mine just fine and hope to exit this life with my uterus in tow, not left behind on some pathology department shelf lined with pickled body parts. My guardianship of the uterus materialized during a medical school lecture one day when, mesmerized by the urgent, clipped expectorations of a visiting British nephrologist (kidney specialist), I, circumspect student, sat with note-taking fingers frozen in disbelief, unwilling, yes unable even, to transcribe the proclamation, "The kidney, my dear fledglings, is the seat of the soul!" Since I knew in that instant, as has been my rare privilege to know anything with such certitude, that this poor professor of grand conviction was oh so wrong.


Women's Guide to Health and Happiness, circa 1900

The seat of the soul is not the bladder's filtering cousin, but the uterus, the womb, where one's refuge is always at the ready in recitation of the Hail Mary, "And blessed is the fruit of thy womb, Jesus..." the seat of Adam's soul upholstered in the haven of Eve's skeletal pelvis, revealed in the ruminations of our beloved Shakespeare in Loves Labours Lost.

"From women's eyes this doctrine I derive.
They sparkle still the right Promethean fire;
They are the books, the arts, the academes,
That show, contain, and nourish all the world..."

The soul's sparkling Promethean fire may be reflected in the eyes of the gentler sex, but it resides, my friends, in the uterus. Make no mistake.

In flagrant perpetuation of man's inhumanity to man¹ this homeland of the human soul is the most frequently excised organ in the female body. Every year in America, "over 600,000 (hysterectomies) are done. One in three women in the United States has had hysterectomy by age 60." ²

We see it all the time in the anatomy lab at the medical school where the students learn about human body structure from head to toe on cadavers (preserved dead bodies). When it comes time to learn female pelvic anatomy, the students scramble from table to table looking for the few female cadavers that still have a uterus and ovaries. Most female cadavers are missing their internal organs of procreation and so the students turn to pictures, videos, and plastic models. The male cadavers, with rare exception, suffer no such fate, typically exiting this life with penis and testicles intact, in stark contrast to their female counterparts who most often land on the metal dissecting tables fully castrated, vagina ending in a blind pouch, crowned by nothing more than a few loops of bowel.

In the name of health, we give every impression of waging war on the uterus, lopping it out as some unnecessary and trouble making appendage. Before I rouse your radical reflexes to a furious lather, however, let's be clear -- hysterectomy is not all bad. In cases of life-threatening or recalcitrant uterine conditions, hysterectomy is essential.


The Mechanics of Uterine Prolapse:
Normal Uterine Support


The Mechanics of Uterine Prolapse:
Laxity of the Uterine Ligaments

Unfortunately, in many cases the uterus is removed before alternatives are tried, or worse, even considered.

Hysterectomy is a good and wise therapy for women with overwhelming conditions, such as fibroids that refuse to behave despite trying every nonsurgical alternative or hemorrhagic, constant vaginal bleeding from adenomyosis, or the only option in cases of cervical, uterine, or ovarian cancer. These are among the most common and bona fide reasons to remove a uterus. In such instances, the hysterectomy is a necessity that will greatly improve, or literally save the woman's life.

For some bizarre reason, uterine prolapse remains engraved on this list of must-do-hysterectomy rules. This is ridiculous and wrong. You don't have to take out the uterus when it falls. You can lift it up, or "resuspend" it. I repeat: When the uterus drops you can pick it back up. The surgery holds up just as well. You don't have to lose your womb.

Taking out the uterus to fix a prolapse is like taking off the knee cap to fix a torn ligament. Imagine all those knees without knee caps, removed because the knee cap was in the way of the ligament that needed fixing. That is how much sense it makes to lop off a prolapsed uterus just because the ligaments that hold it in place gave way. Either way, uterus in or out, your surgeon must fix those ligaments. If your surgeon tells you there is no way to fix your prolapse without taking the uterus out, or doesn't seem to understand that "IT'S THE LIGAMENTS, STUPID," I advise you to RUN, do not walk, to a second opinion.


1 Robert Burns, Poet Laureate of Scotland, said,
"Man's inhumanity to man makes countless thousands mourn..." (Man Was Made to Mourn)