Hysterectomy technically involves removal only of the uterus and/or cervix. The ovaries are separate structures from the uterus. Traditionally, most doctors would recommend removal of both ovaries at the time of hysterectomy to prevent future ovarian cancer. Ovarian removal is certainly not a necessary part of a hysterectomy.
In women younger than 49 years of age, Dr. Maikis recommends keeping the ovaries in place at the time of uterine removal so normal hormones can continue to be made. Even women with endometriosis can elect to keep one ovary in place until natural menopause, and still get excellent pain relief after hysterectomy.
Some women with a family history of breast or ovarian cancer, or a fear of ovarian cancer, prefer to have their ovaries removed at the time of hysterectomy.
The topic is discussed individually with each patient prior to the removal of the uterus, and the choice is made according to what is best for that individual.