What is Hysterectomy?

Hysterectomy is a surgical procedure to remove the uterus. It is performed for conditions that have not responded to other treatments.

Common reasons for hysterectomy include

  • heavy bleeding
  • severe menstrual pain
  • prolapse of the uterus (the uterus falling into the vagina, causing pressure)
  • cancer
  • endometriosis
  • uterine fibroids

A hysterectomy can be:

  • Subtotal - Removal of the uterus without removal of the cervix, also called a supra-cervical hysterectomy.
  • Total - Removal of the cervix and uterus.
  • Radical - Removal of the uterus, cervix and surrounding support structures. This is a more common procedure for cancer.

Removal of the ovaries and fallopian tubes is called a salpingo-oophorectomy. It is a separate procedure from hysterectomy. Since female hormones come from the ovaries, a hysterectomy alone does not cause changes in hormone production.

Types of Hysterectomy

There are multiple approaches to removing the uterus. The type of hysterectomy that is best is selected based on the size of the uterus, scar tissue from previous surgeries or from endometriosis, and prolapse(poor pelvic support).

  • Abdominal Hysterectomy With an abdominal hysterectomy, a vertical or horizontal incision is made. It is the preferred approach for very large uteruses, anyone who is known to have dense scar tissue, or with some types of cancer. It requires longer recovery time and longer hospitalization than vaginal and laparoscopic hysterectomies.
  • Vaginal Hysterectomy This surgery is done through the vagina. It usually requires only an overnight stay in the hospital. The post surgical pain is usually less. This surgery is best suited for women who have some prolapse of the uterus.
    Vaginal Hysterectomy for a Fallen Uterus
  • Laparoscopic Hysterectomy The incisions for laparoscopic hysterectomy are less than an inch in size. It is a minimally invasive surgical approach. The recovery time and post op pain is shorter than for an abdominal hysterectomy. Blood loss is usually less.
  • daVinci Hysterectomy This robotic -assisted hysterectomy is laparascopic. Like traditional laparascopic surgeries, it is minimally invasive. Post op pain and recovery time are shorter. Because the robot allows for more precise movements, this approach can be used in almost any situation. It is especially good for patients who have endometriosis, scar tissue or for patients who are obese, is also ideal for patients who have pelvic support problems, and cancer.

Risks of Hysterectomy

  • Infection - preoperative antibiotics are routinely given to prevent infection 
  • Bleeding- causing anemia or need for blood transfusion
  • Damage to surrounding structures- bladder,urinary tract, bowel, blood vessels
  • Blood clots in the veins or lungs
  • Bowel blockage
  • Complications from anesthesia
  • Urinary incontinence

Recovery from Hysterectomy

The recovery period may vary due to type of surgical approach. Laparoscopic and vaginal approaches usually allow resuming daily activities within 2 weeks. Recovery from abdominal hysterectomies may take an additional 2 weeks. Full recovery will require 6 weeks for all types of hysterectomies. It is recommended not to drive or to do any exercise, other than walking, for the first two weeks. There should be no sexual activity for up to 6 weeks after surgery regardless of technique.

Salpingo-oophorectomy (removal of tubes and ovaries)

When both ovaries and fallopian tubes are removed, there is a sudden drop in hormone production. This change can cause hot flashes, night sweats, moodiness, depression, insomnia, or loss of interest in sex. The lack of estrogen can also cause bone loss. It is important to discuss these issues before surgery. There are medications that your doctor can prescribe to prevent these symptoms. 

After consultation and examination, your doctor can guide you in your decision making.

Developed by Austin Regional Clinic.
Last modified: 2012-05-15
Last reviewed: 2012-05-15

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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