Hysterectomy

Hysterectomy is a medical term for the procedure of the removal of a woman’s uterus and can serve as a solution for:

• Uterine fibroids that cause pain, bleeding, or other symptoms
• Uterine prolapse, a sliding of the uterus from its normal position into the vaginal canal
• Cancer of the uterus, cervix, and ovaries
• Endometriosis
• Abnormal vaginal bleeding
• Chronic abdominal or pelvic pain
• Adenomyosis, a thickening of the uterus

If the doctor has prescribed a hysterectomy, several concerns need to be addressed first:

• Taking a pregnancy test — a hysterectomy cannot be performed while the patient is pregnant
• If an IUD is in place, it must be removed before surgery
• Achieving a healthy weight — having a weight problem can increase the risks involved with surgery and cause other complications
• Stopping smoking — quitting or cutting down on smoking can help with general anesthesia and recovery from surgery
• Gathering information — discuss treatment and recovery with a specialist. They may have other recommendations.

Depending on the reason for the procedure, a doctor may remove all or only a part of the uterus. The most common types of hysterectomy are:

• A supracervical or subtotal hysterectomy, in which only the upper part of the uterus is removed, and the cervix is kept in place
• A total hysterectomy, in which the entire uterus and cervix are removed
• A radical hysterectomy, in which the entire uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina are removed. This type of surgery is only done when cancer is present.

There are two different approaches used for hysterectomy, depending on the reason for the procedure and the patient’s overall health.

• Abdominal hysterectomy — an open surgery in which the doctor makes a 5 to 7-inch incision across the abdomen and removes the uterus through this incision. This is the most common approach to hysterectomy.
• MIP (minimally invasive procedure) hysterectomy — less invasive than an abdominal hysterectomy, this type of procedure allows for faster recovery, less pain and scarring, and a lower chance of infection. This procedure can be done in several ways:
  • Vaginal hysterectomy — a cut is made in the vagina, and the uterus is removed through this incision. The incision is closed, leaving no visible scar.
  • Laparoscopic hysterectomy — a small tube with a lighted camera and other surgical tools are inserted through several small incisions made in the abdomen.
  • Laparoscopic-assisted vaginal hysterectomy — laparoscopic surgical tools are used to remove the uterus through an incision in the vagina.
  • Robot-assisted laparoscopic hysterectomy — the doctor controls a system of surgical instruments from outside the body while viewing the procedure on a three-dimensional screen.

Most patients who undergo a hysterectomy have no serious complications after the procedure. However, the major surgery is not without the risk of complications, which may include:

• Urinary incontinence
• Vaginal prolapse
• Fistula formation
• Chronic pain

If the ovaries were removed during the hysterectomy, the onset of menopause would occur as a result. If the ovaries were not removed, one may still enter menopause at an earlier age than expected.

There will be a brief recovery time in the hospital, and recovery time at home varies depending on the type of procedure. Following an abdominal hysterectomy, the patient will go home two to three days after the surgery, but complete recovery takes about six to eight weeks. Following a MIP hysterectomy, recovery can be as short as two weeks. During this time, abstain from sex and avoid lifting heavy objects. The doctor will advise you on when to return to normal activities.

While a hysterectomy is a major procedure that is a viable solution for many who suffer the conditions listed above, it is not an option for certain situations. One should not have a hysterectomy if:

• Considering the procedure for non-cancerous reasons and have not ruled out all other treatment approaches with a specialist
• Currently experiencing infections, such as pelvic inflammatory disease (PID), that are not responsive to treatment
• Experiencing severe hemorrhaging
• Having a rupture of the uterus

Our board-certified team of women’s health experts are ready to help you with diagnostic care and a range of treatment options.

We will counsel you about the best options for you and your health.