What Is a Hysterectomy?


What Is a Hysterectomy?

A hysterectomy, or surgery to remove the uterus, is the second most common major surgery among women in the United States, second only to cesarean section. About one-third of American women will have a hysterectomy by the time they are 60.

A hysterectomy is a surgical procedure to remove a woman’s uterus. The uterus, also known as the womb, is where a baby grows when a woman is pregnant. The uterine lining is the source of menstrual blood.

You may need a hysterectomy for many reasons. The surgery can be used to treat a number of chronic pain conditions as well as certain types of cancer and infections. The extent of a hysterectomy varies depending on the reason for the surgery. In most cases, the entire uterus is removed. The doctor may also remove the ovaries and the fallopian tubes during the procedure. The ovaries are the organs that produce estrogen and other hormones. The fallopian tubes are the structures that transport the egg from the ovary to the uterus.

Once you’ve had a hysterectomy, you’ll stop having menstrual periods. You’ll also be unable to get pregnant.

Why Is a Hysterectomy Performed?

Several medical conditions can be treated or cured with a hysterectomy. Of the approximately 600,000 hysterectomies each year in the United States, about one-third are performed to treat uterine fibroids. Hysterectomies are also performed to treatendometriosis and to stop abnormal uterine bleeding, although alternative, less invasive treatments for these conditions now are available. Other reasons to have a hysterectomy include:

  • endometrial hyperplasia with atypia, an overgrowth of the uterine lining in which uterine cells contain precancerous changes
  • cancer of the uterus, ovaries, fallopian tubes or cervix
  • pelvic prolapse, in which the ligaments that support pelvic structures like the uterus weaken and the organs drop
  • uterine fibroids, when other, less invasive treatments have not provided relief. (Myomectomy, removal of just the fibroids, is a less invasive surgical option for fibroid removal.)
  • colon or bladder cancer that has spread to the uterus
  • uncontrollable bleeding after childbirth (rarely)


Your doctor may suggest a hysterectomy if you have any of the following:

  • chronic pelvic pain
  • uncontrollable vaginal bleeding
  • cancer of the uterus, cervix, or ovaries
  • fibroids, which are benign tumors that grow in the uterus
  • pelvic inflammatory disease, which is a serious infection of the reproductive organs
  • uterine prolapse, which occurs when the uterus drops through the cervix and protrudes from the vagina
  • endometriosis, which is a disorder in which the inner lining of the uterus grows outside of the uterine cavity, causing pain and bleeding
  • adenomyosis, which is a condition in which the inner lining of the uterus grows into the muscles of the uterus

Alternatives to a Hysterectomy

According to the National Women’s Health Network, a hysterectomy is the second most common surgical procedure performed on women in the United States. It’s considered to be a safe, low-risk surgery. However, a hysterectomy may not be the best option for all women. It shouldn’t be performed on women who still want to have children unless no other alternatives are possible.

Luckily, many conditions that can be treated with a hysterectomy may also be treated in other ways. For instance, hormone therapy can be used to treat endometriosis. Fibroids can be treated with other types of surgery that spare the uterus. In some circumstances, however, a hysterectomy is clearly the best choice. It’s usually the only option for treating uterine or cervical cancer.

What Are the Risks of a Hysterectomy?

A hysterectomy is considered to be a fairly safe procedure. As with all major surgeries, however, there are associated risks. Some people may have an adverse reaction to the anesthetic. There is also the risk of heavy bleeding and infection around the incision site.

Other risks include injury to surrounding tissues or organs, including the:

  • bladder
  • intestines
  • blood vessels


Recovering from a Hysterectomy

After your hysterectomy, you’ll need to spend two to five days in the hospital. Your doctor will give you medication for the pain and monitor your vital signs, such as your breathing and heart rate. You’ll also be encouraged to walk around the hospital as soon as possible. Walking helps prevent blood clots from forming in the legs.

If you’ve had a vaginal hysterectomy, your vagina will be packed with gauze to control the bleeding. The doctors will remove the gauze within a few days after the surgery. However, you may experience bloody or brownish drainage from your vagina for about 10 days. Wearing a menstrual pad can help protect your clothing from getting stained.

When you return home from the hospital, it’s important to continue walking. You can walk around inside your house or around your neighborhood. However, you should avoid performing certain activities during recovery. These include:

  • pushing and pulling objects, such as a vacuum cleaner
  • lifting heavy items
  • bending
  • sexual intercourse

If you’ve had a vaginal or laparoscopic hysterectomy, you’ll probably be able to return to most of your regular activities within three to four weeks. Recovery time will be a little longer if you’ve had an abdominal hysterectomy. You should be completely healed in about four to six weeks.

Pros and Cons of a Hysterectomy

For some women, a hysterectomy is the answer to years of suffering from uterine problems. For others, hysterectomy is a last resort to treat cancer or another life-threatening condition.

Unless you have a severe pelvic infection, cancer or uncontrollable bleeding, there is usually no reason to rush into the decision. Because most hysterectomies are elective procedures (as opposed to emergencies), there is usually plenty of time to explore all options.

What Are the Types of Hysterectomy?

Partial Hysterectomy

During a partial hysterectomy, your doctor removes only a portion of your uterus. They may leave your cervix intact.

Total Hysterectomy

During a total hysterectomy, your doctor removes the entire uterus, including the cervix. You’ll no longer need to get an annual Pap test if your cervix is removed. However, you should continue to have regular pelvic examinations.

Hysterectomy and Salpingo-Oophorectomy

During a hysterectomy and salpingo-oophorectomy, your doctor removes the uterus along with one or both of your ovaries and fallopian tubes. You may need hormone replacement therapy if both of your ovaries are removed.

How Is a Hysterectomy Performed?

A hysterectomy can be performed in several ways. All methods require a general or local anesthetic. A general anesthetic will put you to sleep throughout the procedure so that you don’t feel any pain. A local anesthetic will numb your body below the waistline, but you’ll remain awake during the surgery. This type of anesthetic will sometimes be combined with a sedative, which will help you feel sleepy and relaxed during the procedure.

Abdominal HysterectomyDuring an abdominal hysterectomy, your doctor removes your uterus through a large cut in your abdomen. The incision may be vertical or horizontal. Both types of incisions tend to heal well and leave little scaring.

Vaginal Hysterectomy

During a vaginal hysterectomy, your uterus is removed through a small incision made inside the vagina. There are no external cuts, so there won’t be any visible scars.

Laparoscopic Hysterectomy

During a laparoscopic hysterectomy, your doctor uses a tiny instrument called a laparoscope. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through incisions in the abdomen. Three or four small incisions are made instead of one large incision. Once the surgeon can see your uterus, they’ll cut the uterus into small pieces and remove one piece at a time.


A hysterectomy may be recommended as treatment for a variety of gynecologic conditions. However, in most cases, a hysterectomy is the most invasive option and only one of various treatments that may be available to you. Like any major surgery or treatment, it should be considered carefully, and you should understand why it’s being recommended and the risks and benefits associated with it.

There has been much concern in recent years that too many unnecessary hysterectomies are performed. To decide if a hysterectomy is the right procedure for you, consider getting a second opinion. Most insurance companies will cover the cost. You may want to ask your primary care doctor for a referral to another doctor. Seeking the advice of another health care professional could reveal options you may not have considered.

Below is a list of conditions that often are treated with a hysterectomy; benefits and risks of other treatment options are also included.

Abnormal Uterine Bleeding (AUB)

Many women with abnormal uterine bleeding (AUB) have a hysterectomy, but this approach may be more aggressive than necessary. Abnormal uterine bleeding, or menorrhagia, refers to menstrual periods that are abnormally heavy, prolonged or both or may refer to bleeding between periods. In general, AUB is diagnosed when abnormal bleeding interferes with daily activities and there is no evidence of a physical cause (like cancer or endometriosis).

Abnormal uterine bleeding is a common problem for women between ages 40 and 50 when hormone levels begin to change in the five to seven years before menopause—when menstrual periods end forever.

Here are several alternatives to hysterectomy as a treatment option for AUB:

  • Endometrial ablation. This minimally invasive surgery uses electrical energy, heat, a balloon or freezing to destroy the endometrium, or uterine lining. It can minimize or stop heavy bleeding, but should only be considered in women who are certain they no longer wish to ever become pregnant.Success rates of endometrial ablation vary depending on the specific procedure used and the patient, but success rates for the following three to five years are generally quite high.Risks of endometrial ablation are rare. They include:
    • perforation of the uterus
    • injury to other pelvic organs
    • bleeding
    • infection
    • overloading of fluid into the bloodstream
    • accumulation of blood within the uterus because of scarring.
  • Hormonal treatments. Abnormal uterine bleeding can also be treated with hormonal treatments, like oral contraceptives (estrogen and progestin) that help to balance your body’s hormones. Natazia, which contains the synthetic estrogen estradiol valerate, is the first birth control pill FDA-approved for treatment of heavy menstrual bleeding that is not caused by a condition of the uterus. The combination estrogen-progesterone pill may help women who choose oral contraceptives for contraception and do not have risk factors that may make using hormonal birth control inadvisable.
  • Progesterone IUD. Mirena, an intrauterine device that contains the progesterone levonorgestrel, helps decrease heavy bleeding for some women by slowly releasing progestin into the uterus for up to five years.

Uterine or Endometrial Cancer

Uterine (endometrial) cancer is the most common reproductive cancer in women. Hysterectomy, together with some form of cancer therapy, may be the only treatment choice you have. Your chances of curing this cancer are usually good if it’s diagnosed in its early stages—when the cancer is confined to the uterus and hasn’t spread to other organs.

The type of treatment recommended depends on when the cancer is diagnosed. Hysterectomy is the most common treatment. It generally involves removing the uterus and cervix. This type of hysterectomy is called a total hysterectomy. (Details about other types of hysterectomy can be found in the Treatment section of this topic.) The surgeon may also remove pelvic lymph nodes to determine if the cancer has spread beyond the uterus.

Surgery may be preceded or followed by radiation therapy and, in some cases, chemotherapy.

Ovarian Cancer

Ovarian cancer is the fifth-leading cause of cancer death among women. It is the leading cause of death from gynecologic cancer because less than 20 percent of cases are diagnosed before the cancer has spread beyond the ovaries. If diagnosed and treated at an early stage, however, the five-year survival rate is up to 94 percent.

The initial treatment for ovarian cancer is surgery to remove the ovaries. A hysterectomy is often performed, too, depending on how far the disease has spread and a woman’s age.


About one-third of hysterectomies are performed every year in the United States to treat fibroid tumors. Noncancerous balls of muscular tissue, fibroids can grow inside the uterus, on the surface of the uterus or in the muscular wall of the uterus. They can range in size from less than an inch in diameter to the size of a grapefruit. They don’t always produce symptoms.

However, even small fibroids that bulge into the uterine cavity can cause heavy menstrual bleeding. Plus, these fibroids may affect fertility by interfering with an embryo’s ability to attach to the uterus. Large fibroids might cause frequent urges to urinate; they can also cause heaviness and discomfort in the pelvic region.

If fibroids aren’t causing any problems, however, you don’t need treatment. Plus, because fibroids tend to shrink after menopause, women in their late 40s or early 50s with fibroid-related symptoms may opt to wait to see if symptoms go away with menopause.

Although hysterectomy permanently removes fibroids (because a hysterectomy removes your uterus), there are other options for treating fibroids. These include:

  • Hormone-suppressing drugs. Drugs called gonadotropin-releasing hormones (GnRH) agonists, such as leuprolide (Lupron), nafarelin nasal (Synarel) and goserelin (Zoladex) that are typically used to treat endometriosis, can also help shrink fibroids. Their effects, however, are usually temporary, and the fibroids may eventually grow back larger than before. GnRH agonists also produce side effects in some women, such as hot flashes, headaches, vaginal dryness, constipation and decreased sex drive.
  • Myomectomy. This procedure is one of the best options for treating fibroids if you want to preserve your fertility. During an abdominal myomectomy, fibroids are cut out of the uterus and removed through an incision in the abdomen, and the uterine muscle wall is reconstructed with sutures.If fibroids are located in the uterine cavity, they may be removed through the vagina without an abdominal incision in a procedure called hysteroscopic myomectomy. The technique involves the use of an instrument called a hysteroscopic resectoscope and is primarily useful for women with bleeding or fertility-related problems.They may also be removed laparoscopically, using a small telescope called a laparoscope. During this procedure, a few small cuts are made in your abdomen or pelvis, which allow the laparoscope and other small instruments to be slipped inside, thus enabling the surgeon to remove the fibroids without having to make a large incision.The benefit of a myomectomy is that it preserves the uterus and cervix so pregnancy is still possible. Myomectomy is also an option for women who wish to preserve their uterus for any reason.Also, it may take longer to recover from an abdominal myomectomy than from a vaginal or laparoscopic hysterectomy. Although the goal of myomectomy is to preserve your uterus and your ability to have children, the procedure may cause scarring in the uterus that could require you to have a cesarean with your next pregnancy.
  • Uterine artery embolization (UAE). In this minimally invasive procedure, a narrow, flexible tube called a catheter is passed through the femoral artery in the groin into the uterine artery. Once there, tiny plastic particles the size of grains of sand are slowly released into the blood vessels feeding the fibroid. The particles wedge in the vessels (but can’t travel to other parts of the body), blocking blood flow to the tumor. Without a blood supply, the fibroids shrink.Fibroid embolization usually requires an overnight hospital stay. Most women return to normal activities within a week. Risks include moderate to severe pain and cramping in the first few hours after the procedure, and nausea, fever and infection. Rarely, a woman might enter menopause after embolization. A small percentage of women are readmitted to the hospital after the procedure for complications, some of whom require additional surgery.


Endometriosis occurs when cells from the endometrium—or your uterine lining—grow outside the uterus and adhere to other parts inside your pelvis, such as the ovaries, bowel, fallopian tubes or bladder.

Hysterectomy is generally recommended for endometriosis only when the disease is severe.

Hormone-suppressing drugs used to treat fibroids are also considered effective for endometriosis since both conditions are affected by your body’s production of estrogen. As with fibroids, benefits from these treatments may be temporary.

Aside from hysterectomy, surgical treatments for endometriosis include:

  • Electrocautery techniques, in which stray endometrial tissue is burned away
  • Excision, in which endometrial tissue is cut out
  • Laser vaporization, which uses the laser to destroy the affected tissue

These procedures can usually be done laparoscopically and are often used when preserving fertility is important. Endometriosis frequently recurs, but the addition of postsurgical medical therapy, such as birth control pills or GnRH agonists, such as leuprolide (Lupron) or danazol (Danocrine), for six months may increase the pain-free interval.

The only definitive treatment for endometriosis is removing the ovaries to reduce your body’s production of estrogen, which triggers the growth of endometrial tissue.

Pelvic Prolapse

Pelvic prolapse (a term that describes when the uterus drops into the vaginal canal) occurs when the ligaments that support the pelvic organs fail.

This weakening can occur with age, estrogen deficiency, obesity or after multiple births. Once this pelvic support weakens, pelvic organs, including the uterus, bladder and rectum, may sag, resulting in pressure, rectal discomfort and problems with bladder and bowel control.

Losing weight, stopping smoking and avoiding constipation by getting plenty of liquids and fiber in your diet can sometimes help. Additionally, you can strengthen your pelvic muscles with Kegel exercises. To do these exercises, tighten and relax the muscles used to stop the flow of urine. This strengthens the vaginal canal and pelvic floor muscles, helping control urine flow and enhancing orgasm.

You may also be fitted with a pessary, a device placed in the vagina that holds the organs in place.

Another treatment is short-term hormone therapy to make the vaginal tissue suppler. Estrogen prevents drying and thinning of the vaginal tissues. Supplemental estrogen can help strengthen vaginal tissues. However, because of the potential risks of estrogen therapy, such as increased risk of blood clots, breast cancer and gallbladder disease, the decision to use estrogen must be made only after you and your doctor have weighed all the pros and cons.

Surgery can be an option when organs have prolapsed. Surgery may involve creating a sling for the bladder or using specialized surgical tape to keep the bladder or uterus in place, or removing the uterus, via hysterectomy.


Removing the uterus and cervix was once standard practice for a common precancerous condition called dysplasia, or cervical intraepithelial neoplasia (CIN). Today, cutting, burning or freezing the diseased portion of the cervix is generally recommended for CIN, and hysterectomy is rarely performed for this condition.

Treatment depends on the severity and location of dysplasia, your age, health status and whether you want to preserve your ability to have children.


A hysterectomy is used to treat several conditions. If you decide to have a hysterectomy, you and your health care professional should discuss which type is most appropriate. There are three types:

  • Total hysterectomy. During this procedure, your uterus and cervix are removed. Your ovaries and fallopian tubes may or may not be removed at the same time. If your ovaries are not removed, you will continue to have menstrual cycle-related hormonal changes, but you won’t have any bleeding.If your ovaries and fallopian tubes are also removed, called a bilateral salpingo-oophorectomy, you won’t have monthly hormonal changes. Removing only the uterus can reduce the blood supply to the ovaries, ultimately decreasing their function, however, this only occurs about 10 percent of the time.The decision about removing the ovaries depends on a few factors, including how close you are to menopause, your current estrogen levels and your risk for some other diseases and conditions. Premenopausal women may opt to keep their ovaries to provide a natural source of the hormones estrogen, progesterone and testosterone, which are important for maintaining sexual interest and function and preventing menopausal symptoms like hot flashes and decreased bone density. On the other hand, some premenopausal women with severe PMS, menstrual migraines or other hormone-related conditions may experience an improvement in their symptoms by removing their ovaries.As far as disease risk is concerned, a study published in the January 2013 issue ofMenopause reported that removing both ovaries during a hysterectomy is associated with a decreased risk of ovarian cancer but an increased risk of osteoporosis, problems with cognition and sexual function, and coronary artery disease. As such, women should review their individual risk factors and the pros and cons before making the decision of whether or not to remove their ovaries during a hysterectomy.Ask your health care professional to explain this information to you so you can better understand your surgical options and the best plan for you.
  • Subtotal, partial or supracervical hysterectomy. In this procedure, only the part of your uterus above the cervix is removed. There is a small risk that cancer could develop in the remaining part of the cervix, but routine Pap smears will detect pre-cancer in an easily treatable form. Nonetheless, there may be some benefits to leaving the cervix intact, including a reduced risk of vaginal prolapse (the vagina falling out), shorter recovery time and less postoperative pain. Some women note that leaving the cervix allows intercourse to remain pleasurable.
  • Radical hysterectomy. This type of hysterectomy is performed in some cases of cancer. During this procedure, your uterus, cervix, supporting ligaments and tissues, the upper portion of the vagina and the pelvic lymph nodes are removed. Cancer specialists usually perform this type of hysterectomy.

In addition to discussing which organs should be removed during a hysterectomy, you and your health care professional should discuss how the surgery will be performed. The surgical technique you choose should depend on your individual diagnosis, personal preference and your surgeon’s training. They include:

  • Abdominal, or open, hysterectomy. This is the classic form of hysterectomy, involving an abdominal incision. This allows the surgeon to easily view the pelvic organs and provides more operating space than a vaginal hysterectomy. It is generally used for large fibroids or cancer.If you have this form of hysterectomy, expect a two- to three-day hospital stay and a six-week recuperation time. In most cases, your surgeon can make a “bikini line” incision that your bathing suit hides. Exceptions include cancer surgery or surgery to remove extremely large fibroids. Complete recovery from abdominal hysterectomy can take six to eight weeks, during which time you’ll gradually feel your strength return and gradually be able to resume your normal activities.
  • Vaginal hysterectomy. In this procedure, the surgeon removes the uterus and the cervix through an incision in the vagina, so there’s no large external scar. This form of hysterectomy is ideal when there is uterine prolapse and minimal uterine enlargement.Vaginal hysterectomy can be performed in two ways: entirely through the vagina or using a laparoscope, a small, telescope-like device inserted into the abdomen through a small incision, enabling the surgeon to visualize the pelvic region, also called a laparoscopic-assisted vaginal hysterectomy. Laparoscopically assisted vaginal hysterectomy (LAVH) may be used if standard vaginal hysterectomy would be difficult or if the surgeon wishes to better visualize the ovaries or other pelvic organs during surgery. During this procedure, the uterus is removed through the vagina.Vaginal hysterectomy and abdominal hysterectomy each take between one and two hours and are performed under regional (epidural or spinal) or general anesthesia. One study found that women who had vaginal hysterectomies had significantly fewer complications than those having abdominal hysterectomies. Additionally, the women had shorter hospital stays and returned to their normal activities quicker than the women who had abdominal hysterectomies.Women with large ovarian cysts, a serious case of endometriosis or large fibroids may not be candidates for vaginal hysterectomy.
  • Laparoscopic supracervical hysterectomy (LSH). This newer type of hysterectomy also uses laparoscopic techniques to remove the uterus but leaves the cervix intact; in the past, some studies suggested leaving the cervix might help reduce the complications associated with total hysterectomies, such as pelvic prolapse and urinary incontinence. However, the most recent research shows there is no compelling reason to leave the cervix if it can be easily removed along with the uterus. Hospital stay is usually no more than one night, and recovery takes about two weeks.
  • Computer-assisted (robotic) surgery. Robotic-assisted laparoscopic hysterectomy is similar to a laparoscopic hysterectomy, but the surgeon conducts the operation from outside the body, using a robotic system of surgical tools. This equipment allows the surgeon to view the hysterectomy on a three-dimensional screen and use wrist movements to control the procedure. Hospital stay is usually one night or less, and full recovery can take up to two to four weeks. Robotic surgery is more expensive, takes longer and has more visible incisions than laparoscopic surgery.

Possible Complications

While discussing hysterectomy techniques with your health care provider, you should also talk about possible complications. Rarely, women who undergo a hysterectomy experience complications from surgery, most of which are minor or reversible. Possible complications include:

  • fever and infection following surgery
  • urinary tract infection or injury
  • if your ovaries are removed, menopausal symptoms, such as hot flashes, night sweats and vaginal dryness,
  • constipation
  • depression or other emotional problems
  • pain or discomfort during intercourse
  • loss of sexual pleasure or interest in sex

More serious, but rarer, complications may include:

  • hemorrhage requiring transfusion
  • injury to the bowel, bladder or other internal organs during surgery, requiring repair
  • bowel blockage
  • life-threatening cardiopulmonary events such as a heart attack

If your ovaries are removed, you may experience a sudden drop in hormone levels, which may produce menopausal symptoms such as hot flashes, night sweats and dizziness. Postmenopausal estrogen therapy (ET), taken soon after surgery, may offset menopausal symptoms. Although the FDA now requires a warning on all estrogen products for use by postmenopausal women advising health care professionals to prescribe estrogen products at the lowest dose and for the shortest possible length of time, estrogen therapy may still be recommended after surgery to remove the ovaries.


There likely isn’t anything you can do or could have done to prevent the conditions for which you are considering a hysterectomy, but there is a lot you can do to prepare for this surgery. Fortunately, few hysterectomies are emergencies, so there usually is plenty of time to prepare.

First, be sure this treatment option is right for you.

A hysterectomy may be the only course of treatment for some conditions, such as cancer of the uterus, for example. But other treatment options may be available. Be sure you are comfortable with your health care professional’s recommendation. If you want a second opinion, ask what you should do to get one.

These suggestions may help you prepare and recover from your surgery more easily:

  • Plan the surgery two or three months ahead of time.
  • Review the surgery and recovery needs with your physician. Be sure you understand why and how the surgery is being done. Ask questions if you’re not sure.
  • Be sure sure you know what to expect after surgery. How long will recovery take? What type of activities will you be able to do and not do?
  • Review family and/or work schedules to determine what timing may work best.
  • Ask for (and accept) help from friends and family with your routine; then, schedule it. This might include help with children’s schedules, cooking, pets or household chores, for example.

Facts to Know

  1. Many alternatives to hysterectomy now exist including hormonal therapy, the progesterone IUD, endometrial ablation, laparoscopic excision of endometriosis, myomectomy by hysteroscopy, laparoscopy or abdominal incision and uterine artery embolization.
  2. About one-third of American women will have a hysterectomy by age 60. The United States has one of the highest hysterectomy rates in the world. Many of these procedures may be unnecessary. Hysterectomy rates are higher for African-American women.
  3. A hysterectomy is often performed to stop abnormal uterine bleeding. It may also be recommended to treat fibroids that cause symptoms that aren’t successfully managed by other treatment options.
  4. A considerable number of hysterectomies are performed to correct symptoms of endometriosis. Endometriosis occurs when endometrial tissue, which forms the lining of the uterus, grows in other parts of the body, causing scar tissue and subsequent pain.
  5. Some hysterectomies are performed to treat abnormal uterine bleeding (AUB), or menstrual bleeding excessive enough to disrupt a woman’s life. Abnormal uterine bleeding may be caused by structural problems in the uterus (fibroids, for example), certain medical conditions or hormonal imbalances.
  6. Some women elect to undergo hysterectomy to correct pelvic prolapse, which occurs when the ligaments that support a woman’s pelvic organs weaken and lose their supportive ability.
  7. Hysterectomies can be done several ways: A total or complete hysterectomy removes the uterus, including the cervix. A subtotal, partial or supracervical hysterectomy removes the uterus above the cervix. A radical hysterectomy, performed for certain cancers of the reproductive organs, removes the uterus, cervix, supporting ligaments and tissues, the upper portion of the vagina and the pelvic lymph nodes.
  8. Developments in laparoscopic procedures have added two more surgical options. In laparoscopically assisted vaginal hysterectomy, a surgeon inserts a laparoscope (small telescope) through a woman’s belly button to view the entire pelvis. Parts of the hysterectomy are performed through other small incisions in the abdomen, but most will be completed through the vagina. In a laparoscopic hysterectomy, the entire procedure is performed through laparoscopic incisions in the abdomen.
  9. Depending on the type of hysterectomy you have, you may need to stay in the hospital for a few days. Although normal activities may be resumed gradually, a woman may not be fully recovered until four to six weeks or longer following surgery, depending on the surgical approach used.
  10. Some women’s health centers and hospitals offer support groups or social workers to emotionally support hysterectomy patients. Ask your health care professional for a referral.

Key Q&A

  1. What are the medical reasons for a hysterectomy?Hysterectomy often is recommended for abnormal uterine bleeding and for treating cancer of the ovaries, uterus or fallopian tube. Hysterectomy can relieve chronic abdominal pain and fibroids, endometriosis and certain other disorders, including pelvic prolapse. In rare instances, hysterectomy may be recommended for colon, rectum or bladder cancers that have spread to the reproductive organs, as well as invasive cervical cancer.
  2. How is a hysterectomy performed?The uterus may be removed through either an incision in the abdomen or through an incision in the vagina. Abdominal hysterectomies are usually performed for cancer or large fibroids. Vaginal hysterectomies are usually performed when the uterus is small or when close inspection of other reproductive organs is not necessary. Laparoscopic hysterectomy (LH) occurs through a tiny incision in the abdomen using an instrument with a small camera on the end. Laparoscopically assisted vaginal hysterectomy (LAVH) is performed through the vagina, with the assistance of the laparoscope. A laparoscopic supracervical hysterectomy (LSH) leaves the cervix intact.
  3. Are the ovaries always removed during a hysterectomy?No. When one or both ovaries are removed (in a procedure called oophorectomy), it’s usually because one or both organs are diseased or because the woman is past menopause and wishes to eliminate the risk of ovarian or breast cancer. In premenopausal women, bilateral oophorectomy produces “surgical menopause.” Menopausal symptoms, such as hot flashes, vaginal dryness, insomnia and night sweats can occur suddenly and be more severe compared with natural menopause symptoms. Beginning hormone therapy (HT) soon after oophorectomy can reduce or alleviate these symptoms. Removal of the ovaries may increase long-term health risks. Discuss the risks and benefits associated with hormone therapy with your health care professional.
  4. How long does it take to recover from surgery?Although normal activities may be resumed gradually, full recovery generally takes two to four weeks following laparoscopic or vaginal hysterectomy and four to six weeks following abdominal hysterectomy. Fatigue following any of these procedures may last weeks longer.
  5. What are the possible complications from these surgeries?Hysterectomy is not without its risks; some women who undergo the procedure experience complications. Most of these problems are minor or reversible. They can include:
    • fever and infection following surgery
    • urinary tract infection or discomfort
    • menopausal symptoms, such as hot flashes, night sweats and vaginal dryness
    • constipation
    • depression or other emotional problems
    • pain or discomfort during intercourse
    • loss of sexual pleasure or interest in sex

    More serious, but rarer, complications may include:

    • hemorrhage requiring transfusion
    • injury to the bowel, bladder or other internal organs during surgery, requiring repair
    • bowel obstruction
    • life-threatening cardiopulmonary events such as a heart attack
  6. What are the emotional aspects of hysterectomy?Emotional responses vary, based on the woman’s life experiences, medical and mental health history and her level of support from family and friends.These feelings can include:
    • a sense of loss of the uterus or ovaries and of reproductive function (menstruation and fertility)
    • sadness, anger, depression or anxiety in response to loss
    • a diminished sense of femininity, attractiveness or self-worth
    • anxiety about sexual functioning
  7. Will I be able to resume normal sexual activity after a hysterectomy?Ask your health care professional when you may begin sexual activity after surgery. Because your vagina may be shorter after a total hysterectomy, you and your partner may want to experiment with different positions to find one that is comfortable. Foreplay may enable the vagina to lengthen before intercourse.

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