A hysterectomy is a surgical procedure that involves the removal of all or part of the uterus. The uterus, also known as the womb, is the organ where a fetus grows during pregnancy. After a hysterectomy has been performed, a person will no longer be able to become pregnant, nor will they experience menstrual periods.
In the United States, hysterectomies are the second most common reproductive surgical procedure, following Cesarean sections. Over 600,000 hysterectomies are performed each year, and by the age of 60, one in three adults assigned female at birth in the United States report having had some type of hysterectomy. Keep reading to learn about the different reasons hysterectomies might be recommended, along with what this procedure can entail.
Why Do Doctors Perform Hysterectomies?
There are numerous reasons that a person might undergo a hysterectomy. Most often this procedure is done to treat or prevent certain diseases and medical conditions. These are some of the most common reasons a hysterectomy might be recommended:
- To stop abnormally heavy bleeding during menstruation
- To remove benign tumors in the uterus called fibroids
- To prevent chronic pain and bleeding between menstrual periods caused by endometriosis
- To stop pelvic pressure and issues with urination and bowel movements due to prolapse of the uterus
- To alleviate pain caused by adenomyosis, which is a condition in which tissues that are supposed to line the uterus grow within the muscle wall of the uterus instead
- To treat cancer of the uterus, cervix or ovaries
Types of Hysterectomies
There are several different kinds of hysterectomies, and they’re defined by how much of the uterus is actually removed during surgery. The type of hysterectomy you’re recommended will depend on the symptoms you experience and the reason for the procedure.
- Partial (supracervical) hysterectomy: A partial hysterectomy is when only the upper portion of your uterus is removed, while your cervix remains in your body.
- Total hysterectomy: Total hysterectomy is a procedure that involves removing your entire uterus and cervix.
- Radical hysterectomy: A radical hysterectomy includes the removal of your entire uterus, your cervix and other nearby structures like the upper vagina or surrounding lymph nodes. This type of hysterectomy is commonly associated with the treatment and prevention of cancer.
For each type of hysterectomy, it’s optional to include an oophorectomy, which is the removal of your ovaries. This might be recommended to prevent ovarian cancer if you’re at a higher risk of developing it, or if your ovaries are already impacted by overgrowth of uterine tissue due to endometriosis. If your ovaries are surgically removed, you’ll enter menopause, regardless of your age.
What Does a Hysterectomy Procedure Involve?
You have several options when choosing a hysterectomy procedure. Your surgeon will assist you in choosing the most appropriate procedure based on your medical history and the purpose of the hysterectomy. During this surgery, you’ll be given general or regional anesthesia, and the procedure typically takes between one and three hours. The different surgical techniques for a hysterectomy include:
- Vaginal hysterectomy: This procedure consists of removing your uterus through your vagina. This hysterectomy procedure is utilized when a person’s uterus isn’t too large and/or their vaginal canal is large enough for the procedure, typically due to previous childbirth.
- Laparoscopic hysterectomy: A laparoscopic hysterectomy utilizes a thin tube with a camera at one end called a laparoscope. The surgeon makes several small incisions on your abdomen, and, with the laparoscope and other small tools, cuts the uterus into small pieces that are removed through the incisions.
- Laparoscopy-assisted vaginal hysterectomy: This procedure is a combination of a vaginal and laparoscopic hysterectomies. The surgeon removes your uterus through a cut made inside your vagina, using a laparoscope for guidance.
- Robot-assisted laparoscopic hysterectomy: Similar to a laparoscopic hysterectomy, this procedure uses a special machine, or robot, in conjunction with a laparoscope to access your uterus.
- Abdominal hysterectomy: For this procedure, the surgeon makes a 6-inch to 8-inch incision in your abdomen, either vertically or horizontally, to access your uterus and/or surrounding tissue structures.
Potential Risks of a Hysterectomy
A hysterectomy is generally considered a low-risk surgical procedure. However, just like any other form of surgery, there’s a risk of complications that accompany a hysterectomy procedure. Such complications can include:
- Heavy bleeding or blood clots
- Damage to nearby organs (such as the urinary tract, bladder or rectum)
- Vaginal prolapse
- Allergic reaction to medication or anesthesia
- Early menopause
- Decreased sexual desire (more common with ovary removal)
- Emotional complications related to diagnosis or childbirth options
Many of these risks are uncommon; only a small portion of patients experience any complications at all from a hysterectomy. Keep in mind that people who undergo an abdominal hysterectomy tend to be at a higher risk for infection and complications after surgery than those who undergo a vaginal or laparoscopic hysterectomy.
If you experience any of the following symptoms following a hysterectomy, it’s important to contact a healthcare professional right away:
- Bright red bleeding
- Redness, swelling or drainage from the incision site
- Severe nausea or vomiting
- Increased pain
- Difficulty urinating
What to Expect Post-Op
Once your hysterectomy procedure is complete, you can expect to remain in the hospital for several days. Upon discharge from the hospital, full recovery can take around six weeks, depending on the type of hysterectomy you had. Your doctor may prescribe pain medication to alleviate any discomfort, and they’ll encourage you to start performing gentle movements to support your healing.