A hysterectomy is a surgical procedure to remove a person’s uterus. The uterus, also known as the womb, is where a baby grows when a person 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.
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
- unmanagable 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
- uterine bleeding, which can sometimes occur after pregnancy
There are several different types of hysterectomy.
During a partial hysterectomy, your doctor removes only a portion of your uterus. They may leave your cervix intact.
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. But 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.
A hysterectomy is a very common, safe, and low risk surgery. But a hysterectomy may not be the best option for all people. It shouldn’t be performed on anyone with a uterus who still wants 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.
- hormone therapy
- oral contraception
- pain medications
- laprascopic surgery
- surgery to sear pelvic nerves
- uterine artery embolization, which is used to treat bleeding from fibroids
- endometrial ablation, which is a procedure that destroys the lining of the uterus in an attempt to ease heavy bleeding
- dilation and curettage (D&C), which removes tissue from inside the uterus
But in some circumstances, a hysterectomy is clearly the best choice. It’s usually the only option for treating uterine or cervical cancer.
It’s important to discuss your options with your doctor and determine the best choice for your specific condition.
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.
During 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.
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.
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 it one piece at a time.
Preparing for surgery can be a stressful experience, but there are steps you can take to prepare yourself and make the procedure, and recovery, as smooth and stress-free as possible.
Gathering as much information as possible will help you feel confident and prepared before surgery.
Be sure to write down and discuss any questions you may have with your doctor and surgeon, and research the procedure and recovery so that you know what to expect.
You should also talk with your doctor about any medications, supplements, or herbal products you are taking and find out if you have to change your medication routine before or after surgery.
Some medications may interact with the anesthesia used during an abdominal hysterectomy, so it’s important that you discuss any medications with your doctor ahead of time.
You should also ask your doctor about what type of anesthesia you’ll have and how long you’ll have to stay in the hospital after surgery. Hospitalization times post-procedure will depend on what type of surgery you have.
Before surgery, you should be taking steps to be as healthy as possible. Doing so will reduce your risk of developing complications and help you recover more quickly.
As soon as you know you’re going to have a hysterectomy, you should:
- stop using nicotine (cigarettes, vaping, using other nicotine products)
- focus on eating a nutritious diet
- exercise regularly
- lose weight if your doctor has reccomended it
- try to reduce stress
Make sure you have someone to drive you home from the hospital after surgery. Your activity will be restricted in the days and weeks after surgery, so you should arrange for help at home if possible.
Finally, be sure your insurance coverage is in order so that you can avoid surprise medical bills after your surgery. Before your procedure, ask who will be involved in your care and ensure that each provider is in your plan’s network.
A hysterectomy is considered to be a fairly safe procedure. But as with all major surgeries, there are associated risks. Some people may have an adverse reaction to the anesthetic. There’s also the risk of heavy bleeding and infection around the incision site.
Other risks include injury to surrounding tissues or organs, including the:
- blood vessels
These risks are rare. But if they occur, you may need a second surgery to correct them.
Depending on the type of hysterectomy you’ve had, you’ll most likely need to spend 1 to 5 days in the hospital. Your doctor will give you medication for the pain and monitor your vital signs, like 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. But you may experience bloody or brownish drainage from your vagina for a few days after that. 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. But you should avoid performing certain activities during recovery. These include:
- pushing and pulling objects, like a vacuum cleaner
- lifting heavy items
- 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 3 to 4 weeks. Recovery time will be a little longer if you’ve had an abdominal hysterectomy. You should be completely healed in about 6 to 8 weeks.
A hysterectomy is a major surgery that permanently changes your life.
After a hysterectomy, you’ll no longer have menstrual periods or be able to become pregnant. You’ll also likely feel relief from any symptoms that prompted your surgery in the first place.
Importantly, you may also feel emotional side effects following your hysterectomy.
While many people feel relief from having a hysterectomy, the dramatic and permanent changes — like losing the ability to become pregnant or no longer having a menstrual period — and can bring complicated and confusing emotions.
This is normal, and support groups like Hystersisters may help you navigate these emotions.
If you have a hysterectomy before menopause and have your ovaries removed, you’ll begin menopause. If you keep your ovaries, you may experience menopause at a younger age than average.
Short term side effects
Short-term side effects can happen during or in the days and weeks following a hysterectomy. These are usually temporary and may include:
- bladder problems
- blood clots in legs or lungs
- problems with urination (losing the feeling of having to urinate)
While these side effects may only be temporary, it’s important to talk with your doctor ASAP if you notice any of these occurring after surgery.
Long-term side effects
Long-term side effects may develop months or years after a hysterectomy. They may last a long time. These side effects may include:
- lymphedema, a buildup of fluid in the legs or abdomen
- weakness of muscles or ligaments that support the vagina, bladder, and rectum
- vaginal shortening
- intestinal blockage caused by scar tissue
Many times, these long-term side effects can be eased with a treatment plan designed by your doctor. Make sure to let your doctor know about any side effects you’re dealing with, even if they seem to pop up months down the line.
A hysterectomy is a relatively safe surgery that culminates in the removal of a person’s uterus. There are a few different types of hysterectomies, and your doctor will help you decide which one is best for your situation.
While this surgery is common and mostly safe, there can be some side effects, and some emotional distress is possible.
Make sure you take the time to talk with your doctor and get all the facts about this surgery so you can be prepared when the time comes. For many people, a hysterectomy can provide relief — and may even save their life.