There are four types of hysterectomy. The one you have will depend on why you need it and how much of your reproductive system can safely remain.
A hysterectomy involves the removal of part or all of the uterus. Some types of hysterectomy also take away other parts of the reproductive system.
Read on to find out more about all types of hysterectomy surgery available and when one method might be recommended over another.
A total — or complete — hysterectomy is the most common type. It involves the removal of the uterus and cervix. The ovaries and fallopian tubes are left alone.
A complete hysterectomy may be chosen to treat noncancerous conditions like:
Since the cervix is removed, there’s no chance of developing cervical cancer in the future. That means you won’t need to attend cervical screening appointments after surgery.
A subtotal hysterectomy (also known as a partial or supracervical option) is a little different. While the main part of the uterus is still removed, the cervix is left inside the body.
Doctors might choose this option to treat fibroids or noncancerous conditions like endometriosis.
Some people prefer to have some parts of their reproductive system left intact and may opt for this form of hysterectomy if given the choice. But there’s no distinct advantage or disadvantage to having a cervix.
If you have this type of hysterectomy, you’ll still need cervical screening throughout your life and may have vaginal bleeding similar to a monthly period.
While a total hysterectomy involves the removal of the uterus and cervix, the addition of bilateral salpingo-oophorectomy means the ovaries and fallopian tubes are also removed.
This procedure is typically recommended for people who are at risk of conditions like ovarian cancer.
Afterward, you’ll experience what’s known as surgical menopause. This is triggered by the removal of the ovaries and has similar symptoms to regular menopause.
Surgical menopause may increase the risk of:
Your doctor will be able to guide you through surgical menopause and offer ways to relieve symptoms when needed.
Your clinician may recommend a radical hysterectomy to remove the uterus, cervix, and surrounding tissues. These can include the ovaries, fallopian tubes, lymph glands, and the top part of the vagina.
During a vaginal hysterectomy, an incision is made in the top of the vagina. Your surgeon will remove the uterus and cervix, if needed, through that incision.
It’s a relatively short and minimally invasive procedure that often takes around an hour. You may be unconscious throughout or may remain awake. Either way, you’ll receive an anesthetic so you won’t feel any pain.
Vaginal hysterectomies are the preferred method wherever possible. They typically have quicker recovery times than abdominal surgeries, taking around
It’s normal to experience cramps, bloating, and some brown discharge for a few weeks after surgery. You may have to wait a while before doing anything like heavy lifting, inserting period products, and penetrative sex.
While there are fewer risks with a vaginal hysterectomy than other hysterectomy surgeries, there are still some potential complications to be aware of. These include:
Also known as keyhole surgery, a laparoscopic hysterectomy involves making a small incision in the stomach for a camera to be inserted.
Your surgeon will use the camera to see inside your body. Then, they are able to use other small incisions in the stomach or vagina to remove the uterus and other parts if needed.
Sometimes, they’ll use a robotic arm to perform the surgery — this can lead to less scarring and blood loss.
Research from 2020 found that a robotic laparoscopic hysterectomy may be safer, with a 77.6% 5-year survival rate. Standard laparoscopic hysterectomies had a 76.8% survival rate, and abdominal surgeries had 72.5%.
Unlike a vaginal hysterectomy, laparoscopic surgery usually requires general anesthesia, meaning you’ll be asleep throughout.
Surgeons typically choose this form of surgery if they’re not able to perform a vaginal hysterectomy.
Compared with an abdominal hysterectomy, laparoscopic surgery results in a shorter hospital stay and a faster recovery time. The average recovery time is
An abdominal hysterectomy is the most invasive route of tissue removal.
Usually, your surgeon will only opt for this type of surgery if the other forms of hysterectomy are not suitable for you. For instance, if your uterus is bigger due to fibroids or a tumor it will need a bigger incision to remove it.
For this type of hysterectomy, you’ll be given a general anesthetic to make you fall asleep. Your surgeon will make an incision in your lower stomach — either horizontally or vertically from the belly button — and use it to remove the uterus and other parts.
Abdominal surgery may also be recommended if your ovaries need to be removed via a total hysterectomy with bilateral salpingo-oophorectomy or a radical hysterectomy.
Recovery time for an abdominal hysterectomy can be a little longer, at around
More invasive surgeries carry more risk of complications, including:
- heavy bleeding or blood clots
- problems with breathing or the heart
- injuries to other organs
Death is also a potential risk. But remember that hysterectomy is still considered a safe surgery.
The type of hysterectomy you have and the surgical procedure used will depend on a few things:
- why you’re having a hysterectomy
- the size and shape of your reproductive organs
- your current health
- your future risk of reproductive cancers
- how experienced your surgeon is
- the technology your hospital has available
Of course, you will also be given a say if more than one option is available to you.
Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.