What is a hysterectomy and why is it done?

Hysterectomy is a surgical procedure in which the uterus is removed. There are several types of hysterectomy.

A partial hysterectomy is when only the upper part of the uterus is removed and your cervix is left in place. This is also known as a supracervical hysterectomy.

A total hysterectomy is when both the uterus and cervix are removed.

A radical hysterectomy, or a total hysterectomy with bilateral salpingo-oophorectomy, is when the uterus and cervix are removed along with surrounding structures, such as the ovaries and fallopian tubes.

The most common reason for a hysterectomy is uterine fibroids. Others reasons include:

  • endometriosis, which is an overgrowth of tissue in the uterine lining
  • adenomyosis, which occurs when endometrial tissue grows into the walls of the uterus
  • uterine prolapse
  • abnormal bleeding
  • chronic pelvic pain
  • a gynecologic cancer or precancer

There are three ways to perform a hysterectomy:

  • abdominally, through a surgical incision
  • laparoscopically
  • vaginally

The method will be based on the reason for the surgery, plus other health considerations.

In the United States, hysterectomy is the second most common surgery among women, after cesarean delivery.

Continue reading to learn more about vaginal hysterectomy and what to expect during recovery.

Before the day of your surgery, you’ll receive information on how to prepare. This may involve blood and urine tests, as well as an enema or other bowel prep.

As you are prepped for surgery, an IV will be placed in your arm to deliver fluids and medications. Your pubic area will be cleaned with antiseptic solution, and then shaved.

You won’t have an abdominal incision, but it’s still surgery, so you’ll need general anesthesia. Or you may have an epidural instead of general anesthesia.

A tube will be placed down your throat to help you breathe. Another tube helps to remove gas from your stomach. These tubes are generally inserted and removed while you’re asleep.

A catheter may be inserted into your bladder to handle urine. Compression stockings are used to help prevent blood clots in your legs while you’re in surgery.

The surgeon will use long instruments through a vaginal incision to detach your uterus from the following:

  • upper vagina
  • fallopian tubes
  • ovaries
  • connective tissue
  • blood vessels

The uterus will then be removed through the vagina. Some doctors use a laparoscope to assist in a vaginal hysterectomy.

Dissolvable stitches will be used to close the incision. The surgery takes from one to three hours.

You’ll be given medication to prevent infection, plus a pain reliever, if necessary. You should be in the recovery room for an hour or two while your vital signs are monitored.

After that, you’ll be transferred to a room. Before long, you’ll be asked to stand up and move around a bit.

It’s not unusual to have a few cramps or feel a little bloated following a hysterectomy. Most women also have a bloody vaginal discharge after a hysterectomy that is normally a brownish color and may have a slight odor. This can continue for a few days to several weeks.

Recovery time for a vaginal hysterectomy is shorter than for an abdominal hysterectomy. You’ll be able to leave the hospital after a day or two, depending on how well you are recovering. The hospital will provide you with instructions regarding driving, bathing, and showering.

You’ll be able to enjoy a normal diet and move around as much as is comfortable. Try to move a little bit more every day. For the first four weeks or so, you’ll be advised not to lift anything that weighs more than 10 pounds.

It usually takes three to six weeks for a full recovery and return to normal activities, including sexual intercourse.

Follow up with your doctor as advised.

A vaginal hysterectomy is less risky than an abdominal hysterectomy, but any surgery can have complications. Some of these are:

  • allergic reaction to anesthesia
  • infection
  • blood clots
  • bleeding
  • damage to the bladder or urinary tract
  • bowel obstruction

Let your doctor know if you experience any of the following symptoms:

  • heavy or bright red vaginal bleeding
  • swelling
  • nausea and vomiting
  • increasing pain
  • urinary problems
  • fever above 100°F (37.8°C)
  • chest pain
  • difficulty breathing

Certain things will change after your hysterectomy. How you feel about those changes depends on the reasons for the surgery and your life circumstances. It’s a very personal process, but these are some of the changes you can expect:

Menstruation: You won’t have any more periods or need to buy feminine hygiene products.

Contraception: You’ll never need birth control again. But you’ll still need to protect yourself from sexually transmitted diseases (STDs).

Routine Pap tests: If you no longer have a cervix, and your surgery was for reasons other than precancer or cancer, you may no longer need Pap tests. Ask your doctor if routine Pap tests are necessary for you.

Sexuality: Sexual function should return to normal after you fully recover from a hysterectomy. Depending on the reasons for your surgery, you may find it more pleasurable, since periods and birth control are no longer an issue.

Hormonal changes: If you still have your ovaries, you won’t experience hormonal changes. If your ovaries were removed, menopause will follow. You may experience symptoms of menopause that include:

  • hot flashes
  • vaginal dryness
  • mood changes
  • discomfort during intercourse
  • decreased libido

If symptoms become a problem, talk to your doctor about possible remedies. You may also need to increase your intake of calcium and vitamin D. If menopausal symptoms are severe, hormone replacement therapy may be an option.

Emotional changes: Everyone reacts differently to surgery and many things can affect your emotions, including hormonal changes. Depending on why you needed surgery and your feelings about fertility, you may experience a range of emotions.

This is normal, so don’t hesitate to discuss it with your doctor, especially if you have feelings of depression.

Overall, a vaginal hysterectomy involves less time in the hospital and a faster recovery time. Unless you had complications, it’s also likely to cost less than an abdominal hysterectomy.

Most women make a full recovery and can resume normal activity within six weeks.

Follow your hospital’s discharge instructions. After a vaginal hysterectomy, it might be tempting to try to speed up recovery, but that can actually set you back and increase recovery time. Instead, try to follow these tips:

  • Move a little more each day.
  • Avoid lifting anything heavier than 10 pounds for the first four weeks. Ask for help.
  • Eat a healthy, balanced diet, and drink plenty of fluids.
  • Allow plenty of time to rest so your body can heal.
  • Report unexpected symptoms to your doctor.
  • Make and keep your post-surgery follow-up appointment.