What Is a Hysterectomy?
This article will explain what a hysterectomy is. It will also describe why people choose to have one, what the surgery is like, and what to expect after.
A hysterectomy is the removal of the womb or uterus. It is a commonly performed surgery and means you will no longer be able to get pregnant after.
Sex and gender terms
Sex and gender exist on spectrums. This article will use the terms “female” and “women” when discussing people assigned female at birth to reflect language that appears in source materials.
Although it is common, it is major surgery with significant risks and potential complications. Your body may experience other changes as well, including early menopause if you remove both ovaries.
You may have less invasive treatment options depending on your condition and specific circumstance, so consider getting a second opinion about your treatment options before having a hysterectomy.
The types of hysterectomy procedures include:
- Supracervical hysterectomy: This can be a subtotal or partial hysterectomy. It is the removal of part of the uterus, leaving the cervix intact.
- Total hysterectomy: This is the removal of both the uterus and the cervix.
- Radical hysterectomy: This is an extensive surgery that includes the removal of the uterus, the top of the vagina, and tissues around the cervix. Your doctor may perform a radical hysterectomy if you have cancer.
Other surgical procedures alongside a hysterectomy
Your doctor may perform other procedures in addition to a hysterectomy. These include:
- Oophorectomy: This is the removal of one or both ovaries, which are glands that produce eggs and female hormones. Ovary removal may be necessary for certain conditions, such as cancer.
- Salpingectomy: This is the removal of one or both fallopian tubes, which connect the ovaries to the uterus.
Your doctor may recommend a hysterectomy to treat various conditions of the uterus and reproductive system.
Your doctor may only consider one if other treatment options that involve less risk and fewer complications have been ineffective in treating your condition.
Ask your doctor about all of your treatment options to understand which option may be right for you. Consider getting a second opinion, especially if you still want to bear children or have not yet reached menopause.
Your doctor may recommend a hysterectomy for:
- Abnormal vaginal bleeding: This is when bleeding does not improve with other treatments, such as medication or procedures that do not involve removal of the uterus.
- Adenomyosis: This is a thickening of the uterus that causes heavy, painful periods. In some cases, you can treat adenomyosis with medications instead of a hysterectomy. It may go away on its own after menopause.
- Cancer of the cervix, ovaries, or uterus: Often, this is endometrial cancer. You can treat certain cases of cervical cancer or precancerous changes of the cervix without removing the uterus.
- Childbirth complications: This can include uncontrolled bleeding or uterine rupture, which is rare.
- Chronic pelvic pain: You may get a hysterectomy for chronic pelvic pain if it does not improve with other treatments.
- Endometriosis: This involves tissue similar to that found in the uterus (endometrial tissue) growing outside the uterus. It causes severe menstrual pain, chronic low back and pelvic pain, and uncommon vaginal bleeding. You can treat it with medications instead of a hysterectomy or a minimally invasive laparoscopic procedure.
- Uterine fibroids: Benign tumors of the uterus cause significant bleeding and pain, and may result in fibroids. Fibroids may need no treatment. But you can treat them with medications or less invasive procedures, such as a uterine artery embolization myomectomy.
- Uterine prolapse: This is the uterus dropping or sliding into the vagina. You can treat uterine prolapse with a hysterectomy. Other treatment options include a vaginal device that holds the uterus in place and a surgical procedure that uses ligaments to support the uterus.
The following specialists perform hysterectomies:
- Obstetrician gynecologists: They specialize in female reproductive health and pregnancy.
- Gynecologic oncologists: They specialize in diagnosing, treating, and preventing cancer of the female reproductive system.
A doctor can perform a hysterectomy as an open procedure, through the vaginal canal, or as a minimally invasive laparoscopic procedure.
A laparoscopic hysterectomy uses very small incisions instead of the large incision made in open surgery. Laparoscopic surgery generally entails a faster recovery time and less pain than open surgery.
Surgical approaches to a hysterectomy
A surgeon can perform a hysterectomy using one of the following approaches:
- Abdominal hysterectomy: Also called an open hysterectomy, this is the removal of the uterus through a 5-to-7-inch incision in the lower part of your belly. The incision may be vertical or horizontal. A surgeon will place a horizontal incision very low on the abdomen so that it is not easily visible.
- Vaginal hysterectomy: This is the removal of the uterus through an incision made in the vagina.
- Laparoscopic hysterectomy: This is the removal of the uterus through several small incisions in your abdomen. A surgeon will insert a small tube fitted with a special camera and other surgical instruments through the small incisions to remove the uterus.
- Laparoscopically-assisted vaginal hysterectomy: This is a vaginal hysterectomy that uses a laparoscopic camera to help your doctor see the uterus and surrounding tissues.
- Robot-assisted laparoscopic hysterectomy: This is similar to a laparoscopic hysterectomy but includes a surgeon-controlled robotic device attached to surgical instruments and a laparoscopic camera.
Your doctor will determine which type of hysterectomy may be right for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.
Types of anesthesia used
Hysterectomy surgery uses either general anesthesia or a nerve block.
- General anesthesia: This is generally when a combination of IV medications and gases puts you in a deep sleep. You are unaware of the procedure and do not feel any pain. You may also receive a peripheral nerve block infusion. A peripheral nerve block infusion is an injection or continuous drip of a liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to manage your pain during and after surgery.
- Regional anesthesia: This is also known as a nerve block. Regional anesthesia involves injecting an anesthetic around the nerves in the spine that transmits pain signals from the surgical area. This temporarily eliminates all pain during surgery. You will likely have sedation under regional anesthesia to keep you relaxed and comfortable.
As with all surgeries, a hysterectomy involves risks and the possibility of complications. Complications may become serious and life threatening in some cases. Complications can occur during surgery or recovery.
Complications of a hysterectomy can be serious and include:
- damage to your urinary tract, bladder, rectum, or other pelvic structures during surgery, which may lead to problems, such as urinary or fecal incontinence, and require further surgical repair
- early onset of menopause if there is the removal of both ovaries
Reducing your risk of complications
You can reduce the risk of certain complications by following your treatment plan and doing the following:
- following activity, dietary, and lifestyle restrictions, and recommendations from your doctor before surgery and during recovery
- notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, wound redness or discoloration, swelling, or drainage
- taking your medications exactly as directed
- telling all members of your care team if you have any allergies
Call your doctor if you have questions or concerns between appointments. Call your doctor right away or get immediate medical care if you have:
- problems breathing, such as shortness of breath, difficulty breathing, labored breathing or wheezing
- changes in alertness, such as passing out, unresponsiveness, or confusion
- chest pain, tightness, pressure, or palpitations
- fever, although a low grade fever is common for a couple of days after surgery and not necessarily a symptom of a surgical infection
- inability to urinate or have a bowel movement
- leg pain, redness, discoloration, or swelling, especially in the calf, which may indicate a blood clot
- uncontrolled or heavy bleeding
- drainage unexpectedly, pus, redness, discoloration, or swelling of your incision
Facing surgery can be stressful. It is common for people in these situations to forget some of their questions during a doctor’s office visit.
You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments.
It is also a good idea to bring a list of questions to your preoperative appointments. Questions can include:
- Why do I need a hysterectomy? Are there any other options for treating my condition?
- What type of hysterectomy procedure will I need?
- How long will the procedure take? When can I go home?
- What kind of restrictions will I have after the surgery, and when can I return to work and other activities?
- What kind of assistance will I need at home?
- What medication plan should I follow before and after the surgery?
- How will you help manage my pain?
- When should I follow up with you?
- How should I contact you? Ask for numbers to call during and after regular hours.
Here are some frequently asked questions about hysterectomies.
What is the recovery time for a hysterectomy?
You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. Sore throats often occur if a tube was in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.
In some cases, such as after a laparoscopic supracervical hysterectomy, you may be able to go home on the same day. You may need to stay up to 6 days in the hospital for more extensive procedures, such as an abdominal hysterectomy.
Recovery after surgery is a gradual process. Recovery time varies depending on the specific procedure and type of anesthesia used, your general health, age, and other factors. Full recovery times range from about 6–8 weeks.
How painful is a hysterectomy?
Pain management is important for healing and a smooth recovery. There will be discomfort after your procedure. Your doctor and care team can help manage your pain so that you are comfortable and can get the rest you need.
Contact your doctor if your pain gets worse or changes in any way because it can be a symptom of a complication.
How might a hysterectomy affect my everyday life?
A hysterectomy may cure your condition or reduce your symptoms so that you can lead a full life. For example, a hysterectomy may effectively treat heavy menstrual bleeding, pelvic pain, and pain with sexual intercourse. You will still need to have regular pelvic exams and possibly Pap tests after a hysterectomy.
A hysterectomy can also cause significant changes to your body that may affect your everyday life such as early menopause, loss of childbearing ability, and sexual changes.
A hysterectomy is a procedure in which a healthcare professional surgically removes the womb or uterus. After the removal, you will not be able to get pregnant.
Healthcare professionals usually perform hysterectomies to treat health conditions associated with the uterus such as pelvic pain, heavy periods, noncancerous tumors, and various types of cancer such as ovarian or cervical.
Speak with your doctor if you are considering having a hysterectomy. There are many alternatives to surgery that you may consider first, as having a hysterectomy is a permanent, major surgery.