About Hysterectomy

A hysterectomy is an operation to remove a woman's uterus. Hysterectomy is the second most common major operation performed on women in the United States, after Cesarean section. A woman may have a hysterectomy for different reasons, including:

  • Uterine fibroids that cause pain, bleeding, or other problems.
  • Uterine prolapse, which is a sliding of the uterus from its normal position into the vaginal canal.
  • Cancer of the uterus, cervix, or ovaries.
  • Endometriosis which causes chronic pain and abnormal bleeding.
  • Adenomyosis which is an enlargement of the uterus that can cause chronic pelvic pain and abnormal bleeding.
  • Other less common causes of chronic pelvic pain or abnormal bleeding.
Hysterectomy is usually considered only after all other treatment approaches have been tried without success or contraindicated for medical reasons.

Types of Hysterectomy

Depending on the reason for the hysterectomy, a surgeon may choose to remove all or only part of the uterus. Patients and health care providers sometimes use these terms inexactly, so it is important to clarify if the cervix and/or ovaries are removed:

  • In a supracervical or subtotal hysterectomy, a surgeon removes only the upper part of the uterus, keeping the cervix in place.
  • A total hysterectomy removes the whole uterus and cervix.
  • In a radical hysterectomy, a surgeon removes the whole uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina.  Radical hysterectomy is generally only done when cancer is present.
  • The ovaries may also be removed -- a procedure called oopherectomy -- or may be left in place.

Surgical Techniques for Hysterectomy

Surgeons use different approaches for hysterectomy, depending on the surgeon’s experience, preference, the reason for the hysterectomy, and a woman's overall health. The hysterectomy technique will partly determine healing time and the kind of scar, if any, that remains after the operation.

There are two approaches to surgery – a traditional or open surgery and surgery using a minimally invasive procedure or MIP.

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Risks of Hysterectomy

Hysterectomy is a low-risk surgery. Most women who undergo hysterectomy have no serious problems or complications from the surgery. However, as with any surgery, hysterectomy can result in complications for a small minority of women. Potential complications relative to you medical condition will be discussed with you prior to any planned surgery.

What to Expect After a Hysterectomy

After a hysterectomy, if the ovaries were also removed, a woman will enter menopause and may require hormone replacement. If the ovaries were not removed, a woman will likely enter menopause at an earlier age than she would have otherwise.

Most women are told to abstain from sex and avoid lifting heavy objects for six weeks after hysterectomy.

After a hysterectomy, the vast majority of women surveyed feel the operation was successful at improving or curing their main problem (for example, pain or heavy periods).



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