Gynecology

Hysterectomy

What happens during and after a hysterectomy?

Hysterectomy Why Would I Need One? The Procedure Recovery

What is a Hysterectomy?

A hysterectomy is a surgery to remove all or part of the uterus, the muscular organ that bleeds when women have their periods. It is the second most common procedure in the United States for women of reproductive age.

There are different reasons why your doctor may suggest a hysterectomy, and there are also different approaches. There might also be alternatives.

Why would I need a hysterectomy?

A hysterectomy treats many conditions, but your doctor may suggest other options if you have not yet tried medications or other interventions. There are instances, such as when cancer is present, when a hysterectomy might be the best treatment. Conditions treated by a hysterectomy include:

Uterine fibroids. While most fibroids are benign, they can cause heavy bleeding and pain.
Endometriosis. When the tissue that lines the uterus (endometrium) grows outside of it, you can experience severe pain.
Adenomyosis. If the uterine lining grows inside the wall of the uterus, the wall can become thick, which can lead to bleeding and pain.
Uterine prolapse. When the uterus protrudes into the vagina, you might feel pressure or pain.
Cancer or pre-cancer of the uterus, ovary, cervix or the lining of the uterus.

Note that the removal of the uterus might not cure all symptoms, which is why it’s critical to discuss all available options. Women who want to have a pregnancy in the future are not candidates for hysterectomy.

The Procedure

The health care providers at ChristianaCare’s Center for Advanced Gynecology and Minimally Invasive Surgery can help you arrive at the best choice for your body and medical concern.

What are the different types of hysterectomies?

A total hysterectomy - The surgeon will completely remove the uterus, including the cervix
A partial hysterectomy - Known as a subtotal, partial or supracervical, this type of hysterectomy involves the removal of the upper part of the uterus. The cervix remains
A radical hysterectomy - The uterus, cervix, the tissue on both sides of the cervix and the upper part of the vagina are removed

In each of these surgeries, the ovaries and the fallopian tubes may also be removed, depending on whether they present a potential problem. Removal of these organs is not included in a standard hysterectomy; your doctor will talk about this option separately.

How is a hysterectomy performed?

There are several approaches, including:

Abdominal hysterectomy - In certain circumstances—such as scar tissue from a previous surgery or the presence of a significantly sized growth - an incision is made to the lower abdomen to access the uterus. This surgery often has a longer recovery time, and there can be more risks of complications. If at all possible, your doctor will prefer to take a minimally invasive approach.
Vaginal hysterectomy - The surgeon goes through a small cut in the vagina for a minimally invasive procedure.
Laparoscopic hysterectomy - Small incisions are made to the abdomen through which the surgeon inserts instruments and a camera. The uterus is removed through these cuts or the opening at the top of the vagina
Robotic hysterectomy - The surgeon uses a computer to operate robotic arms and a camera to perform the surgery through small cuts in your lower abdomen that are similar to those made for a laparoscopic hysterectomy

How long will it take to recover?

The recovery time will depend on the type of surgery. It may take from three to six weeks to fully recover. Your health care provider can share what to expect right after the surgery and discuss any changes in your body that you might experience after your uterus is removed.

ChristianaCare offers classes for women having a hysterectomy. You can register online.

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