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Hysterectomy

Hysterectomy is a procedure to surgically remove the uterus (womb). In many cases, the cervix is also removed along with the uterus. Depending on the reason for the hysterectomy, surrounding tissues like fallopian tubes and ovaries are extracted.

Following a hysterectomy, you will lose the ability to become pregnant and menstruate. There are multiple reasons why a hysterectomy is performed, including fibroids and cancer. Due to advanced surgical technology, recovery after a hysterectomy usually takes four to six weeks.

Alternate name

Abdominal hysterectomy

Body location

Pelvic region

How is the surgery performed?

After evaluating your medical records, your doctor will decide the type of hysterectomy procedure you need and the best technique. You will need to change into the hospital gown, and an IV line will be placed in a vein in your arm.

An anesthesiologist will give you regional or general anaesthesia. After that, the surgeon will perform the hysterectomy using one of the following surgical techniques:

  • Vaginal hysterectomy: In this type of hysterectomy, your doctor makes an incision in the upper wall of the vagina to remove the uterus. This technique does not have an external incision, and dissolvable stitches are placed. You can go home on the same day of the procedure. A vaginal hysterectomy is used for uterine prolapse and non-malignant uterine conditions.
  • Laparoscopic hysterectomy: A laparoscope is a thin tube with a camera at its tip. This laparoscope is inserted through a small incision below your belly button into the abdomen. The uterus can be removed in parts. You can return home the same day of the procedure or after a night at the hospital. Laparoscopic hysterectomy has shorter recovery times than abdominal hysterectomy.
  • Abdominal hysterectomy: In this type of hysterectomy, the uterus is removed through a 6- to 8-inch-long abdominal incision. This incision goes from your belly button to your pubic bone or across the pubic hairline. This technique is used in advanced cases of uterine cancer and requires a more extended hospital stay. Recovery time is longer with this technique.

A typical hysterectomy takes between one to three hours, depending on the size of the uterus, the presence of scar tissue from earlier surgery and if any other organs need to be removed.

Preparation 

If you need a hysterectomy, your doctor will discuss the procedure and how it is performed. You will also know what to expect after the procedure and the time for healing.

Preparatory steps before the hysterectomy include:

  • Stopping your blood thinning medications like aspirin, ibuprofen, and warfarin.
  • Evaluating your medical history and the medications you are taking with the doctor. They will inform you if you must stop taking any medications or nutritional supplements before surgery.
  • Quitting smoking before the procedure to ensure normal healing.
  • Undergo a few blood and urine investigations.

 You will need to stay in the hospital for a few days. Be sure to make the necessary arrangements and ask a friend or family member to accompany you for your surgery.

Procedure type

Minimally-invasive surgical procedure.

Follow up

After your hysterectomy, you will usually require a few hours in the recovery room. Your healthcare team will monitor your health and signs of pain. You will receive medicines for pain and infection. You are encouraged to walk soon after surgery once the pain is bearable. 

You may require one to two days of hospital stay after your hysterectomy, depending on the type of procedure. You may notice bleeding or discharge for a few days to weeks after a hysterectomy. However, inform your doctor if you have heavy menstrual bleeding. Your abdominal incision will heal in a few weeks to a month, but the scar may be visible.

Risks 

Any surgery comes with some amount of risk. A few common risk factors of hysterectomy are:

  • Allergy to medications used
  • Bleeding
  • Infection
  • Blood clots
  • Injury to the bladder or the uterus
  • Pain during sexual intercourse
  • Decreased interest in sex
  • Increased risk of heart disease if one or both ovaries are removed before menopause

Recovery

A hysterectomy procedure is major surgery and will require a few days of hospital stay. You will need six to eight weeks to recover completely. However, recovery times can vary from person to person and also depend on the type and extent of surgery. After your hysterectomy, you must get as much rest as possible. Avoid picking up heavy items like shopping bags or suitcases. Since the incision is made through your abdominal muscles, you must allow them to heal before returning to your regular workout routine. Your doctor will inform you about recovering at home.

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