Why is a hysterectomy performed?
- Abnormal or heavy vaginal bleeding that is not controlled by other treatment methods.
- Severe pain with menses that is not controlled by other treatment methods
- Leiomyomas or uterine fibroids (noncancerous tumors).
- Increased pelvic pain related to the uterus but not controlled by other treatment.
- Uterine prolapse (uterus that has "dropped" into the vaginal canal due to weakened support muscles) that can lead to urinary incontinence or difficulty with bowel movements.
- Cervical or uterine cancer or abnormalities that may lead to cancer for cancer prevention.
- Conditions with the lining of your uterus like hyperplasia, recurrent uterine polyps or adenomyosis.
Procedure Details
How do I prepare for a hysterectomy?
The doctor will explain the procedure in detail, including possible complications and side effects. Talk to them about any concerns you have. You may be asked to provide blood and urine samples.
What happens during a hysterectomy?
Your doctor will determine the type of hysterectomy you need and the best surgical method to perform that procedure. You will change into a hospital gown and get hooked up to monitors that track your heart rate. An intravenous (IV) line is placed in a vein in your arm to deliver medications and fluids.
An anesthesiologist will give you either:
- General anesthesia in which you will not be awake during the procedure; or
- Regional anesthesia (also called epidural or spinal anesthesia) in which medications are placed near the nerves in your lower back to "block" pain while you stay awake.
There are several different surgical approaches your healthcare provider may use to perform a hysterectomy:
Vaginal hysterectomy:
- Your uterus is removed through an incision at the top of your vagina. There is no external incision.
- Most commonly used in cases of uterine prolapse and other non-malignant (or noncancerous) conditions.
- Fewest complications and fastest recovery (up to four weeks) and is considered the preferred approach.
- Patients often go home the same day/next day of surgery.
Laparoscopic hysterectomy:
- A laparoscope (a thin tube with a video camera on the end) is inserted in the lower abdomen through a small incision in the belly button.
- Surgical tools are inserted through several other small incisions.
- Your uterus can be removed in small pieces through the incisions in your abdomen or through your vagina
- Some people go home the same day or after one night in the hospital.
- Full recovery is shorter and less painful than an abdominal hysterectomy.
Abdominal hysterectomy:
- Your uterus is removed through a six- to eight-inch-long incision in your abdomen.
- The incision is made either from your belly button to your pubic bone, or across the top of your public hairline. The surgeon will use stitches or staples to close the incision.
- Most commonly used when cancer is involved, when the uterus is enlarged or when disease spreads to other pelvic areas.
- It generally requires a longer hospital stay (two or three days) and a longer recovery time.
Your doctor will probably do tests that include a pregnancy test and a pelvic exam. They might give you an ultrasound to look at your uterus and fallopian tubes.
Treating Hysterectomy
Ectopic pregnancies aren’t safe for the mother. Also, the embryo won’t be able to develop to term. It’s necessary to remove the embryo as soon as possible for the mother’s immediate health and long-term fertility. Treatment options vary depending on the location of the Hysterectomy and its development.
How long does a hysterectomy procedure last?
The procedure lasts one to three hours. The time can vary depending on the size of the uterus, and the need to take down scarring from previous surgeries, and if other tissue, such as endometrial tissue, and other organs are being removed with your uterus (like your fallopian tubes or ovaries).
What are the most common side effects of a hysterectomy?
Some of the most common side effects of a hysterectomy are vaginal drainage (may occur up to six weeks after surgery) and irritation at the incision sites.
If your ovaries were removed at the time of your hysterectomy, you may experience menopausal symptoms such as:
- Hot flashes.
- Vaginal dryness.
- Loss of libido.
- Difficulty sleeping (insomnia).
Your doctor will discuss treatment options to avoid the side effects of menopause mentioned above.
What happens after a hysterectomy?
The amount of time you spend in the hospital following a hysterectomy varies depending on what kind of surgery you had. Your doctor will want to monitor you and ensure there are no signs of complications like blood clots or bleeding. You'll walk around as soon as possible after your surgery to prevent blood clots in your legs.
If you had an abdominal hysterectomy, you might stay in the hospital for a few days. Vaginal and laparoscopic hysterectomies are less invasive and typically do not require any overnight stay in the hospital.
Your healthcare provider will go over recovery instructions, including restrictions to your day-to-day activities. Be sure to discuss any concerns you have about your recovery or the procedure.
Risks / Benefits
What are the advantages of having a hysterectomy?
Having a hysterectomy can help you live a more enjoyable life, especially if you suffer from constant pelvic pain or heavy and irregular bleeding. If you're at a higher risk for uterine cancer, a hysterectomy can lower this risk and potentially be life-saving.
What are the disadvantages of having a hysterectomy?
A hysterectomy is major surgery with a long recovery. It comes with risks and side effects, and is permanent. Depending on the type of surgery you have, you can go into menopause or experience symptoms of menopause. You also won't be able to become pregnant after the procedure.
What are the complications of hysterectomy?
As with any surgery, there is a slight chance that problems may occur. Problems could include:
- Blood clots.
- Severe infection.
- Bleeding.
- Bowel blockage.
- Torn internal stitches.
- Urinary tract injury.
- Problems related to anesthesia.
Recovery and Outlook
How long does it take to recover from a hysterectomy?
Most people recover from a hysterectomy in about four to six weeks. Your recovery depends on the type of hysterectomy you had and how the surgery was performed. Recovering from a vaginal and laparoscopic hysterectomy takes less time than recovering from an abdominal hysterectomy.
You should increase your activity gradually and pay attention to how you feel. If anything causes you pain, you should stop. Talk to your healthcare provider about specific instructions for recovering at home, including what medications to take.
What should I know about recovering at home?
Vaginal and laparoscopic recovery take about two to four weeks. It may take up to six weeks to recovery from abdominal hysterectomy. Talk to your healthcare provider before going home to make sure you know how to best care for yourself.
Common instructions after hysterectomy are:
- You can experience light vaginal bleeding for one to six weeks. Use only a light pantiliner or sanitary pad to catch the discharge.
- Do not lift heavy objects (over 10 pounds) for at least four to six weeks.
- Do not put anything into the vagina for four to six weeks, or as directed by your healthcare provider.
- Do not have sex for six weeks after surgery.
- You may take a shower after consulting with your doctor.
- You can drive about two weeks after abdominal surgery or when you are no longer taking narcotics for pain. If you had a vaginal or laparoscopic hysterectomy, you might begin driving with a few days.
- Resume your exercise routine in four to six weeks, depending on how you feel
- You can usually go back to work in three to six weeks, depending on what kind of work you do.
