What Is a Hysterectomy?

Having your uterus removed during a hysterectomy is a big step, but recovery is usually complete in about six weeks and the benefits may be worth it for you.

What is a hysterectomy?

Several conditions might lead your doctors to advise that you have your uterus surgically removed. The uterus is where a baby grows when you are pregnant.

You will no longer menstruate after a hysterectomy. Normally, you will have tried every other kind of remedy first. But if you are in constant pain or have cancer or are at high risk for cancer in this area, the procedure can change or save your life.

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Why might you need a hysterectomy?

In every case, your doctors should consider every other kind of remedy before advising surgery. You might need a hysterectomy because of:

• Uncontrollable heavy, abnormal vaginal bleeding that might become dangerous. This may have been triggered by endometriosis, when cells in the uterine lining grow outside of the uterus, attach themselves to other organs in the pelvic cavity, and bleed each month in accordance with an ovarian cycle. Besides bleeding, you might have chronic pain or pain during sex.
• Severe menstruation pain.
• Fibroids, noncancerous tumors.
• Blockage in the bladder or intestines because of the uterus.
• Pain in your pelvis caused by your uterus.
• Uterine prolapse (when the uterus drops down into the vagina because of weak muscles). This can lead to uncontrolled urination or difficulty with bowel movements.
• Endometrial, cervical, or uterine cancer or abnormalities that might lead to cancer. About only 10 percent of hysterectomies are performed to handle cancer.
• Adenomysis, or thickening of the uterus.

What are the different kinds of hysterectomy?

• In a total hysterectomy, surgeons remove the uterus and cervix (the canal between the uterus and vagina) but leave the ovaries.
• In a supracervical hysterectomy, the upper part of the uterus is removed but not the cervix.
• In a total hysterectomy with bilateral salpingo-oophorectomy, the fallopian tubes and ovaries are removed along with the uterus and cervix.
• In a radical hysterectomy with bilateral salpingo-oophorectomy, surgeons also remove the upper part of the vagina and some other surrounding tissue, to stop cancer.

Depending what tissue will be removed, surgeons have different options.

• One option is to remove the uterus through an incision at the top of your vagina. This approach has the fewest complications, and you might be able to go home the same day. Most patients recover in a month.
• In a laparoscopic hysterectomy, your surgeon inserts a thin tube with a video camera through your belly button and removes your uterus in small pieces. Sometimes surgeons use robotic arms and instruments. Some people can go home the same day or after one night in the hospital.
• In an abdominal hysterectomy, your surgeon makes a six- to eight-inch incision in your abdomen, across the top of your pubic hairline or vertically from your belly button to your pubic bone. This approach can require three days in the hospital and is usually used when the uterus is enlarged or the disease has spread.

How common is a hysterectomy?

After a C-section to give birth, a hysterectomy is the second most common surgery performed among women in the United States. Every year, about 300,000 women have this surgery. The procedure lasts one to three hours.

Side effects of a hysterectomy

It’s normal to have light bleeding or a dark brown discharge after surgery and some burning or itching around the incisions. You might feel gassy and have a puffy or swollen belly. Some people feel numbness in their legs. If your ovaries are removed, you will enter menopause and may have some symptoms of menopause, which include hot flashes, a dry vagina, loss of libido, and insomnia.

Some women develop blood clots, infection, bleeding, torn stitches, or other problems related to the surgery. Do not lift heavy objects (over 10 pounds) for at least four to six weeks.

Do not put anything in your vagina for a month to six weeks and do not have sex. Hold off on exercise for that long. You might be able to go back to work in three to six weeks. How quickly you can drive will depend upon the procedure you have.

Your emotional reactions can be mild or strong. It’s important to agree to a hysterectomy only after you are prepared to lose the chance of pregnancy.

Do I still need a Pap test if I have had a hysterectomy?

If you had a hysterectomy because of cancer, continue to get Pap tests. Otherwise, you may not need them. Ask your doctor to be certain.

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