What is a hysterectomy?
Hysterectomy is surgery to remove the uterus. Your healthcare provider may also remove one or both ovaries, and the fallopian tubes. In some cases, he or she may remove other parts of the reproductive system.
The types of hysterectomy include:
- Total hysterectomy. Your provider removes the whole uterus including the cervix, but not the fallopian tubes or ovaries. It’s the most common type of hysterectomy.
- Hysterectomy with salpingo-oophorectomy. Your provider removes one or both ovaries, and the fallopian tubes, along with the uterus.
- Radical hysterectomy. Your provider removes the uterus, cervix, and the top part of the vagina. The pelvic lymph nodes may also be removed. Some cases of cancer call for this surgery.
- Supracervical hysterectomy (partial or subtotal hysterectomy). Your provider removes the body of the uterus while leaving the cervix whole.
Hysterectomy techniques include:
- Abdominal hysterectomy. Your healthcare provider makes a large incision in your abdomen and removes the uterus. He or she will use this method to remove the fallopian tubes, when the uterus is enlarged, or when disease has spread to the pelvic cavity, as in endometriosis or cancer. The incision can be made from the navel down to the pubic bone, or along the top of the pubic hairline.
- Vaginal hysterectomy. In this method, your provider removes the uterus through the vaginal opening. It’s most often used for uterine prolapse, or when vaginal repairs are needed. You will not need an incision, which means there is no visible scarring.
- Laparoscope-assisted vaginal hysterectomy. Your provider uses a laparoscope, a thin, flexible tube with a video camera, for this method. He or she inserts thin tubes through tiny incisions in the abdomen near the navel. Your provider removes the uterus in sections through the laparoscope tube or through the vagina.
Your healthcare provider will decide the best method based on your situation.
If you have not yet reached menopause, having a hysterectomy means you will no longer have a period. You will also not be able to get pregnant.
What are the risks of a hysterectomy?
Some possible complications include:
- Injury to the tubes that carry urine from the kidneys to the bladder (ureters) and bladder
- Injury to the bowel or other intestinal organs
- Trouble with urination or urinary incontinence
If you have not reached menopause before a hysterectomy, you may have menopause symptoms. This includes hot flashes, mood swings, and vaginal dryness. You will no longer have a period after a hysterectomy.
You may also have mood swings, depression, and feel a loss of sexual identity after hysterectomy.
You may have other risks based on your condition. Be sure to discuss any concerns with your healthcare provider before the procedure.
What happens after a hysterectomy?
In the hospital
After the procedure, you will be taken to the recovery room. Your recovery will vary based on the type of procedure done and the type of anesthesia used. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room.
You may have abdominal cramping after the surgery. You may get pain medicine as needed, either by a nurse or by giving it to yourself through a device connected to your IV.
If you had an abdominal hysterectomy, you may have a thin, plastic tube put through your nose into your stomach to remove air that you swallow. The tube will be removed when your bowels go back to normal. You will not be able to eat or drink until the tube is removed.
You may have small to moderate amounts of vaginal drainage for several days. The nurse will check the sanitary pads to keep an eye on the amount of drainage.
You will be urged to get out of bed within a few hours after a vaginal procedure or by the next day after an abdominal procedure. You will also be taught to do coughing and deep breathing exercises.
Based on your situation, you may be given liquids to drink a few hours after surgery. Your will gradually be able to eat more solid foods as you can handle them.
Arrange for a follow-up visit with your healthcare provider, usually a few weeks after the procedure.
Once you are home, it is important to keep the incision clean and dry. Your healthcare provider will give you specific bathing instructions. If you went home with stitches or surgical staples, your provider will remove them during a follow-up office visit. If your provider used adhesive strips, keep them dry. They should fall off within a few days.
The incision and the abdominal muscles may ache, especially after long periods of standing. If a laparoscope was used, you may have shoulder pain from the carbon dioxide in your abdomen. Take a pain reliever as recommended by your healthcare provider. Aspirin or certain other pain medicines may increase the chance of bleeding. So, be sure to take only recommended medicines.
You will be able to walk and have limited movement, but avoid strenuous activity. Your healthcare provider will tell you when you can go back to work and other normal activities.
Include fiber and plenty of liquids to avoid constipation. Your healthcare provider may recommend a mild laxative.
If you had a laparoscopic procedure, avoid drinking carbonated drinks for 1 to 2 days after the procedure. This will help lessen the discomfort from the carbon dioxide gas. These drinks may also cause nausea.
Do not use a douche, tampons, have sex, or return to work until your healthcare provider says it’s OK.
Tell your healthcare provider if you have any of the following:
- Fever or chills
- Redness, swelling, or bleeding or other drainage from the incision site(s)
- Increased pain around the incision site(s)
- Abdominal pain, cramping, or swelling
- Increased vaginal bleeding or other drainage
- Leg pain
After a hysterectomy, your healthcare provider may give you other instructions, based on your situation.