Hysterectomy

What is a hysterectomy?

A hysterectomy is surgery to remove the uterus (womb). The uterus is the place where a fetus grows during pregnancy. A hysterectomy treats problems like heavy bleeding, pain, or cancer in the uterus.

After a hysterectomy, you no longer have menstrual periods and can't become pregnant. Sometimes the surgery also removes the ovaries and fallopian tubes. If you have both ovaries taken out,menopause symptoms will usually begin.

What conditions does a hysterectomy treat?

Hysterectomy is a major surgery. Your health care provider may suggest other treatment options first. These might include medicine, hormone therapy, or procedures to remove fibroids or stop heavy bleeding. Sometimes these won't help, or surgery might be the only option, depending on the condition that needs to be treated.

Your provider might recommend a hysterectomy if you have:

• Fibroids, if you are near or past menopause, have large fibroids or very heavy bleeding.
• Endometriosis, that hasn't been cured by medicine or surgery.
• Uterine prolapse, which can happen after several vaginal births, menopause, or because of obesity. It is when the uterus drops into the vagina.
• Cancer, of the uterus, cervix, ovaries, or endometrium (the lining of the uterus).
• Vaginal bleeding, that is heavy or unusual and persists despite treatment.
• Chronic pelvic pain, which starts in the uterus. A hysterectomy is a last resort since it doesn't fix some pelvic pain.
• Adenomyosis, is a thickening of the walls of the uterus. A hysterectomy is only considered if pain is severe and no other treatments have worked.

What are the different types of hysterectomies?

Your provider will discuss the type of hysterectomy you need, depending on your condition.

The different types of surgeries include:

• A total hysterectomy is the most common type and involves the removal of all the uterus, including the cervix. The ovaries and fallopian tubes may or may not be removed.
• A partial (subtotal or supracervical) hysterectomy removes just the upper part of the uterus. The cervix is left in place, and your ovaries may or may not be removed
• A radical hysterectomy removes all the uterus, cervix, and tissue on both sides of the cervix and the upper part of the vagina. This is most often used to treat certain types of cancer, such as cervical cancer. The fallopian tubes and ovaries may or may not be removed.

What methods are used for a hysterectomy?

A hysterectomy may be done several different ways. Your provider will determine the best method for the surgery based on your general health, the reason for the surgery, and other factors.

Methods to perform a hysterectomy include:

• Abdominal hysterectomy. A cut is made in your lower abdomen (belly). Your provider may recommend this method if you have a large uterus or to check other pelvic organs for signs of disease. This surgery has a longer recovery time than the others.
• Vaginal hysterectomy. A small cut is made in your vagina. This may not be an option if you have very large fibroids.
• Laparoscopic hysterectomy. Uses an instrument with a thin, lighted tube and an attached camera. This helps your provider see your pelvic organs. Small cuts are made in either your abdomen (belly) or vagina. This is not an option for all types of uterine fibroids.
• Robotic surgery. Your provider guides a robotic arm to do the surgery through small cuts in your lower abdomen (belly).

After a hysterectomy, it can take four to six weeks to recover, depending on the type of surgery you have.

What are the risks of a hysterectomy?

Like all surgeries, a hysterectomy has risks, even though the results are usually good. Talk to your provider about the benefits and risks of having a hysterectomy.

More serious risks can include:

• Too much bleeding during surgery
• Infection
• Blood clots

Dept. of Health and Human Services Office on Women's Health

Questions for your care team

General prompts to help prepare for your appointment.

• How does this information apply to my situation?
• Which symptoms or results need evaluation?
• Which tests are useful, and what can they tell us?
• What care options, benefits, and risks should we discuss?
• When should I seek urgent help, and whom should I call?
• When is follow-up, and how will we know whether the plan is working?