What Is A Hysterectomy?

A hysterectomy is a surgical procedure that removes your uterus, or womb, which is where a foetus grows during pregnancy. It is the second most common surgery performed on women after Caesarean section.

Depending on the reason for the surgery, a hysterectomy may also involve removing your cervix, ovaries, and fallopian tubes. After surgery, you will not be able to become pregnant and will no longer menstruate. Reasons for having a hysterectomy include abnormal bleeding, uterine prolapse, fibroids and cancer. Recovery usually takes four to six weeks, depending on the type of surgery you have.

Why Is A Hysterectomy Performed?

A hysterectomy is a major operation, with a long recovery time, and should only be considered after less invasive treatments have been tried. Hysterectomies are performed to treat health problems that affect the female reproductive system. Reasons may include:

• Abnormal or heavy periods
• Long-term pelvic pain and severe pain when menstruating
• Non-cancerous uterine tumours (fibroids)
• Uterine prolapse (when the uterus has “dropped” into your vaginal canal due to weakened support muscles)
• Conditions with the lining of your uterus, like hyperplasia, recurrent uterine polyps or adenomyosis
• In cases of severe endometriosis, a hysterectomy may be needed to remove the uterus along with the ovaries and fallopian tubes
• Ovarian cancer, uterine cancer, cervical cancer, or cancer of the fallopian tubes
• Gender affirmation for transgender people and people who are nonbinary

What Happens Before And After A Hysterectomy?

Depending on the type of surgery, our anaesthesiologist will give you either general anaesthesia or regional anaesthesia (also called epidural or spinal anaesthesia). Epidurals are performed by placing medications near the nerves in your lower back to block pain while you stay awake.

The amount of time you spend in the hospital following a hysterectomy depends on the kind of surgery that was performed. If you had an abdominal hysterectomy, you might stay in the hospital for around 3 days. Vaginal and laparoscopic hysterectomies are less invasive and normally do not require an overnight stay in the hospital.

Your doctor will monitor you and ensure that you do not display any signs of complications such as blood clots or bleeding. In order to prevent blood clots in your legs, you will need to walk around as soon as possible after your surgery.

What Are The Different Kinds Of Hysterectomies?

Your healthcare provider will determine the type of hysterectomy and surgical procedure you need depending on your condition. This will determine if your cervix, fallopian tubes and/or ovaries need to be removed.

Total Hysterectomy

This procedure removes your uterus and cervix. If the ovaries are also removed you will experience surgically-induced menopause (if you are not yet menopausal). This is the most common type of surgery.

Partial Hysterectomy 

This procedure, which is also called a supracervical hysterectomy, removes only the uterus, leaving behind the cervix. The risks and benefits of leaving the cervix intact are the subject of ongoing research.

Radical Hysterectomy

This procedure removes the uterus, cervix, and upper part of the vagina. It is usually performed for cancer treatment.

Different Surgical Options For A Hysterectomy

Your doctor will choose a surgical approach based on your specific condition. Surgical options include:

Vaginal Hysterectomy

This procedure is often the preferred approach as it has the fewest complications and quickest recovery time (up to four weeks). It is most used in cases of uterine prolapse and other non-malignant (non-cancerous) conditions.

During this procedure, your uterus (womb) is removed through an incision (cut) at the top of your vagina. Dissolvable stitches are placed inside your vagina and there are no external cuts.

Laparoscopic Hysterectomy (Key-Hole Surgery)

During this procedure, a thin tube with a video camera is inserted in your lower abdomen through a small incision in your belly button. Your uterus is then removed in small pieces using surgical tools that are inserted through several other small incisions. Recovery is less painful and shorter than an abdominal hysterectomy.

Robotic-Assisted Laparoscopic Hysterectomy

This procedure is carried out with the help of a robotic machine. A laparoscope is inserted in your abdomen to view the pelvis. Robotic arms and instruments, which are inserted through a few incisions around your belly button, are controlled by the surgeon. Recovery time is similar to a laparoscopic hysterectomy.

Abdominal Hysterectomy

This procedure is mostly performed when cancer is present, when the uterus is enlarged or when the cancer has spread to other pelvic areas. The uterus is removed through a long incision in your abdomen. An abdominal hysterectomy usually requires a longer hospital stay (two or three days) and a longer recovery time.

What Are The Benefits Of Having A Hysterectomy?

• Having a hysterectomy can improve your quality of life, especially if you have constant pelvic pain or heavy and irregular bleeding.
• A hysterectomy can be lifesaving if you are at risk of developing uterine cancer.

What Are The Disadvantages of Having A Hysterectomy?

• A hysterectomy is a major surgery with a long recovery and comes with risks and side effects. It is permanent and you will not be able to fall pregnant afterwards.
• If your ovaries were removed at the time of your hysterectomy, you can become menopausal and experience symptoms such as hot flashes, vaginal dryness, loss of libido and insomnia (difficulty sleeping).
• Complications of surgery are rare but can include blood clots, severe infection, bleeding, bowel blockage, urinary tract injury and issues related to anaesthesia.