Hysterectomy

What is a hysterectomy and why is it necessary?
A hysterectomy is the surgical removal of the uterus (womb). In some cases, the ovaries and fallopian tubes are also removed.

A hysterectomy may be performed to treat:
· Leiomyomas or uterine fibroids (benign tumors) that have increased in size, are painful or are causing bleeding
· Severe endometriosis (uterine tissue that grows outside the uterus)
· 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
· Cancer of the uterus, cervix or ovary
· Persistent vaginal bleeding that is not controlled by other treatment methods
· Chronic pelvic pain related to the uterus but not controlled by other treatment

A hysterectomy is the second most common surgery among women in the United States. One in three women in the US has had a hysterectomy by the age of 60. But, before having a hysterectomy, it is important to discuss other possible treatments with your health care provider. A hysterectomy will stop your periods, and you will no longer be able to get pregnant. If the surgery removes both ovaries, you will enter menopause.

What are the different types of hysterectomy surgeries?
There are several types of hysterectomies:
· A total or complete hysterectomy is the removal of the uterus and cervix. This is the most common type of hysterectomy.
· A total hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus, cervix, fallopian tubes (salpingo) and ovaries (oophor). If you haven't experienced menopause, removing the ovaries will usually initiate it since your body can no longer produce as much estrogen.
· A partial hysterectomy is the removal of the upper part of the uterus leaving the cervix in place.
· A radical hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus, cervix, fallopian tubes, ovaries, the upper portion of the vagina and some surrounding tissue and lymph nodes. A radical hysterectomy may be performed to treat cervical or uterine cancer.


Details of the procedure

What do I need to do before surgery?
Your surgeon will give you specific instructions on how to prepare for the procedure.

What happens on the day of surgery?
Your surgeon will explain the procedure in detail, including possible complications and side effects.

A nurse will take your blood and urine sample for testing, give you one or more enemas to cleanse the bowel, shave your abdominal and pelvic areas.

An intravenous (IV) line will be placed in a vein in your arm to deliver medications and fluids.

What type of anesthesia will be used?
You may either be given a general anesthesia in which you will not be awake during the procedure or you may be given local 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.

What happens during surgery, and how is it performed?
Hysterectomies are done through a cut in the abdomen (abdominal hysterectomy) or the vagina (vaginal hysterectomy). Sometimes an instrument called a laparoscope is used (a procedure called laparoscopically assisted vaginal hysterectomy or LAVH) to help see inside the abdomen during vaginal hysterectomy. The type of surgery done depends on the reason for the surgery and may last 1 to 3 hours. Abdominal hysterectomies are more common and usually require a longer recovery time.

How long will I be in the hospital?
You will stay in the hospital from one to two days for post-surgery care. Some women may stay in the hospital up to four days.

What are the risks/complications associated with hysterectomy?
A hysterectomy involves some major and minor risks. Most women do not have problems during or after the operation. Some risks include heavy blood loss requiring blood transfusion, bowel injury, bladder injury, wound pulling open, and anesthesia problems (such as breathing or heart problems).

What should I watch out for?
Be sure to call your doctor if any of the following symptoms appear:
· Bright red vaginal bleeding
· A fever over 100°F
· Difficulty urinating, burning feeling when urinating or frequent urination
· Increasing amount of pain

When can I expect to return to work and/or resume normal activities?
In the case of an abdominal hysterectomy, complete recovery usually takes four to eight weeks. You will gradually be able to increase your activities.

In a vaginal or laparoscopic hysterectomy, most women are able to return to normal activity in one to two weeks.

For both, by the sixth week, you should be able to take tub baths and resume sexual activities.

If my cervix was removed in my hysterectomy, do I still need to have Pap tests?
Ask your doctor if you need to have periodic Pap tests. Regardless of whether you need a Pap test or not, all women who have had a hysterectomy must continue to have regular gynecologic exams.


Cost and availability

How much does it cost?
Click here for details.

Which countries/hospitals is it available in?
Click here to check the availability of hysterectomy with our partner hospitals.

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Note: All information presented here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.