Hysterectomy is a surgery performed to remove the woman's uterus or womb. Based on the cause, the uterus might be removed completely or partially. Please read the article to know more in detail.
A hysterectomy is a surgical procedure performed to remove the uterus of a woman. The uterus, also known as the womb, has the main function of developing and holding the baby until the time of birth. Also, the inner lining of the uterus is responsible for producing menstrual blood.
If the patient has some problems pertaining to the uterus or some long-term pain, then a hysterectomy is done to help the patient overcome her problem. There are many possible reasons for which the patient has to undergo a hysterectomy, ranging from chronic pain to cancer.
Hysterectomy generally describes the process of completely removing the uterus, along with the ovaries and fallopian tubes. But based on the reason for surgery, it might differ from one person to another. Once a hysterectomy is done, the menstrual cycle will stop, and also, it will make the woman unable to conceive.
As mentioned earlier, a hysterectomy can be suggested by your doctor if you have any of the following:
Chronic pelvic pain.
Uterine, cervical, or ovarian cancer.
Uterine prolapse – A condition when the uterus drops down through the cervix and projects outside the vagina.
Uncontrollable vaginal bleeding.
Endometritis – A condition where the inner lining of the uterus begins to grow outside the uterine cavity, causing severe pain and bleeding
Fibroids – The benign tumors that develop in the uterus.
Adenomyosis - A similar condition to that of endometritis, where the inner lining of the uterus begins to grow into the uterus muscle.
Pelvic inflammatory disease – A serious infection of the reproductive organs.
For non-cancerous tumors, hysterectomy is considered the last treatment option, only if all the other treatment methods have not shown any progress.
The surgical procedure of hysterectomy is different for each person, and it differs based on the exact reason as to why the procedure is required. Hence based on the reason, the surgeon might choose to remove the entire uterus or only some parts of the uterus. Thus, depending on the parts removed during the procedure, hysterectomy is classified into three as:
Supracervical or Subtotal Hysterectomy: In this procedure, only the upper part of the uterus is removed, and the cervix is left in its place.
Total Hysterectomy: In this procedure, the entire uterus along with the cervix is removed.
Radical Hysterectomy: In this procedure, the entire uterus, along with tissues present in the side of the uterus, the cervix, and the top part of the vagina, is removed. This procedure is done only in the case of cancer.
Hysterectomy and Bilateral Salpingectomy-Oophorectomy:
Other parts such as the ovaries and the fallopian tubes are also connected to the uterus. The ovaries are the organs that are used to produce hormones such as estrogen and progesterone. And fallopian tubes are responsible for transporting the eggs from the ovary to the uterus. Hence if the hysterectomy procedure involves removing the tubes and the ovaries, then it is called hysterectomy and bilateral salpingectomy-oophorectomy.
Also, the surgery differs in approach based on the surgeon’s experience, the reason for the procedure, and the patient’s other health conditions. They are classified into two based on the approach, which are:
1. Open Surgery Hysterectomy: The open surgery hysterectomy is also called abdominal hysterectomy. This is the most common approach and accounts for more than 55% of the procedure done for non-cancerous diseases. This procedure involves a 5 to 7-inch incision across the belly (above or below or side to side). The surgeon will make use of this incision to remove the uterus.
After the open surgery hysterectomy, the patient will have to stay in the hospital for 2 to 3 days for medical care. And this procedure will produce a visible scar at the site of the incision even after full healing.
2. MIP Hysterectomy: MIP is nothing but a minimally invasive procedure wherein the approach is not very invasive and has only a slight cut or incision. There are three different approaches used for MIP hysterectomy, which are:
Vaginal Hysterectomy: As the name suggests, the surgeon will make a small incision inside the vagina and remove the uterus through the vagina. This will have no scars as the incision will be closed inside.
Laparoscopic Hysterectomy: This procedure is done through a small tube called a laparoscope which has a lighted camera. Other surgical tools are inserted through several cuts made in the belly. Also, there is another method called the single-site laparoscopy, where a single small cut is made in the belly button, and the surgery is performed from outside the body with the help of the video from the camera.
Laparoscopic Vaginal Hysterectomy: This procedure is similar to the vaginal hysterectomy, but the only difference is that the laparoscopic tools in the belly are used to assist in the procedure.
Robot-Assisted Laparoscopic Hysterectomy: This is similar to the generic laparoscopic hysterectomy, but the doctor will control the tools using a well technologically advanced system of the robot. This will give the surgeon more accessibility and free movement of the wrist.
Hysterectomy is similar to any other major surgery and has its own set of complications. But there have not been any life-threatening conditions that have occurred as a result of a hysterectomy. Some of the possible complications of hysterectomy procedure include:
Fistula formation in the vagina – The connection between the vagina and the bladder or vagina and the rectum.
Surgical complications such as blood clots, hemorrhage, infections, injury to the surrounding organs, etc.
Hysterectomy is a big procedure, and there might be some physical and emotional traumatic experiences that may be associated with the surgery. If the ovaries are removed during the procedure, then the patient will enter into menopause. Even if the ovaries are not removed, and only the uterus is removed, even then, the patient will enter into menopause at a very early age.
There might be occasional bleeding or light brown discharge from the vagina for the first three to four weeks. And like any other surgery, there might be swelling, pain and redness, or bruising at the site of the incision. Also, your doctor might ask you to refrain from indulging in certain activities for a certain period of time, such as:
Lifting heavy items.
Pushing or pulling objects such as vacuum cleaners or furniture.
The type of surgery will decide the recovery rate and the activities that you can perform. For instance, if the surgery is vaginal or laparoscopic, then the recovery time is usually three weeks, and you can return to your regular activities. But if you have had an abdominal hysterectomy, then the recovery time is usually around six weeks.
There might also be some changes in your sexual life as well. If the ovaries are removed, then there might be a reduction in the sex drive and an increase in vaginal dryness. But there are other treatments that are available to overcome such conditions that are associated with the hormones, such as estrogen therapy.
After the hysterectomy, the body may experience various long-term changes. They include symptoms of menopause (when the ovaries were removed) and changes in sex drive or mood. Rare complications that require future surgeries can also occur.
After undergoing a hysterectomy, there is nothing like you cannot have an orgasm. The clitoris and labia are present, which are highly sensitive, and it is unknown what role the cervix is playing in orgasm. It is said that removing the cervix can have side effects, but some others say it does not.
Hysterectomy is one of the major surgeries that carry the possibility of severe infections, blood clots, bowel obstruction, hemorrhage, or urinary tract injury. The long-term risks include bladder or bowel problems, early menopause, and scars and adhesions in the pelvic area.
Ovaries stay in place after the hysterectomy procedure because they are attached to the abdomen with the help of a ligament named the suspensory ligament, which is considered to be a part of the broad ligament of the uterus.
Most husbands worry their wives may turn different or will no longer express interest in them. But the reality is that sex after hysterectomy is surprisingly similar as before for men. This is because they need to understand that the surgeon removes the uterus alone during the hysterectomy procedure and takes steps to maintain vaginal functionality.
After the hysterectomy,
- Do not lift anything heavy for one month.
- Stay active but avoid strenuous physical activities for at least six weeks.
- Resume with the sexual activity after 6 weeks.
- To return to the regular activities, follow the doctor's recommendations.
After a hysterectomy, the belly appears swollen and puffy, and this is common. The swelling takes several weeks to go down, but it may take about 6 weeks to recover fully.
Following hysterectomy, the reproductive tract is separated from the abdominal cavity, so the sperm has nowhere to go, and it gets eventually expelled from the body along with the normal vaginal secretions.
Hysterectomy improves the quality of life. In some women, it helps to relieve pain and stop heavy bleeding. For others, this surgery is done to prevent or treat cancer. So, before undergoing a hysterectomy, talk to the doctor about how a hysterectomy helps to improve the symptoms.
In the weeks following the hysterectomy procedure, you might experience the following at the incision site:
Urinary incontinence also occurs after a hysterectomy because of the abnormal connection between two body parts, the bladder and the vagina, which can cause continual leakage of urine.
Difficulty in urinating after surgery is a condition known as postoperative urinary retention (POUR). It is the inability to urinate after surgery despite the bladder being full. It occurs when the surgery interferes with bladder functions.
The yellow color of urine is due to the compound urochrome. When urochrome combines with methylene blue, it forms a harmless compound that creates a green or greenish-blue color. The intensity of the green pigment in urine is dose-related.
After surgery, you may go up and downstairs but will walk and climb slowly at first, with one leg at a time. It gets easier when the body heals but avoids lifting heavy objects for six weeks after surgery.
Last reviewed at:
11 Dec 2021 - 5 min read
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