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A guide to hysterectomy

A look at the different ways hysterectomy can be done and some of the things you should know before having the procedure.

Hysterectomy is the second-most common surgery for women in the United States. (The most common: cesarean section to deliver a baby.)

The vast majority of hysterectomies are elective (or planned) procedures that are done safely, successfully and without complication. In fact, the American College of Obstetricians and Gynecologists calls hysterectomy one of the safest surgical procedures.

Still, a hysterectomy is major surgery, and it comes with some consequences to consider. For example, you won't be able to have children after the procedure. Also, if your ovaries are removed as part of a hysterectomy and you haven't gone through menopause, you will experience menopause-like effects because of a lack of estrogen.

Here's a look at the basics about hysterectomy.

Hysterectomy 101

A hysterectomy is the surgical removal of the uterus, or womb.

Sometimes it includes removal of one or both of the fallopian tubes—a procedure called a salpingectomy. If one or both ovaries are taken out, the procedure is called a hysterectomy with oophorectomy.

According to the college and the Office on Women's Health (OWH), common reasons for a hysterectomy include:

  • Cancer of the uterus, ovaries or cervix.
  • Uterine fibroids (benign tumors).
  • Abnormalities in uterine tissue, such as endometriosis.
  • Uterine prolapse, where the uterus slips out of place.
  • Chronic pelvic pain.

Different types of hysterectomy

There are several types of hysterectomy and even more variations on how the surgery can be done.

  • In a partial hysterectomy, only the upper part of the uterus is removed.
  • A total hysterectomy takes out the entire uterus and the cervix.
  • During a total radical hysterectomy, the surgeon removes the uterus, tissue on both sides of the cervix and the upper part of the vagina.

Although hysterectomy is always major surgery, some methods are less invasive than others, according to the college.

Different methods for performing hysterectomy include:

Abdominal hysterectomy. With this approach, the surgeon makes an incision 5 to 7 inches long in the lower part of the belly and removes the uterus and any other organs through it. You can expect a longer hospital stay if you have this procedure than with other methods, according to the college.

Vaginal hysterectomy. The surgeon takes the uterus out through an incision made in the vagina.

Laparoscopic hysterectomy. A laparoscope is a thin tube that has a light and camera on one end. It and other tools are inserted through tiny incisions in the belly. The uterus is cut into pieces and removed through the incisions. Sometimes a laparoscope is used during a vaginal hysterectomy too.

Robot-assisted laparoscopic hysterectomy. In this procedure, the surgeon uses a robotic device to control laparoscopic instruments. 

No matter what kind of hysterectomy you have, you can expect to be in the hospital at least one or two nights, according to the OWH.

Questions to ask your doctor

Before you have a hysterectomy, review your options with your doctor. It may be possible to treat your medical condition without having this surgery, according to the OWH.

Let your doctor know if a future pregnancy is important to you or if you're concerned about early menopause.

Also, ask about the risks of having surgery. Although not common, they can include:

  • Injury to nearby organs like the bowel or bladder.
  • Vaginal dryness or less interest in sex after the procedure.
  • Infection.
  • Heavy bleeding.
  • Blood clots in the legs or lungs.

No matter what kind of hysterectomy you have, you'll want to continue having routine pelvic exams. You also may still need Pap tests if your cervix wasn't removed during your hysterectomy or if you had the surgery because of cancer or precancer.

Reviewed 11/4/2022

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