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Hysterectomy

You may have all or part of the uterus removed during a hysterectomy. The fallopian tubes and ovaries may also be removed.

There are many different ways to perform a hysterectomy. It may be done through:

  • A surgical cut in the belly (called open or abdominal)
  • 3 to 4 small surgical cuts in the belly and then using a laparoscope
  • A surgical cut in the vagina, and using a laparoscope
  • 3 to 4 small surgical cuts in the belly, in order to perform robotic surgery

You and your doctor will decide which type of procedure. The choice will depend on your medical history and the reason for the surgery.

Why the Procedure is Performed

There are many reasons a woman may need a hysterectomy, including:

  • Adenomyosis, a condition that causes heavy, painful periods
  • Cancer of the uterus, most often endometrial cancer
  • Cancer of the cervix or changes in the cervix called cervical dysplasia that may lead to cancer
  • Cancer of the ovary
  • Long-term (chronic) pelvic pain
  • Severe endometriosis that does not get better with other treatments
  • Severe, long-term vaginal bleeding that is not controlled with other treatments
  • Slipping of the uterus into the vagina (uterine prolapse)
  • Tumors in the uterus, such as uterine fibroids
  • Uncontrolled bleeding during childbirth

Hysterectomy is a major surgery. Some conditions can be treated with less invasive procedures such as:

  • Uterine artery embolization
  • Endometrial ablation
  • Using birth control pills
  • Using pain medicines
  • Using an IUD that releases the hormone progestin
  • Pelvic laparoscopy

before-after-hysterectomy

 

After the Procedure

After surgery, you will be given pain medicines.

You may also have a tube, called a catheter, inserted into your bladder to pass urine. Most of the time, the catheter is removed before leaving the hospital.

You will be asked to get up and move around as soon as possible after surgery. This helps preventblood clots from forming in your legs and speeds recovery.

You will be asked to get up to use the bathroom as soon as you are able. You may return to a normal diet as soon as you can without causing nausea or vomiting.

How long you stay in the hospital depends on the type of hysterectomy.

  • You can likely go home the next day when surgery is done through the vagina using a laparoscope or after robotic surgery.
  • When a larger surgical cut (incision) in the abdomen is made, you may need to stay in the hospital¬†1 to 2 days. You may need to stay longer if the hysterectomy is done because of cancer.

Outlook (Prognosis)

How long it takes you to recover depends on the type of hysterectomy. Average recovery times are:

  • Abdominal hysterectomy: 4 to 6 weeks
  • Vaginal hysterectomy: 3 to 4 weeks
  • Robot-assisted or total laparoscopic hysterectomy: 2 to 4 weeks

A hysterectomy will cause menopause if you also have your ovaries removed. Removal of the ovaries can also lead to a decreased sex drive. Your doctor may recommend estrogen replacement therapy. Discuss with your doctor the risks and benefits of this therapy.

If the hysterectomy was done for cancer, you may need further treatment.

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