If you’re considering a hysterectomy, you may be looking forward to relief from unpleasant or painful symptoms. At the same time you may be nervous about having major surgery, the recovery time involved, and the potential effects of the procedure.
Facing hysterectomy surgery can be difficult but there are many new options that may make the prospect of your hysterectomy less challenging. We can help educate and guide you to make the most informed decision.
What is hysterectomy and when is it performed?
Hysterectomy, or surgical removal of the uterus, is a commonly used method of treating many conditions including:
- uterine fibroids
- abnormal uterine bleeding
- uterine prolapse and other pelvic support problems
- chronic pelvic pain
Hysterectomy is major surgery. As with all kinds of major surgery there are associated risks such as infection, bleeding, blood clots, injuries to nearby organs, and complications related to anesthesia. In addition, after hysterectomy, you are no longer able to become pregnant. Because of these issues, you may want to discuss alternative treatments with us.
What are the different types of hysterectomy?
There are three main types of hysterectomy. They are:
Total hysterectomy. In a total hysterectomy the entire uterus including the cervix is removed.
Supracervical hysterectomy. In a supracervical or “partial” hysterectomy, the upper part of the uterus is removed but the cervix is left in place.
Hysterectomy with removal of the fallopian tubes and ovaries. In some cases, a hysterectomy may be combined with removal of one or more ovaries (an oophorectomy) or fallopian tubes (a salpingectomy). If the ovaries are removed when still functioning, replacement hormones may be temporarily necessary.
How is a hysterectomy performed?
A hysterectomy can be performed in different ways, depending on the reason for the surgery and other factors, including your general health.
Hysterectomies are generally conducted using one of three main approaches. These approaches are:
Abdominal hysterectomy. In an abdominal or “open” hysterectomy, the surgeon makes a vertical or horizontal incision through the skin and tissue in the lower abdomen to reach the uterus. This type of hysterectomy gives the surgeon a good view of the uterus and other organs during the operation. This procedure is often the first choice when there are complications such as severe endometriosis or scarring from a prior surgery or cancer. Abdominal hysterectomy may require a longer healing time than vaginal or laparoscopic surgery, and it usually requires a longer hospital stay.
Vaginal hysterectomy. Vaginal hysterectomy involves removal of the uterus through the vagina, without an abdominal incision. Surgeons often use this approach if the condition is non-cancerous, when the uterus is normal size, and when the condition is limited to the uterus. Because the incision is inside the vagina, healing time may be shorter than with abdominal surgery. Potential advantages include fewer complications, lack of external scarring, a shorter hospital stay and a faster recovery. On the other hand, small working space and limited view can make this approach difficult.
Laparoscopic hysterectomy. A laparoscopic hysterectomy is performed using a thin, lighted tube with a camera that is inserted into the abdomen through a small incision in or around the navel. Additional small incisions are made in the abdomen for other surgical instruments. By avoiding large abdominal incisions, patients who have a laparoscopic hysterectomy can usually be discharged from the hospital less than 24 hours after the procedure. They typically experience significantly less postoperative pain and can return to daily activities relatively quickly.
Some hysterectomies, such as total laparoscopic hysterectomy and laparoscopically assisted vaginal hysterectomy, combine different aspects of these approaches.