A hysterectomy is a surgery to remove a woman’s uterus (also known as the womb). The uterus is where a baby grows when a woman is pregnant. During the surgery the whole uterus is usually removed. Your doctor may also remove your fallopian tubes and ovaries. After a hysterectomy, you no longer have menstrual periods and cannot become pregnant.
What happens during a hysterectomy?
Hysterectomy is a surgery to remove a woman’s uterus (her womb). The whole uterus is usually removed. Your doctor also may remove your fallopian tubes and ovaries.
Talk to your doctor before your surgery to discuss your options. For example, if both ovaries are removed, you will have symptoms of menopause.
Ask your doctor about the risks and benefits of removing your ovaries. You may also be able to try an alternative to hysterectomy, such as medicine or another type of treatment, first.
Why would I need a hysterectomy?
You may need a hysterectomy if you have one of the following:
Uterine fibroids. Uterine fibroids are noncancerous growths in the wall of the uterus. In some women they cause pain or heavy bleeding.
Heavy or unusual vaginal bleeding. Changes in hormone levels, infection, cancer, or fibroids can cause heavy, prolonged bleeding.
Uterine prolapse. This is when the uterus slips from its usual place down into the vagina. This is more common in women who had several vaginal births, but it can also happen after menopause or because of obesity.
Prolapse can lead to urinary and bowel problems and pelvic pressure.
Endometriosis. Endometriosis happens when the tissue that normally lines the uterus grows outside of the uterus on the ovaries where it doesn’t belong. This can cause severe pain and bleeding between periods.
Adenomyosis. In this condition the tissue that lines the uterus grows inside the walls of the uterus where it doesn’t belong. The uterine walls thicken and cause severe pain and heavy bleeding.
Cancer (or precancer) of the uterus, ovary, cervix, or endometrium (the lining of the uterus). Hysterectomy may be the best option if you have cancer in one of these areas. Other treatment options may include chemotherapy and
radiation. Your doctor will talk with you about the type of cancer you have and how advanced it is. Learn more about treatment options for these cancers at the National Cancer Institute.
Keep in mind that there may be alternative ways to treat your health problem without having a hysterectomy. Hysterectomy is a major surgery.
Talk with your doctor about all of your treatment options.
What are the different types of hysterectomies?
A total hysterectomy removes all of the uterus, including the cervix. The ovaries and the fallopian tubes may or may not be removed. This is the most common type of hysterectomy.
A partial, also called subtotal or supracervical, hysterectomy removes just the upper part of the uterus. The cervix is left in place. The ovaries may or may not be removed.
A radical hysterectomy removes all of the uterus, cervix, the tissue on both sides of the cervix, and the upper part of the vagina.
A radical hysterectomy is most often used to treat certain types of cancer, such as cervical cancer. The fallopian tubes and the ovaries may or may not be removed.
What are complications of a hysterectomy?
Complications of a hysterectomy include infection, pain, and bleeding in the surgical area. An abdominal hysterectomy has a higher rate of post-operative infection and pain than does a vaginal hysterectomy.
What are the alternatives to a hysterectomy?
As mentioned above, a hysterectomy for conditions other than cancer is generally not considered until after other tests or medications are unsuccessful.
There are also newer procedures, such as uterine artery embolization (UAE) or surgical removal of a portion of the uterus (myomectomy), that are being used to treat excessive uterine bleeding.
Endometrial ablation technique and newer medications are also alternatives.
Should women who have had a hysterectomy continue to have Pap smears?
Any woman with a history of abnormal Pap smears is recommended to have Pap smears for the remainder of her life. When the cervix has already been removed, these smears are more accurately called “vaginal cuff” smears, instead of Pap smears.
This is because of the low, but real chance that cervical cancer can recur right at the surgical site where the cervix was removed.
In addition to women with a history of abnormal Pap smears, other women who require continued Pap smears are women with supracervical hysterectomy, in which the cervix was left in place.
In this case, in contrast to the woman who has had hysterectomy for reasons of cervical cancer, the woman who has had supracervical hysterectomy will be able to follow the same screening guidelines as for other women who have not had surgery.
For example, the physician can stop doing Pap smears at age 65 if the woman has been well-screened and has always had normal Pap smears.
Women who do not need to continue having Pap smears are those who have had vaginal hysterectomy or abdominal hysterectomy for benign (not cancer) reasons, such as uterine fibroids.
Provided that they have had normal Pap smears prior to the procedure, they need not continue to have Pap smears after their surgery.
How long does it take to recover from a hysterectomy?
Recovering from a hysterectomy takes time. Most womenstay in the hospital one to two days after surgery. Some doctors may send you home the same day of your surgery.
Some women stay in the hospital longer, often when the hysterectomy is done because of cancer.
Your doctor will likely have you get up and move around as soon as possible after your hysterectomy. This includes going to the bathroom on your own.
However, you may have to pee through a thin tube called a catheter for one or two days after your surgery.
The time it takes for you to return to normal activities depends on the type of surgery:
- Abdominal surgery can take from four to six weeks to recover.
- Vaginal, laparoscopic, or robotic surgery can take from three to four weeks to recover.
- You should get plenty of rest and not lift heavy objects for four to six weeks after surgery. At that time, you should be able to take tub baths and resume sexual intercourse. How long it takes for you to recover will depend on your surgery and your health before the surgery. Talk to your doctor.
What changes can I expect after a hysterectomy?
Hysterectomy is a major surgery, so recovery can take a few weeks. But for most women, the biggest change is a better quality of life. You should have relief from the symptoms that made the surgery necessary.
Other changes that you may experience after a hysterectomy include:
Menopause. You will no longer have periods. If your ovaries are removed during the hysterectomy, you may have other menopause symptoms.
Change in sexual feelings. Some women have vaginal dryness or less interest in sex after a hysterectomy, especially if the ovaries are removed.
Increased risk for other health problems. If both ovaries are removed, this may put you at higher risk for certain conditions such as: bone loss, heart disease, and urinary incontinence (leaking of urine).
Talk to your doctor about how to prevent these problems.
Sense of loss. Some women may feel grief or depression over the loss of fertility or the change in their bodies.
Talk to your doctor if you have symptoms of depression, including feelings of sadness, a loss of interest in food or things you once enjoyed, or less energy, that last longer than a few weeks after your surgery.