Hysterectomy, a procedure to remove the uterus, is considered major surgery. It is usually not used for sterilization, but it can be because the removal of the uterus makes it impossible for a woman to bear children. If the ovaries are removed during a hysterectomy, this procedure will end menstruation as well as the potential of pregnancy. A hysterectomy may help chronic medical problems such as uterine fibroids, excessive menstrual bleeding, or certain cancers (endometrial, cervical, or ovarian). Otherwise, contraception should be considered a secondary benefit to a hysterectomy and not the sole reason to have this procedure.
During a hysterectomy, the whole uterus or just part of it may be removed. The fallopian tubes and ovaries may also be removed:
- A partial (or supracervical) hysterectomy is removal of just the upper part of the uterus while the cervix is left in place.
- A total hysterectomy is removal of the entire uterus and the cervix.
- A radical hysterectomy is the removal of the uterus, the tissue on both sides of the cervix (parametrium), and the upper part of the vagina. This is done mostly when some cancers are present.
- Complete hysterectomy is a common non-medical term that usually means a total hysterectomy plus removal of the ovaries and fallopian tubes.
- Oophorectomy is the surgical removal of the ovary(s).
- Salpingo-oophorectomy is the removal of the ovary and its adjacent fallopian tube.
A hysterectomy can be performed through the vagina or abdomen. A combined approach can also be used. In the past the most common hysterectomy was done by an incision through the abdomen or at the bikini line (abdominal hysterectomy). Now most surgeries can utilize laparoscopic assisted or vaginal hysterectomy for quicker and easier recovery.
During a vaginal hysterectomy, the surgeon makes a cut in the vagina, and the uterus is taken out through this cut. The incision is then closed with stitches. Laparoscopic hysterectomy consists of the surgeon making 3 to 4 small cuts in your belly. A laparoscope (a narrow tube with a tiny camera on the end) and other surgical instruments are then inserted through the other cuts. The uterus is cut into smaller pieces that are removed through the small cuts. Laparoscopically assisted vaginal hysterectomy is a combination of these methods.
The average hospital stay depends on the type of hysterectomy you had. Most women stay 2 to 3 days. When hysterectomy is done because of cancer, the hospital stay is often longer. The hospital stay generally tends to be longer with an abdominal hysterectomy than with a vaginal hysterectomy, and hospital charges tend to be higher. The procedures seem to take comparable lengths of time (about two hours).
Women also spend several weeks recovering at home after a hysterectomy surgery. Recovery from a vaginal or laparoscopic hysterectomy is faster than recovery from an abdominal hysterectomy. It may also be less painful. Average recovery times are:
- Abdominal hysterectomy -- 4-6 weeks.
- Vaginal hysterectomy -- 3-4 weeks.
Women should not have sexual intercourse for 4 to 6 weeks after having undergone a hysterectomy.