A hysterectomy is surgery to remove a woman’s womb (uterus). The womb is the area where a baby grows when a woman is pregnant.
During a hysterectomy, your doctor may remove the entire uterus or just part of it. The fallopian tubes and ovaries may also be removed.
Types of hysterectomy:
There are many different ways to perform a hysterectomy. It may be done through a surgical cut in either the belly (abdomen) or vagina. Types include:
Your doctor will help you decide which type of hysterectomy is best for you. The specific procedure depends on your medical history and reason for the surgery.
There are many reasons a woman may need a hysterectomy. The procedure may be recommended if you have:
Hysterectomy is a major surgery. It is possible that your condition may be treated without this major surgery. Talk with your doctor or nurse about all your treatment options. Less invasive procedures include:
The risks for any surgery are:
Risks that are possible from a hysterectomy are:
Estrogen replacement therapy can help decrease the risk of heart disease and may help menopause symptoms.
Before deciding to have a hysterectomy, ask your doctor or nurse what to expect after the procedure. Many women who have had a hysterectomy notice changes in their body and in how they feel about themselves. Talk with your doctor, nurse, family, and friends about these possible changes before you have surgery.
Always tell your health care team about all the medicines you are taking, including herbs, supplements, and other medicines you bought without a prescription.
During the days before the surgery:
On the day of your surgery:
After surgery, you will be given pain medicines to relieve any discomfort.
You may also have a tube, called a catheter, inserted into your bladder for 1 to 2 days to pass urine.
You will be asked to get up and move around as soon as possible after surgery. This helps prevent blood clots from forming in your legs and speeds up 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. Sometimes, you can go home the next day. Other times, most women who have a hysterectomy stay in the hospital 2 to 3 days. The hospital stay may be longer if the hysterectomy is done because of cancer.
How long it takes you to recover depends on the type of hysterectomy. Recovery may take anywhere from 2 to 6 weeks. Average recovery times are:
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.
Vaginal hysterectomy; Abdominal hysterectomy; Supracervical hysterectomy; Radical hysterectomy; Removal of the uterus; Laparoscopic hysterectomy; Laparoscopically assisted vaginal hysterectomy; LAVH; Total laparoscopic hysterectomy; TLH; Laparoscopic supracervical hysterectomy; Robotically assisted hysterectomy
Entman SS, Graves CR, Jarnagin BK, Rao GG. Gynecologic surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 75.
Giudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010 Jun 24;362(25):2389-98.
Van Voorhis B. A 41-year-old woman with menorrhagia, anemia, and fibroids: review of treatment of uterine fibroids. JAMA. 2009 Jan 7;301(1):82-93.
National Comprehensive Cancer Network. NCCN Practice Guidelines in Oncology: Cervical Cancer. v.1.2010
Middleton LJ, Champaneria R, Daniels JP, et al. Hysterectomy, endometrial destruction, and levonorgestrel releasing intrauterine system (Mirena) for heavy menstrual bleeding: systematic review and meta-analysis of data from individual patients. BMJ. 2010 Aug 16;341:c3929.
ACOG Committee Opinion No. 444: choosing the route ofhysterectomy for benign disease. Obstet Gynecol. 2009;114(5):1156-1158.
Updated by: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine.
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