A hysterectomy is a major operation for a woman that involves the removal of her uterus. It is the most common non-pregnancy-related surgery performed in women in the United States.
Hysterectomy may be recommended for uterine cancer when all other treatment options have failed. It is also mostly reserved for women who already have children or are not willing to have more kids.
The most common reasons for a hysterectomy are as follows:
- Uterine fibroids (noncancerous growths in the wall of the uterus): Hysterectomy will be recommended only if the woman is experiencing heavy bleeding or extreme pain due to the fibroids.
- Heavy or prolonged vaginal bleeding: This can be due to changes in hormone levels, infection, cancer, or fibroids.
- Uterine prolapse (slipping from its normal place down into the vagina): This occurs more commonly in women with multiple vaginal deliveries.
- Endometriosis (abnormal growth of the uterine tissue outside the uterus, most commonly in the ovaries): This can cause severe pain and bleeding between periods.
- Adenomyosis: In this condition, there is a thickening of the uterine wall due to abnormal growth of tissues.
- Pelvic inflammatory disease (PID): PID is a bacterial infection of the reproductive organs, which if spread extensively can lead to severe pelvic pain.
- Cancer (or precancer stage) of the uterus, ovary, cervix: Hysterectomy is often the option for treating cancer of the uterus.
What are the different types of hysterectomies?
Depending upon which other reproductive organs are removed along with the uterus, a hysterectomy is of three types:
- Total hysterectomy: This is the most common type of hysterectomy that involves the removal of the uterus and cervix.
- Partial (or subtotal) hysterectomy: In this type, just the upper part of the uterus is removed.
- Radical hysterectomy: Through this surgery, all the uterus, cervix, ligaments (tissue on both sides of the cervix), and upper part of the vagina are removed. It is performed mostly for cancer of the cervix.
How is a hysterectomy performed?
The surgeon will explain different approaches to performing a hysterectomy. These are as follows:
- Abdominal hysterectomy: Your doctor makes a large cut of about 6-12 inches in the lower abdomen. He cuts the structures that hold the uterus in the abdomen and takes it out. The wound is stitched back.
- Vaginal hysterectomy: The operation is performed via the vagina. The surgeon detaches the uterus from ovaries, fallopian tubes, upper vagina, and blood vessels and connective tissue that support it, before removing the uterus.
- Laparoscopic hysterectomy: A long and thin camera-like tube is inserted through one of the several small cuts in the lower abdomen. This tube helps in visualizing the uterus. The uterus is then removed either through one of the incisions or vagina.
- Robotic surgery: The surgeon uses a robotic arm to perform the surgery through small cuts in your lower abdomen.
How long does it take to recover from a hysterectomy?
How long a woman will stay in the hospital after her hysterectomy depends on the surgical approach, her age, and her general health status.
With a vaginal or laparoscopic hysterectomy, the woman may be discharged one to four days after the surgery.
If the woman had an abdominal hysterectomy, she will have to stay for four to five days in the hospital.
Follow-up may be scheduled generally within four to six weeks of the surgery. However, in most cases, it is not necessary unless there are any complications.
Full recovery from an abdominal hysterectomy generally takes about four to six weeks, whereas it is earlier in case of a vaginal or laparoscopic hysterectomy.
Sex can be resumed within four to six weeks, depending upon how soon the vagina heals.
Walking can be resumed soon but lifting weights should be avoided for at least to six weeks after the surgery.
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