Hysterectomy

Surgeons use different approaches for hysterectomy surgery, depending on their experience, the reason for your hysterectomy, and your overall health. The technique will partly determine how long your healing time will be and the kind of scar, if any, you'll have after the operation.

With an MIP, you're generally able to resume your normal activity within about 3-4 weeks, compared to 4-6 weeks for an abdominal hysterectomy. And the cost of an MIP is considerably lower, depending on the instruments used and the time spent in the operating room. But robotic procedures can be much more expensive. There's also less risk of incisional hernias with an MIP.

Hysterectomy

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A hysterectomy is a major surgery that's only recommended when other treatments don't work. But it can save your life if you have certain cancers, and relieve serious symptoms from some other conditions. Your doctor can help you weigh the benefits and risks.

A hysterectomy is surgery to remove a woman's uterus or womb. The uterus is the place where a baby grows when a woman is pregnant. After a hysterectomy, you no longer have menstrual periods and can't become pregnant. Sometimes the surgery also removes the ovaries and fallopian tubes. If you have both ovaries taken out, you will enter menopause.

Before deciding to have a hysterectomy, ask your health care provider what to expect after the procedure. Many women notice changes in their body and in how they feel about themselves after a hysterectomy. Talk with provider, family, and friends about these possible changes before you have surgery.

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. Discuss with your provider the risks and benefits of this therapy.

Removing the fallopian tubes (but not the ovaries) at the time of hysterectomy also may be an option for women who do not have cancer. This procedure is called opportunistic salpingectomy. It may help prevent ovarian cancer. Talk with your surgeon about the possible benefits of removing your fallopian tubes at the time of your surgery.

A hysterectomy can be done in different ways: through the vagina, through the abdomen, or with laparoscopy. The choice will depend on why you are having the surgery and other factors. Sometimes, the decision is made after the surgery begins and the surgeon is able to see whether there are other problems.

In a vaginal hysterectomy, the uterus is removed through the vagina. There is no abdominal incision. Not all women are able to have a vaginal hysterectomy. For example, women who have adhesions from previous surgery or who have a very large uterus may not be able to have this type of surgery.

Vaginal hysterectomy generally causes fewer complications than abdominal or laparoscopic hysterectomy. Healing time may be shorter than with abdominal surgery, with a faster return to normal activities. It is recommended as the first choice for hysterectomy when possible.

Laparoscopic surgery requires only a few small incisions in your abdomen. A laparoscope inserted through one of these incisions allows the surgeon to see the pelvic organs. Other surgical instruments are used to perform the surgery through other small incisions. Your uterus can be removed in small pieces through the incisions, through a larger incision made in your abdomen, or through your vagina (which is called a laparoscopic vaginal hysterectomy).

A robot-assisted laparoscopic hysterectomy is performed with the help of a robotic machine controlled by the surgeon. In general, it has not been shown that robot-assisted laparoscopy results in a better outcome than laparoscopy performed without robotic assistance.

Compared with abdominal hysterectomy, laparoscopic surgery results in less pain, has a lower risk of infection, and requires a shorter hospital stay. You may be able to return to your normal activities sooner. There also are risks with laparoscopic surgery. It can take longer to perform compared with abdominal or vaginal surgery, especially if it is performed with a robot. Also, there is an increased risk of injury to the urinary tract and other organs with this type of surgery.

Abdominal hysterectomy can be performed even if there are adhesions or if the uterus is very large. But abdominal hysterectomy is associated with greater risk of complications, such as wound infection, bleeding, blood clots, and nerve and tissue damage, than vaginal or laparoscopic hysterectomy. It generally requires a longer hospital stay and a longer recovery time than vaginal or laparoscopic hysterectomy.

Some problems related to the surgery may not show up until a few days, weeks, or even years after surgery. These problems include formation of a blood clot in the wound or bowel blockage. Complications are more common after an abdominal hysterectomy.

You may need to stay in the hospital for up to a few days after surgery. The length of your hospital stay will depend on the type of hysterectomy you had and how it was done. You will be urged to walk around as soon as possible after your surgery. Walking will help prevent blood clots in your legs. You also may receive medicine or other care to help prevent blood clots.

You can expect to have some pain for the first few days after the surgery. You will be given medication to relieve pain. You will have bleeding and discharge from your vagina for several weeks. Sanitary pads can be used after the surgery. Constipation is common after most hysterectomies. Some women have temporary problems with emptying the bladder after a hysterectomy. Other effects may be emotional. It is not uncommon to have an emotional response to hysterectomy. You may feel sad that you are no longer able to bear children, or you may be relieved that your former symptoms are gone.

A partial hysterectomy, shown top left, removes the uterus. A total hysterectomy, shown top right, removes the uterus and cervix. The surgeon also may remove the ovaries and fallopian tubes, shown on the bottom.

An abdominal hysterectomy is an operation that removes the uterus through a cut in the lower belly, also called the abdomen. This is known as an open procedure. The uterus, also called the womb, is where a baby grows when someone is pregnant. A partial hysterectomy removes the uterus, leaving the neck of the womb in place. The neck of the womb is the cervix. A total hysterectomy removes the uterus and the cervix.

A hysterectomy also can be done through a cut in the vagina. This is called a vaginal hysterectomy. Or you may have laparoscopic or robotic surgery, which uses long, thin instruments passed through small cuts in the belly.

After hysterectomy, you can no longer get pregnant. If there's a chance you might want to become pregnant in the future, ask your health care provider about other treatment options. In the case of cancer, a hysterectomy might be your only option. But for conditions such as fibroids, endometriosis and uterine prolapse, there may be other treatments.

During hysterectomy surgery, you might have a related procedure to remove the ovaries and the fallopian tubes. If you're still having periods, removal of both ovaries leads to what's known as surgical menopause.

During abdominal hysterectomy, your surgeon makes a vertical or a horizontal cut, called an incision, in the lower abdomen. A vertical cut, shown left, gives the surgeon more access to the pelvis. A horizontal cut, shown right, follows the skin's natural lines, usually leaving a thinner scar.

What type of incision you'll need depends on many factors. These include the reason for the hysterectomy, the need to explore the upper abdomen, the size of the uterus and whether you have any scars from prior surgeries.

You may be in the hospital for 1 to 2 days, but it could be longer. Sanitary pads can help control vaginal bleeding and discharge. You may have bloody vaginal drainage for several days to weeks after a hysterectomy. Let your care team know if you have bleeding that is as heavy as a period or bleeding that won't stop.

But you may have a sense of loss after a hysterectomy. Premenopausal women who need to have a hysterectomy to treat gynecologic cancer may grieve the loss of fertility. If sadness or negative feelings interfere with your enjoyment of everyday life, talk with a health care provider.

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.

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.

Hysterectomy is major surgery. Sometimes a hysterectomy may be medically necessary, such as with prolonged heavy bleeding or certain types of cancer. But sometimes you can try other treatments first. These include:

Each year in the United States, nearly 500,000 women get hysterectomies.2 A hysterectomy is the second most common surgery among women in the United States. The most common surgery in women is childbirth by cesarean delivery (C-section).

Ovaries may be removed during hysterectomy to lower the risk for ovarian cancer. However, women who have not yet gone through menopause also lose the protection of estrogen, which helps protect women from conditions such as heart disease and osteoporosis.

All women who have a hysterectomy will stop getting their period. Whether you will have other symptoms of menopause after a hysterectomy depends on whether your doctor removes your ovaries during the surgery.

If you keep your ovaries during the hysterectomy, you should not have other menopausal symptoms right away. But you may have symptoms a few years younger than the average age for menopause (52 years). e24fc04721