A hysterectomy can treat various health problems affecting the female reproductive system. At NewYork-Presbyterian, our team of expert gynecologic surgeons provides comprehensive care for women receiving any type of hysterectomy.
What is a Hysterectomy?What is a Hysterectomy?
A hysterectomy is a surgery performed to remove the uterus, often achieved through an incision in the vagina or the abdomen. Depending on the reason for the operation, your doctor may remove the uterus, or the procedure may also involve removing surrounding organs such as the cervix, ovaries, or fallopian tubes. After the operation, you’ll lose the ability to get pregnant and will no longer menstruate. Some reasons for a hysterectomy include endometriosis, uterine fibroids, abnormal vaginal bleeding, and cancer.
Types of HysterectomiesTypes
A gynecologic surgeon will determine the type of hysterectomy required. They will consider whether the uterus needs to be removed and if the cervix, fallopian tubes, and ovaries should also be removed.
- Total hysterectomy - Removal of the uterus and cervix
- Supracervical hysterectomy - Removal of the uterus, leaving the cervix in place. This is sometimes referred to as a “partial” or “subtotal” hysterectomy.
- Radical hysterectomy - Removal of the entire uterus, cervix, fallopian tubes, ovaries, and the upper part of the vagina. This type of hysterectomy is generally only performed when cancer is present.
How is a Hysterectomy Performed?Procedure
There are several ways a doctor can carry out a hysterectomy. They will choose the best method based on a patient’s biology, the reason for the hysterectomy, and the patient’s overall health. Hysterectomies can be performed through an incision in the vagina or abdomen, with a laparoscope, or with the assistance of a robotic system. The procedure is usually performed under general anesthesia.
- Abdominal hysterectomy: Removal of the uterus through an incision in the lower abdomen, which may be made vertically or horizontally. Also known as open surgery, a doctor may recommend an abdominal hysterectomy if the patient has a very large uterus.
- Vaginal hysterectomy: Removal of the uterus through an incision in the top of the vagina. A vaginal hysterectomy is less invasive than an abdominal hysterectomy and leaves no visible scar.
- Laparoscopic hysterectomy: Removal of the uterus with the help of a laparoscope, a slender tool with a telescope, and a tiny video camera at the end. The doctor inserts the laparoscope and several other surgical instruments through very small incisions in the abdomen and can perform the hysterectomy from outside the body. In this minimally invasive technique, the uterus is removed either in small pieces through the incisions in the abdomen or an incision in the vagina.
- Robotic-assisted laparoscopic hysterectomy: Removal of the uterus with the assistance of a robotic system of surgical tools. Similar to a laparoscopic hysterectomy, the robot involved in this procedure allows the doctor to perform more complex movements.
Hysterectomy Risks to ConsiderRisks
Hysterectomies are generally very safe, and most patients do not experience serious complications. As with any surgery, however, there are always associated risks, including:
- Infection - There is always a risk of infection after an operation. Infections can usually be treated easily with antibiotics.
- Bleeding - There is a small risk of heavy bleeding after having a hysterectomy. If significant blood loss occurs, you may need a blood transfusion.
- Blood clots - Any major surgery is a risk factor for blood clots (thrombosis). In order to reduce blood clot risk after surgery, your doctor may recommend light exercise and anticoagulant medication.
- Anesthesia complications
- Damage to surrounding organs
Preparing for HysterectomyPreparing
After discussing the risks and benefits of a hysterectomy and the best type of procedure with your doctor, it’s time to prepare for the surgery. It’s normal to feel anxious about having a hysterectomy, but there are a few things you can do to ensure your procedure goes as smoothly as possible.
- Ask questions - It’s important to gather all the information you need to feel comfortable about your decision to have a hysterectomy. Don’t be afraid to ask your doctor questions about how the surgery will go or what to expect during recovery. Knowing all the steps involved in the procedure helps some patients feel more confident about undergoing a hysterectomy.
- Discuss medication with your doctor - Tell your doctor about any prescription medications, over-the-counter drugs, or dietary supplements you take. Your physician may recommend changing your medication routine before having a hysterectomy.
- Plan for recovery - Depending on the type of hysterectomy, you may have to plan for a hospital stay and, consequently, take time away from work. Recovery time varies but could take up to several weeks. Arranging for help from a family member or friend can make this time easier.
- Follow your doctor’s instructions about eating and drinking - You may be instructed to avoid solid foods and/or liquids for a certain amount of time before your hysterectomy. Be sure to follow your doctor’s directions regarding what is safe to eat and drink in the days and hours before your surgery.
What to Expect after Hysterectomy SurgeryAfter the Surgery
After a hysterectomy, you will spend time recovering in the hospital for anywhere from a few hours to two days. During this time, your doctor will monitor you for signs of complications and encourage you to walk as soon as possible to prevent blood clots. What hysterectomy recovery looks like differs based on the procedure performed, but you will be asked to schedule follow-up appointments after undergoing any hysterectomy.
You’ll be required to abstain from sexual intercourse for at least six weeks, and your movement will be restricted during recovery. Walking is encouraged, but be sure to ask your doctor when you can safely resume normal activities like driving or lifting heavy objects.
- Abdominal hysterectomy: This type of hysterectomy usually requires a hospital stay of two to three days following the surgery. Recovery takes around six to eight weeks.
- Vaginal hysterectomy: Vaginal hysterectomies are less invasive than abdominal hysterectomies, and recovery time can be as short as three to four weeks
- Laparoscopic or robotic hysterectomy: Usually requires a recovery period of three to four weeks
Side effects to consider
Following your hysterectomy, you should call your doctor if you suffer serious complications, including fever, heavy bleeding, and chest pain. However, there are several common side effects you may experience that are normal and expected after undergoing a hysterectomy.
- Mild pain and fatigue: It’s common to experience some pain and tiredness after awakening from general anesthesia. Your doctor may administer pain medication to manage symptoms.
- Vaginal bleeding and discharge: After a hysterectomy, you may experience vaginal bleeding and/or discharge for several weeks following the surgery. For the next few weeks, you can use a sanitary pad (not a tampon). Visit your doctor if you experience heavy bleeding or the discharge has a strong odor.
- Menopausal symptoms: If your hysterectomy involves the removal of your ovaries, you might experience menopausal symptoms, including hot flashes, anxiety, and sweating. Your doctor may present treatment options like hormone therapy (HT) to manage these symptoms.
How long does a hysterectomy take?
A hysterectomy procedure usually lasts about two hours, though you may spend additional time on site preparing for the surgery. The procedure length depends on several factors. This includes uterus size, scarring from previous surgeries, and if other organs are being removed along with the uterus.
What not to do after a hysterectomy?
Why is my stomach bigger after a hysterectomy?
Bloating and swelling are common after a hysterectomy. Swelling can take four to six weeks to go down but may subside more quickly.
Experts in Hysterectomy Surgery at NewYork-Presbyterian
At NewYork-Presbyterian, multidisciplinary teams of physicians can provide patients undergoing a hysterectomy with a comprehensive care plan that considers their individual needs. Our experienced gynecologic surgeons are trained in the most cutting-edge hysterectomy techniques and have subspecialties in minimally invasive surgery, including laparoscopic and robotic techniques.