If you have been diagnosed with fibroids, are experiencing chronic pelvic pain, heavy or painful periods, or have a prolapsed uterus, your doctor may recommend a hysterectomy, a surgery to remove the uterus.
According to the U.S. Department of Health and Human Services, more than 600,000 hysterectomies are performed each year. One in three American women has a hysterectomy by age 60.
Types of hysterectomy*
- Complete or total – the most common type of hysterectomy, involves removing the cervix as well as the uterus.
- Partial or subtotal (also called supracervical) – the upper part of the uterus is removed, but the cervix is left in place.
- Radical – this type may be done if there is a cancer diagnosis. In addition to the uterus and cervix, the upper part of the vagina, fallopian tubes, ovaries and lymph nodes may be removed.
*In any type of hysterectomy the ovaries may or may not be removed. When the ovaries are removed, the procedure is referred to as a hysterectomy with a salpingoophrectomy.
Women who have had a hysterectomy no longer experience monthly bleeding. If the ovaries are removed, the patient will enter menopause, and hormone replacement therapy may be necessary. Patients should talk to their doctor about which type of hysterectomy is best for their individual needs.
Hysterectomies can be performed using a variety of techniques. Not all patients are candidates for all types of surgery. Your doctor can recommend the procedure that best fits your health situation.
- Abdominal hysterectomy – the surgery is performed through an incision in the abdomen.
- Vaginal hysterectomy – the uterus is removed through the vagina. Vaginal hysterectomy is less invasive than the abdominal procedure, but not all patients are a good candidate for this type of hysterectomy.
- da Vinci® hysterectomy – the surgeon uses robotic technology to complete the procedure laprascopically, using only a few small incisions. Learn more >>
All of these procedures are performed under general anesthesia and require a hospital stay. Recovery time for vaginal and da Vinci® hysterectomies is typically shorter than with an abdominal procedure.
Though hysterectomy is a common procedure, it is an inpatient surgery, which means it requires a hospital stay. In many cases, a minimally-invasive alternative may address symptoms without removing the uterus. These procedures can typically be done on an outpatient basis.
- Endometrial ablation – this procedure is used to treat excessive menstrual bleeding (menorrhagia). Learn more >>
- Uterine fibroid embolization (UFE), also called uterine artery embolization – UFE treats uterine fibroids. Learn more >>
- Tubal ligation or tubal implants (Essure) – permanent birth control. Learn more >>
Talk to your doctor to learn more about the benefits and risks associated with these procedures, and whether they are appropriate treatment options for your health situation.
Below are questions patients commonly ask prior to scheduling a hysterectomy. Your Community physician will be able to discuss these topics with you in further detail based on your individual health situation. To find a physician, try our online Find a Doctor tool.
Is hysterectomy my only option?
Ask your doctor if there are any minimally invasive alternatives to a hysterectomy. First make sure that the option of medical treatment has been adequately explored. This could include birth control pills, the Depo-Provera shot, or a Mirena intrauterine device. Other procedural options could include an endometrial ablation, which can be done for heavy bleeding or a uterine artery embolization, which can be done for fibroids.
How will the hysterectomy be performed?
There are different surgical techniques for performing a hysterectomy. Be sure to ask your doctor which procedure is best for you: abdominal, vaginal or laparoscopic.
Is it necessary to remove the ovaries as part of the hysterectomy?
Patients who have their ovaries removed as part of the hysterectomy will go through menopause following the procedure. The transition is more abrupt with surgical removal of the ovaries than with natural menopause. The ovaries still produce testosterone and small amounts of estrogen after menopause. Because hormone levels vary from woman to woman, medicines don’t always duplicate exactly the biochemical makeup of the ovary. “Your doctor will be able to guide you as to whether or not removal of the ovaries should be part of your hysterectomy procedure,” says Dr. Ertel, M.D., Ob/Gyn at Community Health Network. “However, if you have a family history of breast or ovarian cancer, or have endometriosis you probably want to consider having your ovaries removed.”
Will my sex life change after surgery?
In general, post-hysterectomy sexual function is similar to pre-hysterectomy sexual function. The exception is that if you are having the hysterectomy to resolve pain during intercourse, sex should be more enjoyable once the uterus is removed. Studies have shown that post-hysterectomy sexual function is similar whether you leave the cervix in or remove it with the hysterectomy. Your doctor can answer this question based on your particular health situation.
How will I feel during recovery?
A common complaint after surgery is fatigue, so most patients need to take time to rest and recover. Recovery time varies by patient and by how the hysterectomy is performed (abdominally, vaginally or laparascopically). “In general, if you are optimistic going into surgery, you will recover faster than someone who isn’t,” says Dr. Ertel. “Talk to your doctor about any questions you have prior to surgery, no matter how trivial the detail. We want you to feel as safe as possible before, during and after surgery.”