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Learning About Hysterectomy Surgery

Female pelvic organs

What is a hysterectomy?

A hysterectomy is surgery to take out the uterus. Sometimes the ovaries and fallopian tubes also are removed at the same time.

How is this surgery done?

There are many ways to do the surgery. The type you have depends on your medical condition. It also depends on your overall health. Talk with your doctor about which type is right for you.

Abdominal surgery

This is done through a cut, called an incision, that the doctor makes in the lower belly. Your doctor may do surgery this way if:

  • You have a lot of scar tissue around your uterus.
  • Your uterus is very large.
  • You have cancer of the uterus or cervix.
  • Your doctor needs to check the area around your uterus for problems.

Vaginal surgery

This is done through the vagina. Your doctor may do surgery this way if:

  • Your uterus is normal in size. The smaller size means it can be removed easily.
  • You do not have endometriosis. (It is a problem that causes tissue in the uterus to grow in other parts of the body.)
  • You do not have cancer of the uterus or cervix.

Laparoscopically assisted vaginal surgery

This is done through the vagina and one or more small cuts in the belly. The doctor will insert a laparoscope and special tools through the cuts in the belly. The scope and tools help free the uterus. Then it is removed through the vagina.

Laparoscopic supracervical surgery

This is done through several small cuts in the belly. The doctor inserts a scope and special tools through the cuts in the belly. He or she takes out the uterus in small pieces through the cuts. The cervix is left in place. This is an option when cancer of the cervix is not a concern.

In rare cases, during a vaginal or laparoscopic surgery, the doctor may find a problem that makes abdominal surgery a better choice. If this happens, the doctor will take out the uterus through a cut in the lower belly.

What can you expect after your surgery?

Recovery can take from 4 to 6 weeks. It depends on which type of surgery you have. You will need help around the house while you get better. You won't be able to do any heavy lifting. And you will have to take it easy for a few weeks. It is normal to feel more tired than usual. You also may notice that your emotions go up and down more than usual for a while.

After surgery, you will no longer have periods. You will not be able to get pregnant. If there is a chance that you will want to have a baby in the future, talk to your doctor about other treatment options.

The surgery should not lower your interest in sex after you have healed. In fact, some women enjoy sex more. They no longer have to worry about birth control or heavy bleeding. Some women have vaginal dryness after the surgery. It can make sex less comfortable. A vaginal lubricant, such as Astroglide or K-Y Jelly, can help.

You may need to take hormone pills after your surgery if your ovaries are removed and you have not gone through menopause. Taking out the ovaries before menopause causes a sudden drop in the hormone estrogen. This increases your risk of getting weak and brittle bones (osteoporosis). Although estrogen therapy lowers this risk, it does slightly raise the risk of some other problems. These include breast cancer and stroke. Talk with your doctor about the pros and cons of taking estrogen if you have your ovaries removed.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It is also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

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