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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 that the doctor makes in the lower belly. The cut is called an incision. It may be across the bikini line or straight up and down. The doctor takes out the uterus and the cervix. This procedure is most often done when the woman might have cancer. It's also often done when the uterus is hard to remove. This may be because of severe endometriosis, a lot of scar tissue (adhesions), or a very large uterus.

Vaginal surgery

This is done through the vagina. The doctor makes a small cut in the vagina instead of the belly. This method isn't used when there's a chance that cancer may be in the uterus, cervix, or ovaries. It's used when the uterus is normal in size and easy to remove.

Laparoscopic surgery

The doctor puts a lighted tube (laparoscope) through small cuts in the belly. The doctor can see your organs with the scope. The doctor can insert surgical tools to cut the tissue that holds your uterus in place. Then the uterus is removed. It may be removed through small cuts in the belly. (This is called laparoscopic abdominal hysterectomy.) Or it may be removed through the vagina. (This is called laparoscopically assisted vaginal hysterectomy.)

What can you expect after your surgery?

Recovery can take 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's common 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 won't be able to get pregnant. If there's 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 people enjoy sex more. They no longer have to worry about birth control or heavy bleeding. You may 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 haven't gone through menopause. Taking out the ovaries before menopause causes a sudden drop in the hormone estrogen. This raises your risk of getting weak and brittle bones (osteoporosis). Estrogen therapy lowers this risk. But it slightly raises 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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