(Surgical Removal of the Uterus; Abdominal Hysterectomy)
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Hysterectomy is a surgery to remove the uterus. There are different types of surgeries, such as:
- Supracervical hysterectomy—removal of the uterus without including the cervix
- Total hysterectomy—removal of the uterus and cervix (the lower portion of the uterus leading to the vagina)
- Radical hysterectomy—removal of the uterus, ovaries, fallopian tubes, upper part of the vagina, and the pelvic lymph nodes
- Salpingo-oophorectomy—removal of the ovaries and fallopian tubes (may be combined with any of the above procedures)
Laparoscopic surgery uses small incisions to access the area. It can lead to fewer problems and shorter recovery than open surgery. Scars from the surgery will also be much smaller.
Reasons for Procedure
A hysterectomy may be done if there are health problems that cannot be treated by other means. Some common reasons are:
- Treat cancers such as uterine, endometrial, and ovarian cancers
- Remove uterine fibroids
- Treat chronic pelvic pain
- Treat heavy bleeding
Surgery is often the last choice. Other treatments are often tried first.
Complications are not common but all procedures have some risks. The doctor will review a list of possible problems from this surgery including:
- Reactions to anesthesia
- Injured pelvic organs—bowel and/or bladder
- Urinary incontinence—problems controlling your urine
- Loss of ovarian function and early menopause
- Sexual dysfunction
Some things may increase the risk of problems such as:
What to Expect
Prior to Procedure
The doctor will review results from earlier tests. Before the procedure the doctor may ask:
- About any current medicine. Some medicine may need to be stopped up to 1 week before the procedure.
- That you arrange for a ride home and help at home.
- That you do not eat or drink anything after midnight the night before.
General anesthesia will be used. You will be asleep during the surgery.
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Description of the Procedure
Your care team may give antibiotics just before surgery.
Small cuts are made in the lower belly. Small tools and a tiny camera are passed through the incisions. The surgeon will be able to see inside the belly. The uterus can be removed through these openings. Additional options include:
- Laparoscopic-assisted vaginal hysterectomy—After the steps above, tissue is removed through the vagina.
- Robot-assisted hysterectomy—the surgery is done with robot arms. This helps the surgeon do very fine movements. It can help to reduce injury to nearby tissue.
Immediately After Procedure
IV fluids and medicine will be given in recovery.
How Long Will It Take?
1 to 3 hours—although it may take longer
Will It Hurt?
You will not have pain during the surgery because of the anesthesia. The lower belly and incision will be sore for a few weeks. Pain medicine and support can ease discomfort. It will ease over time.
Average Hospital Stay
You may go home on the same day or the next. A longer stay may be needed if there are problems.
At the Hospital
You will be encouraged to walk. A catheter may be left in place to help pass urine.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chances of infection such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions
Movement can be uncomfortable for a few weeks. Some activity will be limited.
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, leakage, or any discharge from the incision sites
- Nausea and/or vomiting
- Cough, shortness of breath, or chest pain
- Heavy bleeding
- Pain that you cannot control with the medications you have been given
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Swelling, redness, or pain in your leg
If you think you have an emergency, call for emergency medical services right away.
The American Congress of Obstetricians and Gynecologists
Family Doctor—American Academy of Family Physicians
Canadian Medical Association
American College of Obstetricians and Gynecologists. Committee Opinion No 701: Choosing the route of hysterectomy for benign disease. Obstet Gynecol. 2017 Jun;129(6):e155-e159.
Hysterectomy. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq008.pdf?dmc=1&ts=20120815T1040007858. Updated March 2015. Accessed March 19, 2020.
Hysterectomy. EBSCO DynaMed website. Available at:https://www.dynamed.com/procedure/hysterectomy/. Updated August 16, 2019. Accessed March 19, 2020.
Nesbitt-Hawes EM, et al. Laparoscopic subtotal hysterectomy: evidence and techniques. J Minim Invasive Gynecol. 2013 Jul-Aug;20(4):424.
Last reviewed September 2019 by EBSCO Medical Review Board Mary-Beth Seymour, RN Last Updated: 9/16/2020