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Hysterectomy—Open Surgery

(Surgical Removal of the Uterus [or Womb]; Abdominal Hysterectomy; Vaginal Hysterectomy)

Click here to view an animated version of this procedure.

Definition

Hysterectomy is surgery to remove the uterus (womb). Pregnancy will no longer be possible.

There are different types this surgery:

  • Supracervical hysterectomy—removal of the uterus only
  • Total hysterectomy—removal of the uterus and cervix (the opening 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)

Reasons for Procedure

This procedure may be done if the uterus is causing health problems that cannot be treated by other means. It may also be done to:

  • Treat cancers, such as uterine, endometrial, and ovarian cancers
  • Remove uterine fibroids
  • Treat conditions, such as chronic pelvic pain or heavy bleeding

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

Things that may raise the risk of problems are:

  • Smoking
  • Drinking alcohol
  • Chronic diseases, such as diabetes or obesity
  • Previous pelvic surgery or serious infection

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Whether you need to clean the bowels with an enema the night before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Arranging a ride to and from surgery
  • Tests that will need to be done before surgery, such as images of the area

Anesthesia

General anesthesia will be used. You will be asleep.

Description of the Procedure

This surgery will be done in one of two ways:

Open Abdominal Hysterectomy

An incision will be made in the lower abdomen. This will expose the tissue and blood vessels that surround the uterus. The tissue will then be cut. The blood vessels will be tied off. The uterus will be removed. Next, the abdominal wall will be sewn back together and the skin will be closed with stitches or staples. If the cervix is also removed, stitches will be put in the top of the vagina. Bandages will be placed over the abdomen. The vagina will be packed with gauze. This will be removed in 1 to 2 days.

Open Vaginal Hysterectomy

This method will not involve any outside incisions. The vagina will be stretched and kept open with special tools. Next, the uterus and cervix will be cut free. The connecting blood vessels will be tied off. The uterus and cervix will be removed through the vagina. Lastly, the top of the vagina will be closed with stitches. The vagina will be packed with gauze. This will be removed in 1 to 2 days.

How Long Will It Take?

1 to 3 hours

Will It Hurt?

Pain, bloating, and vaginal discharge and bleeding are common in the first few days. Medicine and home care can help.

Average Hospital Stay

The usual length of stay is 1 to 3 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, the staff may:

  • Give you pain medicine
  • Encourage you to walk

At Home

It will take about 3 to 8 weeks to fully heal, depending on which procedure was done. Physical activity and sex will be limited during this time. Tampons will need to be avoided. Ask for help with daily activities and delay your return to work.

Call Your Doctor

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, excessive bleeding, or discharge
  • Pain that you cannot control with medicine
  • Pain, burning, urgency or frequency of urination, or lasting blood in the urine
  • Swelling, redness, or pain in the legs

If you think you have an emergency, call for medical help right away.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org

Women's Health—US Department of Health and Human Services
http://www.womenshealth.gov

CANADIAN RESOURCES

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

Women's Health Matters
http://www.womenshealthmatters.ca

REFERENCES:

Hysterectomy. American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/womens-health/~/link.aspx?_id=38BFB30FBDF24ABBB6B8AF4406E9100D&_z=z. Accessed August 25, 2021.

Hysterectomy. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/hysterectomy. Accessed August 25, 2021.

Hysterectomy. Women's Health—US Department of Health and Human Services website. Available at: https://www.womenshealth.gov/a-z-topics/hysterectomy. Accessed August 25, 2021.

Last reviewed July 2021 by EBSCO Medical Review BoardBeverly Siegal, MD, FACOG  Last Updated: 8/25/2021