(Surgical Removal of the Uterus; Abdominal Hysterectomy)
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Hysterectomy is the surgical term for the removal of the uterus. This results in the inability to become pregnant.
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)
Reasons for Procedure
You may have a hysterectomy if your uterus is causing health problems that cannot be treated by other means. Some reasons a woman may have a hysterectomy are to:
- Treat cancers such as uterine, endometrial, and ovarian cancers
- Remove uterine fibroids
- Treat chronic pelvic pain
- Treat heavy bleeding
Explore your options before having a hysterectomy. There are other treatments for many of these problems.
If you are planning to have hysterectomy, your doctor will review a list of possible complications, which may include:
- 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
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
The following may also increase the risk of complications:
- Previous pelvic surgery or serious infection
- Use of certain medications
What to Expect
Prior to Procedure
Your doctor may do the following:
- Blood and urine tests
- Pap smear
- MRI scan of abdomen and kidneys—a test that uses magnetic waves to take a picture of structures inside the body
- CT scan of abdomen and kidneys—a test that uses radiation to take a picture of structures inside the body
- Pelvic ultrasound —a test that uses sound waves to show organs in the abdomen
- Dilation and curettage (D&C)—surgical removal of tissue from the lining of the uterus
- Endometrial biopsy —removes a sample of tissue from the lining of the uterus
You should do the following:
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
- Arrange for a ride home and for help at home.
- Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
General anesthesia will be used. You will be asleep during the surgery.
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Description of the Procedure
You may be given antibiotics just before your surgery.
Laparoscopic procedures are minimally invasive. This means that small incisions are made, rather than the large incisions that are used during open surgery. Small tools and a tiny camera are placed through the incisions to allow the surgeon to see inside and perform surgical tasks.
Laparoscopic-Assisted Vaginal Hysterectomy
Similar to the above surgery, small incisions will be made in the abdominal area and tools will be inserted. Incisions will be made in the vagina to help detach the lower portion of the cervix and the uterus. The cervix and uterus will then be removed through the vaginal opening.
A hysterectomy can also be done using robotic technology. Like the laparoscopic procedures, tools are placed through small incisions in the abdominal area. The doctor, though, sits at a console and views the organs via a monitor that displays a 3D image. The surgery is done using a joystick-like device to control the tools.
Immediately After Procedure
You will be given IV fluids and medications.
How Long Will It Take?
1-3 hours—although it may take longer
Will It Hurt?
You will not have pain during the surgery because of the anesthesia. During your recovery time, you will be given pain medication.
Average Hospital Stay
You may be able to leave the hospital on the same day or the next day. You will stay longer if you have complications.
At the Hospital
While you are recovering at the hospital, you may receive the following care:
- On the first night, the nurse will help you sit up and walk.
- During the next morning, the IV will be removed if you are eating and drinking well.
- You may need to wear special stockings or boots to help prevent blood clots.
- You may have a Foley catheter for a short time to help you urinate.
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
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
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 September 11, 2017.
Hysterectomy. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116102/Hysterectomy. Updated May 25, 2017. Accessed September 11, 2017.
The treatment: robot-assisted laparoscopic hysterectomy. UC Davis Health System website. Available at: http://www.ucdmc.ucdavis.edu/obgyn/specialties/robotic_surgery/hysterectomy.html. Accessed September 11, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Beverly Siegal, MD, FACOG Last Updated: 9/30/2014