Hysterectomy is a surgery to remove a woman's uterus or womb. Hysterectomy is second only to C-section deliveries as the most common surgery for women; about 600,000 hysterectomies are performed in the United States each year. A hysterectomy can be necessary to treat:
- Invasive cancer of the uterus, cervix, vagina, fallopian tubes, and/or ovaries
- Prolapse of the uterus
- Fibroids
- Endometriosis
- Unmanageable bleeding
- Chronic pelvic pain
There may be ways to treat your health problem without having a hysterectomy, and you should talk with your doctor about all of your treatment options. Hysterectomy surgery can involve more than the removal of the uterus:
Partial Hysterectomy removes the body of the uterus while the cervix is left in place. In some cases, “partial” may also refer to removal of the uterus and cervix, leaving the ovaries intact. If you are planning a hysterectomy, be sure that you and your doctor understand each other when it comes to whether the cervix will be removed.
Total or Simple Hysterectomy removes the entire uterus and cervix. Sometimes, the term “total” can refer to removal of both ovaries, as well as the cervix and uterus
Radical Hysterectomy removes the uterus, cervix, ovaries, fallopian tubes, and possibly upper portions of the vagina and affected lymph glands.
There are a number of ways that a hysterectomy can be performed. They include:
Abdominal Hysterectomy – in which a surgeon uses a vertical incision or a "bikini cut" horizontal incision across the abdomen. This once was the most common approach for removing the uterus and other reproductive organs, and it is becoming less common as robotic surgery is being performed more widely. However, in many cases, it may still be the safest approach, depending on your particular situation.
Vaginal Hysterectomy – in which the uterus is removed through the vagina, avoiding visible scarring and typically allowing for a quicker recovery than with an abdominal hysterectomy.
Laparoscopic-Assisted Vaginal Hysterectomy – which employs video technology to provide the surgeon with greater visibility when removing the uterus through the vagina.
Robotic-assisted surgery – in which a surgeon uses a special robotic tool to perform the surgery through small cuts in your belly, much like a laparoscopic hysterectomy.
Recovering from a hysterectomy takes time. Most women stay in the hospital overnight for a vaginal, laparoscopic-assisted vaginal, or robotic hysterectomy, and from 1 to 2 days after an abdominal hysterectomy. You will gradually be able to increase your activities, but abdominal surgery recovery takes from 4 to 6 weeks. Minimally invasive methods such as laparoscopic or robotic surgery result in a shorter hospital stay, less pain and scarring, and less risk of infection. Recovery is faster and typically takes just 2 to 4 weeks.
