Health
doctor holing a uterus and ovaries model
doctor holing a uterus and ovaries model
doctor holing a uterus and ovaries model

Hysterectomy

Hysterectomy is surgery to remove the uterus (womb). After a hysterectomy, you will not menstruate (have periods) or be able to get pregnant. Uterus removal is a common treatment for a variety of conditions that affect a woman’s reproductive organs.

About half a million hysterectomies are performed each year in the U.S. It is the second most common surgical procedure for women, after cesarean delivery (C-section). Most hysterectomies are performed between the ages of 40 and 50. 

What is a hysterectomy?

A hysterectomy removes the uterus and sometimes other reproductive organs, such as the ovaries and fallopian tubes. The type of hysterectomy you have will depend on the reason for treatment.

Types of Hysterectomies

There are several types of hysterectomies. Your healthcare provider will discuss the risks, benefits and potential side effects of each procedure. It’s also important to ask your healthcare provider if they are recommending removal of the ovaries and fallopian tubes during your hysterectomy. Types of hysterectomies include:

  • Total hysterectomy removes the entire uterus and the cervix (most common type).
  • Partial hysterectomy (also called supracervical hysterectomy) removes only the upper part of the uterus, not the cervix (research is ongoing about the risks and benefits of leaving the cervix intact).
  • Radical hysterectomy removes the uterus, cervix and upper part of the vagina (usually for cancer treatment).

How long does hysterectomy surgery take?

Hysterectomy surgery can take between one and four hours. The duration of surgery depends on the type of procedure you have and how it is performed.

Types of hysterectomy

Reasons for a Hysterectomy

There are a variety of reasons your doctor may recommend a hysterectomy, including:

Abdominal Hysterectomy

A surgeon performs an abdominal, or open, hysterectomy through an incision (cut) in your abdomen. The incision is usually horizontal and low on your belly, just above your pubic bone. In some cases, a surgeon may use a longer vertical incision if you have a very large uterus.

For an abdominal hysterectomy, you can expect:

  • Anesthesia: General
  • Hospitalization: two to three days
  • Incision size: 6 to 12 inches for horizontal incisions; longer for vertical incisions
  • Procedure time: one to two hours
  • Recovery: four to six weeks

Laparoscopic or Robotic Hysterectomy

In many cases, a hysterectomy can be performed using minimally invasive techniques. A laparoscopic hysterectomy is performed through several small incisions in your abdomen instead of one large incision.

A surgeon inserts a laparoscope (a thin, flexible tube containing a video camera) through one incision. The laparoscope allows the surgeon to view your pelvic organs on a video monitor. Tiny surgical tools may also be used in the other incisions to remove your uterus intact or in sections.

A robotic hysterectomy is another type of minimally invasive uterus removal. Your surgeon uses the assistance of a robotic arm to remove your uterus through small abdominal incisions.

For a laparoscopic or robotic hysterectomy, you can expect:

  • Anesthesia: General
  • Hospitalization: one night
  • Incision size: 5–12 millimeters
  • Procedure time: one to three hours
  • Recovery: three to four weeks

Hysteroscopic Hysterectomy

Hysteroscopic (vaginal) hysterectomy is the least invasive approach to uterus removal. The uterus is removed through an incision at the top of the vagina, so you don’t have any external scarring.

Several factors may determine whether you are a candidate for a hysteroscopic hysterectomy, including:

  • Conditions that could prevent vaginal access to the uterus, such as severe endometriosis or adhesions (scar tissue)
  • Need for ovary and fallopian tube removal
  • Previous vaginal births
  • Size and shape of your vagina and uterus

For a hysteroscopic hysterectomy, you can expect:

  • Anesthesia: General or sedation
  • Hospitalization: one night, though many women can go home the day of the procedure
  • Incision size:
  • Procedure time: one to two hours
  • Recovery: three to four weeks

Hysterectomy Side Effects and Risks

Hysterectomy is generally a safe procedure with excellent success rates. However, potential risks and side effects of the procedure include:

  • Early menopause, with symptoms such as hot flashes or insomnia when ovaries are removed
  • Excessive bleeding or blood clots
  • Incontinence due to bladder or bowel damage
  • Reactions to anesthesia
  • Vaginal dryness or lower libido (sex drive)
  • Vaginal prolapse
  • Wound infection

Hysterectomy Recovery

Recovery after a hysterectomy will depend on the type of procedure you have. After an abdominal hysterectomy, expect a recovery period of four to six weeks. Recovery after a minimally invasive hysterectomy, such as robotic, laparoscopic or hysteroscopic, is about three to four weeks. During this time, avoid strenuous activity and lifting heavy objects. Your doctor will let you know when you can resume normal activities such as work, exercise and sexual intercourse.

Hysterectomy for Gender Affirmation

Men who are transgender and people who are nonbinary may consider hysterectomy salpingectomy (removal of the fallopian tubes), oophorectomy (removal of the ovaries) or a combination of these procedures as part of their gender affirmation surgery plan.

The procedure or procedures you and your health care practitioner decide on may depend on several factors, including your general health and your preferences regarding fertility and the ability to carry a pregnancy or to become a biological parent. Reproductive technology experts can explain the range of options available, including egg freezing and other ways to retain fertility.

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