A hysterectomy is surgery to remove a woman’s uterus, or womb. The womb is the area where a baby grows when a woman is pregnant.
During a hysterectomy, your doctor may remove the entire uterus or just part of it. The fallopian tubes (the tubes that connect the ovaries to the uterus) and ovaries may also be removed.
Types of hysterectomies and procedures
- Partial (or supracervical) hysterectomy: The upper part of the uterus is removed. The cervix is left in place.
- Total hysterectomy: The entire uterus and cervix are removed.
- Radical hysterectomy: The uterus, upper part of the vagina, and tissue on both sides of the cervix are removed. This is most often done if you have cancer.
There are many different ways to perform a hysterectomy. It may be done through a surgical cut in either the belly (abdomen) or vagina.
Your doctor will help you decide which type of hysterectomy is best for you. The specific procedure depends on your medical history and reason for the surgery.
- Abdominal hysterectomy: The surgeon makes a 5- to 7-inch surgical cut in the lower part of your belly. The cut may go either up and down, or it may go across your belly, just above your pubic hair. This is called a "bikini cut."
- Vaginal hysterectomy: The surgeon makes a cut in your vagina and removes the uterus through this opening. The wound is closed with stitches.
- Laparoscopic hysterectomy: A laparoscope is a narrow tube with a tiny camera on the end. Your surgeon will make 3 to 4 small cuts in your belly. The laparoscope and other surgical instruments will be inserted through the openings. The surgeon cuts the uterus into small pieces that can be removed through these openings.
- Laparoscopy-assisted vaginal hysterectomy: The surgeon removes the uterus through a cut that is made inside your vagina. A laparoscope is used to guide the procedure.
- Robotic hysterectomy: This procedure is like laparoscopic surgery, but a special machine (robot) is used. Robotic surgery is most often used to perform a hysterectomy when a patient has cancer or is very overweight and vaginal surgery is not safe.
Risks possible from a hysterectomy
- Injury to the bladder or ureters
- Pain during sexual intercourse
- Early menopause, if the ovaries are removed or if a woman is close to menopause
- Decreased interest in sex
How long it takes you to recover depends on the type of hysterectomy. Recovery may take anywhere from 2 to 6 weeks. Average recovery times are:
- Abdominal hysterectomy: 4 - 6 weeks
- Vaginal hysterectomy: 3 - 4 weeks
- Robot-assisted hysterectomy: 2 - 4 weeks
A hysterectomy will cause menopause if you also have your ovaries removed. Removal of the ovaries can also lead to a decreased sex drive.
Before surgery, the bladder is usually drained with a catheter, and the abdomen and vagina are cleaned. The surgery is performed under general anesthesia.
- Most hysterectomies are abdominal hysterectomies, which access the uterus by cutting through the tissue of the lower part of the belly.
- Hysterectomies can also be vaginal, meaning the uterus is removed through the vagina, rather than an incision in the abdomen.
- Under either procedure, the surgeon will carefully sever the uterus, and possibly fallopian tubes, ovaries and the upper part of the vagina from the surrounding tissue and remove it from body.
- If the hysterectomy was performed through the abdomen, stitches or staples will be used to seal the incision.
The surgery usually takes around 2 hours.
Before the procedure
- Ask your doctor what to expect after the procedure.
- Many women who have had a hysterectomy notice changes in their body and in how they feel about themselves.
- Talk with your doctor, family, and friends about these possible changes before you have surgery.
- Always tell your health care team about all the medicines you are taking, including herbs, supplements, and other medicines you bought without a prescription.
- You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), warfarin (Coumadin), and any other drugs like these.
- Ask your doctor which drugs you should still take on the day of your surgery.
- If you smoke, try to stop. Ask your doctor or nurse for help quitting.
The night before your surgery
- Do not eat or drink anything after midnight, EVEN WATER, unless otherwise instructed.
What to bring
- Personal hygiene items (toothbrush, powder, deoderant, razor, etc.)
- Sweat pants
- Well-fitted slippers
- Tennis shoes
- Comfortable, loose-fitting clothing for therapy sessions
On the day of your surgery
- Drive to Avera McKennan and park in the ramp. If possible, park on the 3rd level of the parking ramp and take the skywalk to the main entrance of the hospital.
- Go directly to the Admitting Department on the ground floor.
- You will be escorted to the Ambulatory Nurses station on the second floor. Family members can be with you.
After the procedure
- After surgery, you will be given pain medicines to relieve any discomfort.
- You may also have a tube, called a catheter, inserted into your bladder for 1 to 2 days to pass urine.
- You will be asked to get up and move around as soon as possible after surgery. This helps prevent blood clots from forming in your legs and speeds up recovery.
- You will be asked to get up to use the bathroom as soon as you are able.
- You may return to a normal diet as soon as you can without causing nausea or vomiting.
- How long you stay in the hospital depends on the type of hysterectomy. If you have a robot-assisted hysterectomy, you will likely go home the next day.
- Other times, most women who have a hysterectomy stay in the hospital 2 to 3 days.
- The hospital stay may be longer if the hysterectomy is done because of cancer.
Total Laparoscopic Hysterectomy (TLH)