A hysterectomy is the surgical removal of the uterus. A hysterectomy may be done to treat conditions that affect the uterus:
- Uterine fibroids
- Pelvic support problems (such as uterine prolapse)
- Abnormal uterine bleeding
- Chronic pelvic pain
There are several types of hysterectomy:
- Total hysterectomy—The entire uterus, including the cervix, is removed.
- Supracervical (also called subtotal or partial) hysterectomy—The upper part of the uterus is removed but the cervix is left in place.
- Hysterectomy with removal of the fallopian tubes and ovaries
How is a laparoscopic hysterectomy performed?
In a laparoscopic hysterectomy, a laparoscope is used to guide the surgery. A laparoscope is a thin, lighted tube that is inserted into the abdomen through a small incision in or around the navel. It allows the surgeon to see the pelvic organs on a screen. Additional small incisions are made in the abdomen for other instruments used in the surgery.
In a total laparoscopic hysterectomy, the uterus is detached from inside the body and then removed in small pieces through the incisions or through the vagina. In a laparoscopic assisted vaginal hysterectomy, the uterus is removed through the vagina, and the laparoscope is used to guide the procedure. In a robot-assisted laparoscopic hysterectomy, the surgeon uses a robot attached to the instruments to assist in the surgery.
- Bleeding during or after surgery • Injury to the urinary tract or nearby organs
- Deep vein thrombosis (DVT), which is a risk with any surgery
- Problems related to anesthesia
- Bowel blockage from scarring of the intestines
- Formation of a blood clot in the wound
What should I expect during my recovery?
You will be urged to walk around as soon as possible after your surgery. Walking will help prevent DVT. You also may receive medicine or other care to help prevent DVT. You can expect to have some pain for the first few days after surgery. You will be given medication to relieve pain. You will have bleeding and discharge from your vagina for several weeks. Sanitary pads can be used. Do not put anything in your vagina during the first 6 weeks. That includes douching, intercourse, and tampons.
What are the physical changes that occur after hysterectomy?
After a hysterectomy, your periods will stop. If the ovaries are left in place and you have not yet gone through menopause, they will still produce estrogen, a hormone that affects the body in many ways. Depending on your age, if your ovaries are removed during hysterectomy, you will have signs and symptoms caused by a lack of estrogen, which include hot flashes, vaginal dryness, and sleep problems. You also may be at risk of a fracture caused by osteoporosis at an earlier age than women who go through natural menopause. Most women who have these intense symptoms can be treated with estrogen therapy.
Are there emotional effects that occur after having a hysterectomy?
Some women may feel depressed because they can no longer have children. While other women may feel relieved because the symptoms they were having have stopped.
Will sexual changes occur after having a hysterectomy?
Some women notice a change in their sexual response after hysterectomy. Because the uterus has been removed, uterine contractions that may have been felt during orgasm will no longer occur. Some women feel more sexual pleasure after hysterectomy. This may be because they no longer have to worry about getting pregnant. It also may be because they no longer have the discomfort or heavy bleeding caused by the problem leading to hysterectomy.