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Hysterectomy

A hysterectomy is a surgical procedure where your uterus is removed. There are fewer and fewer hysterectomies being performed as advances are made in other treatments and procedures. Nowadays, a hysterectomy is only considered if it is seen as the only way to fix menstrual problems, fibroids or cancerous abnormalities.  

There are different sorts of hysterectomies

A hysterectomy is always a big decision. And there are all sorts of reasons for wanting or needing one. The most common is a total hysterectomy, where both the uterus and cervix are removed. A partial hysterectomy is less common, and where only the uterus is removed.

Other procedures, like the removal of ovaries or fallopian tubes, can be included as part of the hysterectomy. Reasons for needing a hysterectomy can include:

  •       Heavy menstrual bleeding 
  •       An enlarged uterus
  •       Fibroids
  •       A prolapsed uterus
  •       Cervical, Uterine or Ovarian cancer.

Dr Guy Skinner is a Gynaecologist with over 20 years’ experience and can help you decide if you need one, why you may need one, and what type of hysterectomy is best for you. 

Different types of operation                                      

If you are having a hysterectomy, you’ll have three options. 

Abdominal Hysterectomies

Are usually used to remove an enlarged uterus or if the ovaries need to be removed. Like a caesarean section, you’ll need stitches and will end up with a small scar across the lower part of your abdomen.

Vaginal Hysterectomies

Are often used when the uterus has prolapsed and is able to be removed through the vagina.

Keyhole Surgery Or Laparoscopic Hysterectomies

Are performed through both the abdomen and the vagina. A camera is inserted through a tiny incision in your abdomen and the uterus is removed from your abdominal wall and then removed through the vagina. More information on laparoscopic surgery is available here.

A few days in hospital

A hysterectomy is, surgically speaking, a fairly simple operation. As a result, in most instances, you’ll only need a few days in hospital. And, with a vaginal or laparoscopic hysterectomy, you can expect to be relatively free from pain within a week. Full recovery can usually take between four to six weeks.

Things you should know.

While a hysterectomy is a common and safe procedure, every surgery is different and comes with its own unique considerations.

Should you require a hysterectomy, Guy will take you through all the possible things which might happen.

These might include the low risk of infection or thrombosis, how much bleeding you should expect, the unlikely risk to other organs or a hernia.

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You may experience light vaginal bleeding. This is perfectly normal. If you do have heavier bleeding, please contact your gynaecologist.

You may get emotional. This is normal after an operation like this. Once your body has recovered, you should start feeling normal relatively soon after that.

You should plan to have a few weeks off work. While it is important to be as active as possible, you will be tired and should plan to rest for between two to five weeks after the operation.

FAQ’s

A hysterectomy is a surgical procedure to remove the womb (uterus). 

Once you’ve had a hysterectomy, you’ll no longer have periods and no longer be able to get pregnant.

Many women have hysterectomies, for all sorts of reasons. 

It is usually done for women in their forties or fifties.

There are a number of reasons why a woman might need a hysterectomy. These include:

  • heavy or painful periods
  • long-term pelvic pain or pain in the lower abdomen – even if this is a long-term dull ache, it is worth having a talk to your gynaecologist about
  • fibroids
  • cancer – including cancers of the fallopian tubes, cervix or uterus. 

In each case, we recommend a discussion with a trusted doctor or gynaecologist before committing to the procedure.

There are three main types of hysterectomy. What type you may need depends on the reason for the operation and how much of your uterus, if any, can be left intact. 

These are:

  • total hysterectomy – the most common type involves the removal of the womb and the cervix 
  • subtotal hysterectomy – in some cases, the cervix can be left in place. In these instances, only the uterus is removed
  • total hysterectomy with bilateral salpingo-oophorectomy – this is a total hysterectomy which also removes the ovaries and the fallopian tubes. (The removal of the ovaries is called an oophorectomy. The removal of the fallopian tubes is called a salpingectomy.)
  • radical hysterectomy – the most invasive of the procedures and only recommended in rare cases, it involves the removal of the uterus, the fallopian tubes, ovaries, lymph glands, fatty tissue and part of the vagina. 

In most cases, the hysterectomy will be performed through keyhole surgery in the lower abdomen (a laparoscopy). Depending on the type of hysterectomy and the reasons for the operation, your gynaecologist might also recommend a vaginal hysterectomy – where the procedure is performed through a small cut in the vagina – or an abdominal hysterectomy – through a larger cut in the lower tummy. 

There are very few risks involved in a hysterectomy. It is a common operation and, while it has a long recovery time, it presents very few real challenges for a good gynaecological surgeon. 

It does carry the same risks as any major operation. These include:

  • heavy bleeding
  • infection – although you will be given strong antibiotics afterwards, some women react to major procedures in unexpected ways
  • damage to your bladder or bowel – depending on the size of the procedure, this is a very rare possibility, but something you should be aware of
  • a serious reaction to the general anaesthetic 

A hysterectomy is a major operation. You can be in hospital for up to 5 days after surgery. Depending on the type of hysterectomy, full recovery can take about 6 to 8 weeks.

The first few weeks will require complete rest as you will need your abdominal muscles to heal. 

Light exercise and minimal movement for a few weeks after that can then be followed up with more strenuous exercise. Please keep your doctor informed of your progress, especially if you feel any discomfort or notice any excessive bleeding.