Abdominal hysterectomy is a surgical procedure that removes your uterus through an incision in your lower abdomen. Your uterus — or womb — is where a baby grows if you're pregnant. Sometimes a hysterectomy includes removal of one or both ovaries and fallopian tubes. Hysterectomy is one of the most common surgical procedures among women.
Hysterectomy can also be performed through an incision in the vagina (vaginal hysterectomy) or by a laparoscopic or robotic surgical approach — which uses laparoscopic instruments passed through small abdominal incisions. Abdominal hysterectomy may be recommended over other surgical approaches if you have a large uterus or if your doctor wants to check other pelvic organs for signs of disease.
Types of hysterectomy surgery
A partial hysterectomy (top left) removes just the uterus, and a total hysterectomy (bottom left) removes the uterus and cervix. A total hysterectomy can also include removal of the uterus, cervix, ...
Why it's done
Hysterectomy may be needed if you have one of the following conditions:
Hysterectomy ends your ability to become pregnant. If you think you might want to become pregnant, ask your doctor about alternatives to this surgery. In the case of cancer, hysterectomy might be the only option. But other conditions — including fibroids, endometriosis and uterine prolapse — have alternative treatments that you can try first.
During hysterectomy surgery, your surgeon might also perform a related procedure that removes your ovaries and fallopian tubes (bilateral salpingo-oophorectomy). You and your doctor will discuss ahead of time whether you should have this procedure done.
Female reproductive system
The ovaries, fallopian tubes, uterus, cervix and vagina make up the female reproductive system. ...
Hysterectomy is generally very safe, but with any major surgery comes the risk of complications.
Risks associated with abdominal hysterectomy include:
How you prepare
Hysterectomy is an inpatient procedure — meaning you're admitted to the hospital to have it done. How long you'll be in the hospital depends on what type of hysterectomy you have and what your doctor recommends. Generally, abdominal hysterectomy requires a hospital stay of at least one to two days.
Plan for an extended recovery time once you get home. Full recovery could take several weeks. Your doctor may recommend restricting your activities during your recovery, such as avoiding driving or lifting heavy objects. Arrange for help at home if you think you'll need it.
What you can expect
During an abdominal hysterectomy, your surgeon detaches your uterus from the ovaries, fallopian tubes and upper vagina, as well as from the blood vessels and connective tissue that support it. The lower part of your uterus (cervix) is usually removed (total hysterectomy) but may sometimes be left in place (partial, or supracervical, hysterectomy). At the time of the hysterectomy, additional pelvic organs and tissue, such as your ovaries and fallopian tubes, may be removed.
Before the hysterectomy
The day before your surgery, you may be instructed to take a medication or drink a solution to empty your digestive tract in preparation for surgery. A preoperative cleansing of your vagina (vaginal douche) may be done to reduce your risk of infection. Immediately before surgery, you'll also be given an intravenous antibiotic medication to minimize your risk of developing an infection after the procedure.
During the hysterectomy
To begin the procedure, a member of your surgical team passes a urinary catheter through your urethra to empty your bladder. The catheter remains in place during surgery and for a short time afterward. Your abdomen and vagina are cleaned with a sterile solution prior to surgery. Any hair at the incision site is shaved.
To perform the hysterectomy, your surgeon cuts through skin and connective tissue in your lower abdomen to reach your uterus. The surgeon uses one of two types of abdominal incisions for the hysterectomy. A vertical incision starts in the middle of your abdomen and extends from just below your navel to just above your pubic bone. A horizontal bikini-line incision lies about an inch above your pubic bone. Which incision type your surgeon chooses depends on many factors, including the reason for your hysterectomy, the need to explore the upper abdomen, the size of your uterus and the presence of any scars from prior abdominal surgeries. For instance, hysterectomies performed for endometriosis, large fibroids and gynecologic cancers are done mainly through a vertical incision.
After the hysterectomy
You'll need to use sanitary pads for vaginal bleeding and discharge. It's normal to have bloody vaginal drainage for several days after a hysterectomy. However, let your surgeon know if you experience heavy vaginal bleeding — such bleeding that's as heavy as a menstrual period.
The abdominal incision will gradually heal, but a visible scar on your abdomen will remain.
Recovering from a hysterectomy
Life after a hysterectomy
Other parts of your life will return to normal or perhaps improve once you've recovered from your hysterectomy. For example:
On the other hand, because the uterus is strongly associated with femininity, you may feel a sense of loss after hysterectomy. Premenopausal women who must undergo hysterectomy to treat gynecological cancer may experience grief and possibly depression over the loss of fertility.
Vertical and horizontal incisions
A vertical incision gives your surgeon greater access to the pelvis. A horizontal incision follows your skin's natural lines, usually leaving a thinner scar. ...
Last Updated: 2010-03-10
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