Hysterectomy: Surgery to remove your uterus
Abdominal hysterectomy — Surgery that removes the uterus and treats gynecologic conditions, such as cancer.
Abdominal hysterectomy is a surgical procedure that removes your uterus through an incision in your lower abdomen. Sometimes the procedure also includes removal of one or both ovaries and fallopian tubes. Hysterectomy ranks as one of the most common surgical procedures among women.
Your uterus is where a baby grows if you're pregnant. The ovaries produce eggs to be fertilized and hormones that regulate your reproductive cycles. The fallopian tubes carry eggs from the ovaries to the uterus. The cervix at the lower end of the uterus provides the opening through which sperm enter to fertilize an egg or through which a baby is delivered during childbirth.
Hysterectomy can also be performed through an incision in the vagina (vaginal hysterectomy). But abdominal hysterectomy is the preferred approach if you have a large uterus or if your doctor wants to check other pelvic organs for signs of disease.
Female reproductive system
The ovaries, fallopian tubes, uterus, cervix and vagina make up the female reproductive system.
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 also should have this procedure done.
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 or two days.
Plan for an extended recovery time once you get home. Full recovery could take several weeks. Arrange for help at home if you think you'll need it.
What you can expect
In 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) may be left in place (partial or subtotal hysterectomy) or removed (total hysterectomy). Hysterectomy may also include removal of additional organs and tissue, such as your ovaries and fallopian tubes (bilateral salpingo-oophorectomy).
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 (Pfannenstiel incision) lies about an inch above your pubic bone. Which incision type your surgeon chooses depends on many factors, including the need to explore the upper abdomen, the size of your uterus and the presence of any scars from prior abdominal surgery.
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. The abdominal incision will gradually heal, but a visible scar on your abdomen will remain.
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 also can include removal of the uterus, cervix, ovaries and fallopian tubes (right).
Vertical and Pfannenstiel incisions
A vertical incision (left) gives the surgeon greater access to your pelvis. A Pfannenstiel incision (right) follows your skin's natural lines, usually leaving a thinner scar.
Last Updated: 03/13/2008
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