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For women facing the option of a hysterectomy, many questions may come to mind about what to expect before and after surgery. First, a few definitions: a hysterectomy is an operation to remove your uterus. Your uterus (or womb) is a hollow muscular organ located between your bladder and rectum; its main function is to provide a home for a developing fetus (baby). It is pear shaped and about 3” long. 1
There are three types of hysterectomies: a partial hysterectomy removes only the upper part of the uterus (and leaves the cervix alone); a total hysterectomy removes the uterus and cervix; and a radical hysterectomy removes the uterus, the cervix, part of the vagina, and other surrounding tissue. An oopherectomy can also take place—removing the ovaries. 2
Before surgery, your doctor may want you to try alternative treatments before a hysterectomy is recommended. For example, excessive menstrual bleeding and endometriosis can respond to hormone therapy. Fibroids can shrink after menopause when you don’t have estrogen.
If you do have a hysterectomy, the technique your surgeon uses determines the healing time and the kind of scar after the operation—traditional surgery or MIP (minimally invasive procedure). If traditional surgery is performed, there is a 5-7 inch incision, either vertical or horizontal, across the belly and the uterus is removed through this opening. There are usually 3+ days in the hospital and a visible scar later.
If a MIP is used, surgery can be performed through the vagina leaving no scar you can see. It could also be performed laparoscopically—tools and a camera are inserted through a tiny cut in the belly button and the surgeon watches on a video screen. A Band-Aid can usually cover the tiny cut. Sometimes robots help with this type of surgery.
MIP surgery usually has shorter hospital stays, faster recovery, less chance for infection, and less pain and scarring. You can resume your normal activity in about 3-4 weeks (compared to 4-6 weeks for an abdominal hysterectomy). And the cost is usually lower.
However, there is controversy surrounding laproscopic or robotic surgery techniques involving the surgerical devices called power morcellators. Their use is linked to additional life-threatening risks after surgery, like uterine cancer. The FDA has released a Safety Announcement to discourage their use in hysterectomy and myomectomy surgeries.
After surgery you’ll have pain for a few days and bleeding/discharge for a few weeks. Also you usually have to avoid sex/tampons/douching and lifting heavy objects for about a month afterwards. 4
A hysterectomy is common surgery. It is considered low-risk and most women have no serious complications or problems. 5 However, some woman can experience urinary incontinence, surgical complications afterwards (e.g., infection), injury to other organs during surgery, or continuing pain.
Note that after a hysterectomy, you do not get your period ever again and you cannot get pregnant ever again. If you also had your ovaries removed, and you are a young woman, you will immediately enter early menopause (as there are no ovaries to produce estrogen anymore).
Other sources that provide helpful information on hysterectomy surgeries can be found at the American College of Obstetricians and Gynecologists (ACOG), the National Institutes of Health (NIH), and the Office of Women’s Health. As always, ask your doctor any questions about available treatments so that you understand your options.