Hysterectomy Surgery

A hysterectomy is a surgical procedure to remove the womb or uterus. A hysterectomy treats conditions such as:

• heavy menstrual flow caused by fibroids
• pelvic pain due to endometriosis
• Pelvic Inflammatory disease (PID)
• Adenomyosis
• prolapse of the uterus
• cancer-related to the cervix, ovaries, or uterus.

Alternate Name of Hysterectomy

oophorectomy, salpingectomy

Body Location:

Lower abdomen

How is Hysterectomy Surgery Performed?

There are several ways of performing a hysterectomy.

• In a laparoscopic hysterectomy or keyhole surgery, the uterus is removed from the abdomen through several small incisions.
• In a vaginal hysterectomy, a small incision is made just above the vagina to remove the uterus.
• In an abdominal hysterectomy, the uterus is removed through a small incision made in the lower abdomen.
• In a radical hysterectomy, the uterus, its surrounding tissues, including the ovaries, fallopian tubes, lymph glands, and fatty tissues, are removed.
• In a total hysterectomy, the cervix and uterus both are removed. Only the uterus is removed during a subtotal hysterectomy.
• Robot-assisted laparoscopic hysterectomy is when a robotic arm mimics the surgeon’s hand movements on a 3D screen.

Preparation for Hysterectomy

Before performing the hysterectomy, there are specific procedures involved. The pre-operative tests depend on the medical history of the patient. Some of the standard tests conducted are:

• Pap test or Cervical cytology: helps detect abnormal cells that may be cancerous in the cervical region (cervical cancer).
• Pelvic ultrasound: Detects the presence, size, and location of ovarian cysts, uterine fibroids, or polyps in the endometrial region.
• Endometrial biopsy: Determines if there are any abnormal cells in the uterus lining (endometrial cancer).
• As a part of the pre-operative test, vaginal douche (cleansing of the vagina) and enema (cleaning of the rectum) may be done based on the doctor’s advice.
• Right before the surgery, the patient takes an antibiotic medication via IV to minimize any risks of infection.  

Hysterectomy Procedure Type

- Traditional or open surgery

- Minimally Invasive procedure (MIP)

Follow up

One to two weeks after the surgery, the doctor will check the incision site to check if it is healing as expected. If staples hold the incision site in place, it will be removed. Six weeks post the surgery, a vaginal exam will be conducted to check for any unusual bruising or swelling. After the entire treatment, a follow-up is advised every 6 to 8 weeks. A check-up is necessary every 3 to 6 months for the first two years after the surgery and every year. There will be a pelvic examination, a visual examination, and a vault smear during the follow-up sessions. These tests vary from person to person, depending on the medical history and conditions.

Risks of Hysterectomy Surgery

• Urinary incontinence: when urine leaks involuntarily
• Vaginal prolapse: a part of the vagina comes out of the opening
• Formation of vaginal fistula: an abnormal connection that forms between the rectum or bladder and the vagina
• Chronic pain in the vaginal region

Recovery after Hysterectomy

The usual recovery period for an abdominal hysterectomy is between four and eight weeks. Laparoscopic and vaginal hysterectomy take two to six weeks to heal. It is essential to stick to the follow-up schedule with the doctor to ensure that there are no complications or concerns. Activities such as rigorous workouts, driving, sitting for long hours, sex, lifting weights or heavy objects, etc., must be avoided to promote faster healing and avoid complications. It is also essential to watch out for unusual signs and symptoms such as abnormal drainage from the incision site, fever, etc.