Different Types of Hysterectomies
What is a hysterectomy?
Hysterectomy is the surgical removal of the uterus. It ends menstruation and the ability to become pregnant. Depending on the reason for the surgery, a hysterectomy may also involve the removal of other organs and tissue.
- A partial hysterectomy is the removal of the upper part of the uterus.
- A total (or complete) hysterectomy is the removal of the uterus and cervix.
- A total hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus, cervix, fallopian tubes (salpingo) and ovaries (oophor). If you haven’t experienced menopause, removing the ovaries will usually initiate it since your body can no longer produce as much estrogen.
- A radical hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus, cervix, fallopian tubes, ovaries, the upper portion of the vagina and some surrounding tissue and lymph nodes. A radical hysterectomy may be performed to treat cervical or uterine cancer.
Why is hysterectomy performed?
A hysterectomy may be performed to treat:
- Abnormal vaginal bleeding that is not controlled by other treatment methods
- Severe endometriosis (uterine tissue that grows outside the uterus)
- Leiomyomas or uterine fibroids (benign tumors) that have increased in size, are painful or are causing bleeding
- Increased pelvic pain related to the uterus but not controlled by other treatment
- Uterine prolapse (uterus that has "dropped" into the vaginal canal due to weakened support muscles) that can lead to urinary incontinence or difficulty with bowel movements
- Cervical or uterine cancer
Are there alternatives to hysterectomy?
Yes. A hysterectomy is only one way to treat problems affecting the uterus. For certain conditions, however, hysterectomy may be the best choice. Please ask your health care provider to discuss what alternatives are available to treat your specific condition.
Does hysterectomy affect sexual function?
A woman’s sexual function is usually not affected after hysterectomy, and her sexual desire should not change. If the ovaries were removed with the uterus prior to menopause, decreased sex drive may occur and vaginal dryness may be a problem during sex. However, estrogen therapy can relieve vaginal dryness and other hormone-related effects.
Before the procedure
A health care provider will explain the procedure in detail, including possible complications and side effects. He or she will also answer your questions.
- Blood and urine tests are taken
- One or more enemas may be given to cleanse the bowel
- Abdominal and pelvic areas may be shaved
- An intravenous (IV) line is placed in a vein in your arm to deliver medications and fluids
During the procedure
An anesthesiologist will give you either:
- General anesthesia in which you will not be awake during the procedure; or
- Regional anesthesia (also called epidural or spinal anesthesia) in which medications are placed near the nerves in your lower back to "block" pain while you stay awake.
The surgeon removes the uterus through an incision in your abdomen or vagina. The method used during surgery depends on why you need the surgery and the results of your pelvic exam.
During a vaginal hysterectomy, some doctors use a laparoscope (a procedure called laparoscopically assisted vaginal hysterectomy or LAVH) to help them view the uterus and perform the surgery.
How long does the procedure last?
The procedure lasts 1 to 3 hours. The amount of time you spend in the hospital for recovery varies, depending on the type of surgery performed.
The day of discharge
A responsible adult must drive you home the day you are discharged from the hospital.
- You may resume your normal diet, as tolerated.
- You may take a bath or shower. Wash the incision with soap and water (the stitches do not have to be removed, as they will dissolve in about 6 weeks). A dressing over the incision is not necessary. If skin clips (staples) were used, they will need to be removed by your health care provider.
- You may use lotions and creams on the skin around the incision to relieve itching.
- Increase your activity gradually every day, when you feel capable and aren’t in pain. Completely normal activities can be resumed within 4 to 6 weeks or sooner if the procedure was performed vaginally.
- Drive when you feel capable -- about 2 weeks after surgery.
- You can travel out of town 3 weeks after surgery, including air travel.
- Avoid lifting heavy objects (over 10 pounds) for at least 4 weeks.
- Do not douche or put anything into the vagina for 4 weeks.
- You may have intercourse 4 weeks after surgery, or as directed by your health care provider.
- Light swimming is permitted 2 weeks after surgery in a swimming pool, but avoid vigorous swimming until 4 weeks after surgery.
- Resume your exercise routine in 4 to 6 weeks, depending on how you feel.
- Your doctor can tell you when it’s best to go back to work. You can usually go back to work in 3 to 6 weeks, depending on the procedure.
How will I feel after hysterectomy?
After hysterectomy, your periods will stop. Occasionally, you may feel bloated and have symptoms similar to when you were menstruating. It is normal to have light vaginal bleeding or a dark brown discharge for about 4 to 6 weeks.
You may feel discomfort at the incision site for about 4 weeks, and any redness, bruising or swelling will disappear in 4 to 6 weeks. A burning, itching feeling around the incision is normal. You may also experience a numb feeling around the incision and down your leg; this is normal and if present, usually lasts about 2 months.
If the ovaries remain, you should not experience hormone-related effects. If the ovaries were removed with the uterus before menopause, you may experience the symptoms that often occur with menopause, such as hot flashes. Your health care provider may prescribe hormone replacement therapy to relieve menopausal symptoms.
Emotional reactions to hysterectomy vary, depending on how well you were prepared for the surgery, the reason for having it and whether the problem has been treated.
Some women may feel a sense of loss or become depressed, but these emotional reactions are usually temporary. Other women may find that hysterectomy improves their health and well-being, and may even be a life-saving operation. Please discuss your emotional concerns with your health care provider.
What are the complications of hysterectomy?
As with any surgery, there is a slight chance that problems may occur. Problems could include blood clots, severe infection, bleeding after surgery, bowel blockage, urinary tract injury or problems related to anesthesia.
When should I call my health care provider?
Call your health care provider if you have:
- Bright red vaginal bleeding
- A fever over 100°F
- Difficulty urinating, burning feeling when urinating or frequent urination
- Increasing amount of pain
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