A hysterectomy is an operation which involves the removal of the uterus. After a hysterectomy you will no longer have periods and you will be unable to become pregnant.
There are 3 Types of Hysterectomy:
The surgeon will remove the whole of the uterus, including the cervix.
The surgeon will remove the top part of the uterus, leaving the cervix behind.
This is a more extensive hysterectomy performed for cancer of the uterus or cervix.
With any type of hysterectomy, the ovaries and fallopian tubes may be removed as well. Current recommendations suggest considering removal of the tubes at the time of hysterectomy if there is no increased risk relating to surgery. Ovarian conservation is still recommended where possible up until the age of 65. Please feel free to discuss your preferences with your doctor.
The operation is performed through a 15-20cm incision in the abdomen. The incision may be horizontal and quite low (Bikini line) or vertical from the umbilicus down to the pubic bone.
This is the traditional way of performing a hysterectomy and is still required in some difficult cases. It usually requires a longer hospital stay and longer recovery period than the other methods of performing a hysterectomy.
The uterus is removed via incisions in the vagina.
This is the safest way to perform a hysterectomy. Its main disadvantages are that it may not be technically possible to perform (eg large uterus), and that the surgeon may not be able to see or treat other problems inside the abdomen.
Total Laparoscopic Hysterectomy
Through 4 small incisions in the abdomen, and by using “keyhole surgery” techniques, the uterus and/or ovaries can be cut free and removed via the vagina.
This form of hysterectomy is only performed by a small number of well trained surgeons. It enables women with more complex problems to enjoy the same benefits of a short hospital stay and quick recovery provided by vaginal hysterectomy. Laparoscopic hysterectomy has been shown to be as safe as vaginal hysterectomy in simple cases but is a slightly higher risk than abdominal hysterectomy in more difficult cases.
Laparoscopically Assisted Vaginal Hysterectomy
“Keyhole surgery” is used to help the surgeon perform a vaginal hysterectomy in situations where the only other option would be abdominal hysterectomy. Performed by many gynaecologists, it is useful for removing the ovaries or when other pathology is present, such as fibroids or endometriosis.
All surgery involves risks. The risk of a particular complication may vary depending on the complexity of the surgery or the severity of your condition.
These risks can be divided into general risks associated with any surgery and risks specific to hysterectomy.
wound, chest or urinary tract infection, 3-5% Risk
major haemorrhage requiring blood transfusion, 2-4% Risk
blood clots in the legs or lungs <1% Risk
risks of the anaesthetic including heart attacks or strokes. <1% Risk
abnormal scar tissue formation (keloid) variable Risk
Chronic post operative pain, including wound and pelvic pain <5% Risk
Injury to adjacent organs including Bowel, Bladder or Ureter <1% Risk
Pelvic haematoma (blood clot) 3-5% Risk
The above list is not exhaustive and does not include all possible risks. If you have any further concerns please feel free to ask your specialist.
Length of Hospital Stay
You will usually go home on the second or third post operative day for laparoscopic and vaginal surgery and on the fourth or fifth post operative day for abdominal hysterectomy.
Return to work
Patients return to non-strenuous employment 4 – 6 weeks after surgery.
Light duties can be started within 3 weeks.
Click here to View a YouTube video clip of a hysterectomy.