Vaginal hysterectomy; Abdominal hysterectomy; Supracervical hysterectomy; Radical hysterectomy; Removal of the uterus; Laparoscopic hysterectomy; Laparoscopically assisted vaginal hysterectomy; LAVH; Total laparoscopic hysterectomy; TLH; Laparoscopic supracervical hysterectomy; Robotically assisted hysterectomy
Hysterectomy is surgery to remove a woman's womb (uterus). The uterus is a hollow muscular organ that nourishes the developing baby during pregnancy.
You may have all or part of the uterus removed during a hysterectomy. The fallopian tubes and ovaries may also be removed.
There are many different ways to perform a hysterectomy. It may be done through:
You and your doctor will decide which type of procedure. The choice will depend on your medical history and the reason for the surgery.
The female reproductive system is a very complex system. And as with any system, occasionally, things go wrong. When treatments and therapies can't fix an issue, sometimes surgery is required. Surgery to remove a woman's uterus or womb, a major component of this system, is called hysterectomy. Let's talk about this procedure. There are many reasons a woman may need a hysterectomy: cancer of the uterus, usually endometrial cancer; cancer of the cervix; childbirth complications, such as uncontrolled bleeding; other long-term vaginal bleeding problems; long-term pelvic pain. Other reasons include severe endometriosis, including growths outside the uterus; slipping of the uterus into the vagina and perhaps tumors in the uterus, such as uterine fibroids.During a hysterectomy, your doctor may remove the entire uterus or just part of it. The fallopian tubes, which connect the ovaries to the uterus, and the ovaries themselves may also be removed.There are several different ways to perform a hysterectomy. It may be done through a surgical cut in either the belly or vagina. It may be done using laparoscopy, using a camera and smaller incisions, or it may be performed using robotic surgery. Your doctor will help you decide which type of procedure is best for you. After surgery, you will receive pain medications to relieve discomfort. You may also have a tube, called a catheter, inserted into your bladder for a day or two to pass urine. You will be asked to get up and move around as soon as possible after surgery; this helps prevent blood clots from forming in your legs and speeds up recovery.How long you stay in the hospital depends on the type of hysterectomy. If you have a robot-assisted hysterectomy, you will likely go home the next day. Most women who have a hysterectomy, however, will stay in the hospital for 2 to 3 days, maybe even longer if you have a hysterectomy due to cancer.Recovery may take anywhere from 2 to 6 weeks, depending on the type of hysterectomy you have. A hysterectomy will cause menopause if you also have your ovaries removed. Removal of the ovaries can also lead to a decreased sex drive. Your doctor, then, may recommend estrogen replacement therapy. There is some good news. Removing the problematic organs should keep you from having problems in this area again.
There are many reasons a woman may need a hysterectomy, including:
Hysterectomy is a major surgery. Some conditions can be treated with less invasive procedures such as:
Risks of any surgery are:
Risks of a hysterectomy are:
Before deciding to have a hysterectomy, ask your health care provider what to expect after the procedure. Many women notice changes in their body and in how they feel about themselves after a hysterectomy. Talk with provider, family, and friends about these possible changes before you have surgery.
Tell your health care team about all the medicines you are taking. These include herbs, supplements, and other medicines you bought without a prescription.
During the days before the surgery:
On the day of your surgery:
After surgery, you will be given pain medicines.
You may also have a tube, called a catheter, inserted into your bladder to pass urine. Most of the time, the catheter is removed before leaving the hospital.
You will be asked to get up and move around as soon as possible after surgery. This helps prevent blood clots from forming in your legs and speeds recovery.
You will be asked to get up to use the bathroom as soon as you are able. You may return to a normal diet as soon as you can without causing nausea and vomiting.
How long you stay in the hospital depends on the type of hysterectomy.
How long it takes you to recover depends on the type of hysterectomy. Average recovery times are:
A hysterectomy will cause menopause if you also have your ovaries removed. Removal of the ovaries can also lead to a decreased sex drive. Your doctor may recommend estrogen replacement therapy. Discuss with your provider the risks and benefits of this therapy.
If the hysterectomy was done for cancer, you may need further treatment.
ACOG Committee Opinion No. 444: choosing the route of hysterectomy for benign disease. Obstet Gynecol. 2009;114(5):1156-1158. PMID: 20168127
Burney RO, Giudice LC. Endometriosis. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 130.
Jones HW III. Gynecologic surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 71.
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN guidelines): cervical cancer. Version 1.2016.
Last reviewed on: 4/5/2016
Reviewed by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.