A quick guide to hysterectomy
Many women have hysterectomies each year, for a spectrum of different reasons. It’s a very common procedure, albeit one can that be carried out in a number of different ways. How your doctor chooses to conduct the procedure depends on your body and the reason you’re having the surgery, as we’ll see shortly.
Why do I need it?
A hysterectomy is the complete removal of your uterus (womb) and is therefore a fairly serious procedure. You may need to have a hysterectomy to put a stop to heavy periods, pelvic pain or pelvic inflammatory disease, or prolapse of the uterus. Your doctor may also need to conduct a hysterectomy to remove a tumor if you have been diagnosed with cancer of the womb, ovaries or cervix.
What happens during the procedure?
What happens during the procedure varies depends on which type of hysterectomy you are having done. In a vaginal hysterectomy, your uterus will be removed through your vagina, meaning that no incisions will be necessary.
A laparoscopic hysterectomy is removal of the uterus using ‘keyhole surgery’. In this very precise procedure, a small incision is made in your belly button, only big enough to fit through a thin tube called a laparoscope (see our quick guide to laparoscopy for more). This tube is fitted with a light and camera which allows your doctor to see inside your body. The uterus will be removed in pieces through one or two additional small incisions in your abdomen. It may also be removed through your vagina, as in a vaginal hysterectomy.
You may need to have an abdominal hysterectomy. In this case, your uterus will need to be removed through your abdomen. This requires a vertical or horizontal incision to be made in the abdomen above your womb. Women often have this type of hysterectomy if a large tumor needs removing.
How will I feel afterwards?
Given that a hysterectomy can be carried out in three quite different ways, your recovery time, the risks involved and how you will feel afterwards varies considerably.
The least after-effects will be felt if you’ve had a vaginal hysterectomy. As there won’t have been any incisions, the procedure carries less risk and there will be a much shorter recovery time. It’s a quicker piece of surgery and you won’t need to spend so long in hospital. While laparoscopic hysterectomy involves smaller incisions, the delicacy of the operation means that you’ll be under general anesthetic for longer and so may feel the effects of this more than with other procedures. There’s a risk of bladder injury from the laparoscope, but you’ll be at lower risk of infection and spend less time in hospital. An abdominal hysterectomy involves incisions and therefore requires stitches and a longer healing time.
With all types of hysterectomy (as is the case for most procedures of any kind), infection, bleeding, blood clots and damage to nearby organs are among the risks involved. But as you’ll be required to stay in the hospital for a few days, you’ll be closely monitored and cared for after your surgery.
Some abdominal pain, light bleeding and discharge can be common for a couple of weeks and for six weeks, you should avoid sex and inserting anything such as tampons into your vagina.
The most obvious after-effect of a hysterectomy is that you won’t have any more periods. But so long as your ovaries were left in place, your body will continue to produce estrogen until the menopause.
Many women also experience a mixture of emotions after having a hysterectomy, sometimes related to knowing they can no longer conceive. Once you’ve recovered fully, you may find sex temporarily more or less enjoyable: You may feel more relaxed now that the procedure has removed the physical problems you were having, although some women report less intense sensations – linked to a lack of uterine contractions during orgasm. The important thing is that your body will now be healthier and any issues you were having will hopefully be resolved.