Hysterectomy

A hysterectomy is a surgical procedure to remove the uterus (also known as the womb), which stops menstruation and prohibits future pregnancies. Every year, around 600,000 hysterectomies are done in the US.

Hysterectomy is a common treatment for conditions like:

• Painful or heavy periods
• Uterine fibroids
• Endometriosis
• Uterine prolapse
• Uterine cancer, cervical cancer or ovarian cancer
• Chronic pelvic pain

Depending on the reason for your surgery, a hysterectomy may also remove surrounding organs and tissues, like your fallopian tubes and ovaries.

Yes, hysterectomy is a major surgery. After a hysterectomy, you will no longer have periods, and you will be unable to get pregnant. While this may feel like a big change, it may be an effective treatment option for your condition.

The type of hysterectomy you need as well as the need to remove your fallopian tubes and/or ovaries depends on your condition. Your health care provider and/or surgeon will discuss this with you.

A minimally invasive option is the laparoscopic/robotic hysterectomy, which removes the uterus through the vagina with help from surgical instruments passed through small incisions in the abdomen. These instruments separate the uterus from what is holding it in place in the pelvis so that it can be removed via the vagina. It is performed using smaller incisions rather than one large incision, allowing for a shorter recovery time.

The different types of hysterectomy surgeries are:

• Total hysterectomy

A total hysterectomy will remove your uterus and cervix, but leave the ovaries behind. This means you may not enter menopause immediately after surgery.

• Radical hysterectomy

A radical hysterectomy will remove the uterus, cervix and some surrounding tissues, but also leaves the ovaries behind. This is usually done by a large incision in the abdomen.

• Partial hysterectomy

Partial hysterectomy (also called supracervical hysterectomy) will remove only the uterus, and will leave the cervix and ovaries behind.

• Vaginal hysterectomy

A vaginal hysterectomy refers to the removal of the uterus through the vagina. Ovaries are left behind.

In addition, a few procedures are commonly associated with hysterectomy:

• Salpingectomy: Removal of the fallopian tubes.
• Oophorectomy: Removal of the ovaries. Note that removing your ovaries will start menopause immediately, if you haven’t yet gone through it.

Bilateral salpingo-oophorectomy: Removal of both left and right ovaries as well as both fallopian tubes.

A hysterectomy procedure can last up to one to three hours. This depends on the following factors:

• Uterus size
• Presence of scar tissue (usually from past surgeries)
• Presence of endometriosis (excessive growth of the uterine lining)
• Removal of other tissues or organs (e.g. ovaries or fallopian tubes)

The procedure is conducted under general anesthesia, so you will not feel any pain during the surgery. Afterwards, you may experience soreness and discomfort for a few weeks. A few options for pain relief are available as you recover. This may include prescription pain medication, NSAIDs (non-steroidal anti-inflammatory drugs) or acetaminophen (also known as Tylenol). Sometimes stronger pain medications may be required briefly.

The usual recovery time for a hysterectomy ranges from four to six weeks but can vary depending on your overall health condition. Recovery from vaginal hysterectomy or a laparoscopic hysterectomy will be faster than recovering from an abdominal hysterectomy.

In the US, a hysterectomy typically costs around $5,000 to $11,000 USD.