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Hysterectomy- What You Need to Know
This article is provided by Ethicon Women’s Health & Urology
Division of Ethicon, Inc.


A hysterectomy is the surgery performed on a woman to remove her uterus. In addition to the uterus, the fallopian tubes and ovaries may also be removed during the procedure.
 

Did you know that 600,000 hysterectomies are performed in the United States every year1 – but in many cases, their symptoms could be treated with less invasive options, such as global endometrial ablation, or a myomectomy? Exploring all your options with your doctor may help you minimize pain, scarring, hospital and recovery times – while getting the treatment you need.
 

Why undergo a major surgery like hysterectomy without knowing all your choices and discussing them with your doctor? You may also find a second opinion helpful. Click here for a list of physicians in your area who may be able to help you.
 

Rarely is a hysterectomy an emergency surgery. There is usually considerable time to research and explore alternatives for discussions with your doctor. Take the time to understand your condition and all the treatment options available to you by Assessing Your Symptoms. Click here to answer a few questions about your condition and learn about potential solutions.
 

Reasons for Hysterectomy
 

Your doctor may recommend a hysterectomy as treatment for a wide variety of conditions, some of which are listed below. While hysterectomies may sometimes be absolutely necessary, in many cases symptoms can be treated with less invasive options. Make sure you explore alternative treatment options with your doctor.

  • Fibroids – benign or noncancerous growths inside the uterus.
  • Heavy periods – also known as menorrhagia, cause pain, fatigue and disruption to your quality of life.
  • Endometriosis – a condition where tissue that normally resides in the uterus appears in other parts of the abdomen.
  • Pelvic support problems/prolapse – a condition in which the uterus drops out of its normal position, causing women to urinate more frequently, and often avoid sex and limit their movements because of pain.
  • Some uterine and cervical cancers may be treated with hysterectomy or with other treatment methods.

If hysterectomy is still your best treatment option, you may have choices as to how your hysterectomy is performed. Today, there are several types of hysterectomies, including less invasive procedures that may reduce hospital and recovery times as well as minimize scarring, compared to traditional procedures.


Types of Hysterectomy


Definition of Hysterectomy: A hysterectomy is the surgical removal of all or part of the uterus, or womb. The doctor may also remove the fallopian tubes, ovaries and/or the cervix during the same surgery.
 

Hysterectomy Terms based on WHAT is Removed:
 

  • Supracervical Hysterectomy (Also called “Subtotal Hysterectomy” or “Partial Hysterectomy”): Removes the uterus but leaves the cervix in place, which some research suggests may reduce the risk of pelvic organ prolapse and preserve sexual function.
  • Total Hysterectomy (“Traditional Hysterectomy”): Removes the uterus and cervix.
  • Radical Hysterectomy May remove all of these organs (the uterus, cervix, fallopian tubes, ovaries), plus the pelvic lymph nodes.
     

Hysterectomy Terms based on HOW the Surgery is Performed:


There are 3 different ways to perform hysterectomies:

  • Laparoscopic: With this hysterectomy method, a thin, lighted, telescope-like instrument called a laparoscope, along with small surgical instruments, are inserted into the abdomen through 3 to 4 tiny incisions, to remove the uterus. It usually requires no more than 1-3 days in the hospital. Recovery takes from 6 days to about 3-4 weeks, depending on the type of laparoscopic hysterectomy. Based upon your clinical need, your doctor might perform a Laparoscopic Supracervical Hysterectomy (LSH), allowing you to keep your cervix, or a Total Laparoscopic Hysterectomy (TLH).
  • Vaginal: This hysterectomy method uses a smaller incision inside the vagina to remove the uterus and other organs, as determined by your doctor. This incision is not visible externally. Vaginal hysterectomies usually require a 1-3 day hospital stay and a 3-4 week recovery.
  • Abdominal (also known as Open): This hysterectomy method requires either a small up and down incision from the pubic bone to the belly button or a horizontal incision just above the pubic bone to remove the uterus and cervix and, in some cases, other organs. The most invasive kind of hysterectomy, this type is performed under general anesthesia, with a typical hospital stay of 3-6 days and up to 6 weeks of recovery time.



Know your Hysterectomy Options

 

Type of Hysterectomy

What is it?

What does it look like?

Hospital stay

Recovery time

Laparoscopic

 

 

 

 

Laparoscopic Supracervical Hysterectomy (LSH)

A specific type of laparoscopic hysterectomy in which the cervix is left in place

1 day or less

6 days

Total Laparoscopic Hysterectomy (TLH)

A type of laparoscopic hysterectomy in which the uterus and cervix are removed

1-3 days

3-4 weeks

Vaginal

 

 

 

 

Vaginal Hysterectomy

 

Uterus, cervix and sometimes other organs are removed via a smaller incision inside the vagina

 

1-3 days

 

3-4 weeks

Abdominal

 

 

 

 

Abdominal Hysterectomy

 

Uterus, cervix and sometimes other organs are removed via a 4- to 8-inch horizontal incision below the belly button

 

3-6 days

 

4-6 weeks

 



Speak up About your Hysterectomy Choices

  • If you and your doctor have determined that hysterectomy is the best course of action for your symptoms, make sure you talk through your choices of procedure. And consider getting a second opinion. Today’s less invasive hysterectomy options, like laparoscopic or vaginal, can help you significantly reduce hospital and recovery times, and minimize scarring and pain afterwards.2,3
  • Talk to your doctor about which organs need to be removed, too. Some research suggests keeping your cervix after hysterectomy may reduce the risk of pelvic floor prolapse and preserve sexual function. A laparoscopic supracervical hysterectomy offers a less invasive alternative to traditional abdominal hysterectomy and allows you to retain your cervix.

Click here for a list of questions to ask your doctor about hysterectomy options.

Before making a final decision about your treatment, review all your options, and consider getting a second opinion.


References

1 Keshavarz H, Hillis SD, Kieke BA, Marchbanks PA. Hysterectomy surveillance -- United States, 1994-1999. Morb Mortal Wkly Rep CDC Surveill Summ. 2002; 51 (SS05): 1-8.
2 Sarmini OR, Lefholz K, Froeschke M. A comparison of laparoscopic supracervical hysterectomy and total abdominal hysterectomy outcomes. The Journal of Minimally Invasive Gynecology. 2005;12:121-124.
3 Candiani M, Izzo S, Bulfoni A, Riparini J, Ronzoni S, Marconi A. Laparoscopic vs vaginal hysterectomy for benign pathology. American Journal of Obstetrics & Gynecology. 2009; 368.

For more information about hysterectomy and hysterectomy surgery and recovery, click this link.

Proposed keywords: hysterectomy recovery, hysterectomy surgery, alternatives to a hysterectomy, hysterectomy for fibroids


 



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