What is a hysterectomy?

A hysterectomy is an operation to remove your uterus (womb). Your cervix is usually also removed. Your ovaries may need to be removed at the same time (see figure 1).

The common reasons for having an abdominal hysterectomy include heavy or painful periods, and fibroids, where the muscle of your womb becomes overgrown.

What are the benefits of surgery?

A hysterectomy may cure or improve your symptoms. You will no longer have periods.

Are there any alternatives to an abdominal hysterectomy?

Heavy periods can be treated using oral medications, an IUD (intra-uterine device), or by removing only the lining of the womb.

Depending on the size and position of fibroids, you can take medication to try to control the symptoms. Other treatments include surgery to remove the fibroids only or uterine artery embolisation.

What does the operation involve?

The operation is usually performed under a general anaesthetic. The operation usually takes about an hour.

Your gynaecologist will make a cut on your abdomen, usually on your ‘bikini’ line. They will remove your womb, usually along with your cervix, through the cut. To remove your cervix, they will also need to make a cut at the top of your vagina.

What complications can happen?

1 General complications

  • Pain
  • Feeling or being sick
  • Bleeding
  • Infection of the surgical site (wound)
  • Blood clots
  • Unsightly scarring

2 Specific complications

  • Pelvic infection or abscess
  • Damage to structures close to your womb
  • Developing a fistula
  • Developing a haematoma
  • Vaginal cuff dehiscence

Long-term problems

  • Prolapse
  • Continued pain
  • Adhesions
  • Stress incontinence
  • Feelings of loss (a hysterectomy will make you infertile)
  • Menopause, even if your ovaries are not removed

How soon will I recover?

You will usually be able to go home after four to six days.

Rest for two weeks and continue to do the exercises that you were shown in hospital. You can usually return to work after six to eight weeks, depending on your type of work

You should be feeling more or less back to normal after three months.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Summary

A hysterectomy is a major operation usually recommended after simpler treatments have failed. Your symptoms should improve.

Acknowledgements

Author: Mr Jeremy Hawe MBChB MRCOG and Dr Clare Myers MBBS FRANZCOG

Illustrations: Medical Illustration Copyright © Nucleus Medical Art. All rights reserved. www.nucleusinc.com

 

This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.

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