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 a hysterectomy include heavy or painful periods and fibroids.

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 a hysterectomy?

Heavy periods can be treated using oral medications, an IUD (intra-uterine device), or by removing only the lining of your 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 90 minutes.

Your gynaecologist will make several small cuts on your abdomen.

They will insert surgical instruments, along with a telescope, inside your abdomen and perform the operation.

Your gynaecologist may need to place instruments through your vagina to help them remove your womb. They will make a cut around your cervix at the top of your vagina so they can remove your womb and cervix.

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

  • Surgical emphysema
  • Damage to structures such as your bowel, bladder or blood vessels
  • Developing a hernia near one of the cuts
  • Conversion to an abdominal hysterectomy
  • Pelvic infection or abscess
  • 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 one to three days.

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

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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