A hysterectomy is a surgical procedure to remove a person’s uterus, and in some cases, other reproductive tissues. A hysterectomy can reduce the risk of ovarian cancer. However, it does not eliminate the risk entirely.

Ovarian cancer is cancer that develops in the ovaries. These are female reproductive organs that are responsible for producing eggs and releasing the hormones estrogen and progesterone.

This article discusses the different types of hysterectomy and how they affect a person’s risk of developing ovarian cancer.

It also outlines what to expect following a hysterectomy, and highlights some of the risks associated with the procedure.

Finally, it discusses ovarian cancer symptoms and risk factors, and offers advice on when to contact a doctor.

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There are several types of hysterectomy, which differ according to how much of the uterus and surrounding tissues the surgeon removes. These include:

  • Supracervical or partial hysterectomy: The surgeon removes the upper uterus and leaves the cervix in place. The cervix is the lower part of the uterus.
  • Total hysterectomy: The surgeon removes both the uterus and cervix.
  • Radical hysterectomy: The surgeon removes the uterus and cervix, along with tissue on either side of the cervix and the top part of the vagina.
  • Total hysterectomy with bilateral salpingo-oophorectomy (BSO): The surgeon removes the uterus and cervix along with the fallopian tubes and ovaries.

It is possible for a person to develop ovarian cancer after a hysterectomy. If the surgeon does not remove the ovaries, then a person can still develop ovarian cancer.

It is also possible to develop cancer if the surgeon removes one or both of the ovaries. However, the risk is significantly lower.

The American Cancer Society (ACS) notes that a hysterectomy with BSO reduces the risk of ovarian cancer. However, it does not eliminate the risk completely.

This is because residual ovarian cells after the surgery can affect the peritoneum, which is the thin layer of tissue that lines the inside of the abdomen. This can put people at risk of developing cancer after a hysterectomy with BSO.

Peritoneal cancer and link with ovarian cancer

Ovarian cancer and primary peritoneal cancer form in the same type of tissue. Epithelial cells make up the peritoneum. They are the same types of cells that cover the surface of the ovaries.

As such, the symptoms of peritoneal cancer mimic those of most ovarian cancers, and the treatments for the two diseases are the same.

A small number of peritoneal cancers may have an association with BRCA1 and BRCA2 gene mutations. These are the same gene mutations that increase the risk of breast and ovarian cancers.

A person can also develop peritoneal cancer if they have ovarian cancer. A 2018 report in the journal Cellular and Molecular Life Sciencesnotes that the peritoneum is often a site that ovarian cancer cells travel to.

The treatment for peritoneal cancer sometimes involves a peritonectomy to remove the peritoneum.

A person who undergoes a hysterectomy with BSO may continue to be at risk of developing peritoneal cancer, since the procedure leaves the peritoneum intact.

A 2022 population-based cohort study found that a hysterectomy with BSO is an effective prevention strategy for ovarian cancer.

The ACS states that a hysterectomy with BSO may reduce the risk of ovarian cancer in people who have BRCA gene mutations. These mutations can increase the risk of certain cancers, including ovarian cancer.

People who have BRCA gene mutations and undergo a hysterectomy with BSO reduce their risk of ovarian cancer by 85–95%.

Additionally, a large 2015 study also found that removing both ovaries during a BSO decreases the incidence of ovarian cancer. The study added that removing only one ovary may reduce the risk of ovarian cancer, though further research is necessary to confirm this.

However, the ACS warns that a person should only have a hysterectomy for a valid medical reason, not just to reduce their risk of ovarian cancer.

A doctor may recommend a hysterectomy to treat the following:

If a person is at high risk of developing ovarian cancer, a doctor may recommend a prophylactic bilateral oophorectomy, which is a procedure to remove both ovaries.

While this procedure reduces the risk of ovarian cancer by approximately 90%, it does not completely eliminate the risk.

Other factors that can reduce the risk of ovarian cancer include:

During or following a hysterectomy, a person’s surgical team will likely:

  • place an IV drip in the person’s arm to administer necessary fluid and medications
  • place dressings over any wounds
  • insert a urinary catheter to drain urine from the bladder into a collection bag
  • insert a drainage tube into the abdomen to drain blood from the area
  • insert a gauze pack into the vagina to minimize the risk of bleeding

When a person first wakes up from the procedure, they may feel tired and may experience some pain or discomfort. The doctor will administer pain relief and antinausea medications where appropriate.

The day after the procedure, a doctor or nurse may suggest taking a short walk to help promote blood flow and reduce the risk of deep vein thrombosis.

A nurse will remove the person’s stitches 5–7 days after the operation.

Recovery time

The time it takes for a person to recover from a hysterectomy depends on several factors, including:

  • the person’s age
  • the person’s overall health
  • the method the surgeon used to perform the hysterectomy, which will include one of the following:
    • Abdominal hysterectomy: This involves removing tissues through an incision in the lower abdomen.
    • Vaginal hysterectomy: This involves removing tissues through an incision in the top of the vagina.
    • Laparoscopic or “keyhole” hysterectomy: This involves inserting a thin tube, or “laparoscope,” into a small incision in the abdomen. A surgeon then inserts surgical instruments and removes tissues using the tube.

The United Kingdom’s National Health Service (NHS) suggests that a person who has undergone an abdominal hysterectomy may be able to leave the hospital within around 5 days. A person who has undergone a vaginal or laparoscopic hysterectomy may be able to leave sooner, within 1–4 days.

The overall recovery time for an abdominal hysterectomy is 6–8 weeks, while the overall recovery time for a vaginal or laparoscopic hysterectomy tends to be shorter.

In either case, a person may need to make a follow-up appointment with a doctor within 4–6 weeks of the surgery to check that they are healing as expected.

As with any type of surgery, a hysterectomy has associated risks and complications.

These include:

  • Complications from general anesthesia: Although rare, complications may include:
  • Damage to the bowel or bladder: Damage to these organs may cause issues, such as:
  • Damage to the ureter: Surgeons typically repair any ureter damage during the hysterectomy.
  • Infection: Most infections are responsive to antibiotic treatment.
  • Heavy bleeding: A person who experiences heavy bleeding following a hysterectomy may require a blood transfusion.
  • Blood clots: In some cases, a doctor may administer medication to reduce the risk of blood clots following surgery.
  • Vaginal issues: A vaginal hysterectomy may result in slow wound healing in the vagina, and may increase the risk of prolapse in subsequent years.
  • Ovary failure: A person who reserves one or both ovaries may still experience ovary failure within 1–5 years of having a hysterectomy.
  • Early menopause: Removal of the ovaries can trigger menopause symptoms, such as:

Not everyone with ovarian cancer experiences symptoms during the early stages of the disease. Early symptoms can be difficult to recognize as they may mimic those of other, less serious conditions.

Possible symptoms of ovarian cancer include:

As ovarian cancer progresses or spreads, other symptoms can also appear. These may include:

Factors that can increase a person’s risk of developing ovarian cancer include:

  • being over 40 years of age
  • having a first baby after the age of 35 years
  • never carrying a pregnancy to term
  • having overweight
  • having fertility treatments such as in vitro fertilization (IVF)
  • undergoing hormone therapy following menopause
  • having a family history of ovarian, breast, or colorectal cancer
  • having BRCA1 or BRCA2 gene mutations
  • having breast cancer

A person who experiences symptoms of ovarian cancer following a hysterectomy of any sort should make an appointment with a doctor.

If a person had ovarian cancer before the hysterectomy, the doctor may run the following tests to determine whether cancer has developed in the peritoneum:

  • a physical examination to check for abdominal bloating or pelvic pain
  • blood tests to check for tumor markers, such as CA-125
  • medical imaging tests, such as CT scans

A person should contact a doctor if they experience any persistent or recurrent symptoms of ovarian cancer.

After having a hysterectomy, a person should contact a doctor if they experience any of the following:

  • bleeding at the site of the incision
  • discoloration or swelling at the site of the incision
  • fever

There are several types of hysterectomy. They differ according to how much of the uterus and the surrounding tissues the surgeon removes.

Some hysterectomies leave part or all of the ovaries intact. A hysterectomy with BSO involves the removal of the uterus, as well as both fallopian tubes and ovaries.

A hysterectomy with BSO significantly reduces a person’s risk of developing ovarian cancer, though it does not eliminate the risk entirely.

A person who undergoes a hysterectomy can expect to recover fully within 6–8 weeks. Anyone who experiences symptoms of ovarian cancer following their surgery should contact a doctor for further advice.