A hysterectomy is a standard surgical procedure that involves the complete or partial removal of a person’s uterus.
A person may require a hysterectomy for one of several reasons. The surgery can help treat chronic pain conditions, as well as certain types of cancers and infections.
According to the Centers for Disease Control and Prevention (CDC), hysterectomies are very common, with 1 in 3 women in the United States having had one by the age of 60.
In this article, we discuss different types of hysterectomy, how and why a doctor may perform one, and what to expect during recovery.
A hysterectomy is a surgical procedure that completely or partially removes a person’s uterus. The uterus, also known as the womb, is where a fetus grows during pregnancy. The uterine lining also produces menstrual blood.
A person who has a hysterectomy will no longer have menstrual periods or become pregnant.
There are several types of hysterectomy, including:
- Partial (supracervical) hysterectomy: During a partial hysterectomy, a surgeon only removes the upper portion of the uterus.
- Total hysterectomy: Surgeons use this procedure to remove both the uterus and cervix.
- Radical hysterectomy: During this procedure, a surgeon removes the womb, cervix, and upper part of the vagina. They may also remove the ovaries, fallopian tubes, and surrounding lymph nodes.
- Total hysterectomy with bilateral salpingo-oophorectomy: This type involves the removal of one or both of a person’s ovaries and fallopian tubes. A surgeon can perform a salpingo-oophorectomy during a hysterectomy.
People who have a hysterectomy cannot become pregnant and may experience early menopause. As a result, where possible, a doctor will likely avoid recommending a hysterectomy to someone who has not entered menopause.
However, a doctor may advise a person to undergo a hysterectomy if they have one or more of the following conditions:
- unusually heavy vaginal bleeding
- chronic pelvic pain
- uterine fibroids, which are benign growths that develop in the uterus
- uterine prolapse, which occurs when the uterus descends toward or into the vagina
- endometriosis, which causes the endometrium — the inner lining of the uterus — to grow outside of the uterus
- adenomyosis, a condition in which the endometrium grows into the uterine walls
- cancer of the uterus, cervix, ovaries, or endometrium
A doctor or another healthcare professional will explain how to prepare for a hysterectomy. Requirements may vary depending on the type of hysterectomy and the reason for the procedure. However, people can expect the following advice:
- stop taking blood-thinning medication and aspirin a week before the procedure
- avoid smoking a few days before the procedure
- avoid eating and drinking several hours before the procedure
- pack an overnight bag in case a doctor recommends an extended hospital stay
- arrange transportation to and from the hospital
Before the procedure, people should also inform their doctor if they:
Surgeons can perform a hysterectomy in three different ways:
- Vaginal hysterectomy: This method involves removing the uterus through the vagina, which does not require any external incisions and leaves no visible scarring. The American College of Obstetricians and Gynecologists recommend vaginal hysterectomies whenever possible.
- Abdominal hysterectomy: A surgeon removes the uterus through a small incision below the bellybutton. This type of hysterectomy has a longer recovery period than a vaginal hysterectomy.
- Laparoscopic-assisted hysterectomy: A surgeon inserts an instrument called a laparoscope (a long, thin tube with a light and high resolution camera on the end) through a small incision in the bellybutton. Once they locate the uterus with the laparoscope, they will cut it into small pieces, which they will remove through two or three additional incisions in the abdomen.
People may feel drowsy after surgery while the anesthesia wears off. A healthcare professional will provide pain relievers and monitor a person’s vital signs.
A doctor may discharge some people from the hospital on the same day, while others may need to stay longer. A hospital stay is likely if the hysterectomy was part of the person’s cancer treatment.
During the first few weeks after surgery, people may experience vaginal bleeding or spotting and mild pain in the lower abdomen.
It takes time to recover from a hysterectomy. It may take several weeks before a person can return to their normal activities.
During this time, it is important that people get plenty of rest and perform light exercise, such as walking. However, they should avoid the following activities for 4–6 weeks after surgery:
- lifting heavy objects
- pushing or pulling objects
- using tampons
- sexual intercourse
All surgical procedures carry some risks and side effects, such as:
- vaginal bleeding or spotting
- difficulty urinating
- digestive issues
- damage to blood vessels, nerves, or surrounding organs
- delayed healing
People may experience the following symptoms of menopause if they undergo the removal of their ovaries:
A hysterectomy is a safe and effective procedure with a low risk of complications. About 5% of people develop an infection or experience delayed healing after a hysterectomy.
Less common complications include:
- blood clots
- damage to the urinary tract
- injuries of the gastrointestinal tract
- heavy bleeding or hemorrhage
- breathing or heart complications due to anesthesia
Recovery times vary depending on the type of surgery.
In general, most people recover from a vaginal or laparoscopic hysterectomy within 3–4 weeks and from an abdominal hysterectomy within 4–6 weeks.
People should be able to return to their regular activities, such as work, driving, and workout regimens, within 4–6 weeks. However, it is advisable to talk with a doctor before resuming strenuous exercise, including high intensity interval training (HIIT), weightlifting, or contact sports.
A hysterectomy may be necessary for people who have reproductive health conditions that do not respond to less invasive forms of treatment.
However, it is not the only option. Some alternatives to a hysterectomy include:
- hormone therapy for endometriosis
- Kegel exercises for uterine prolapse
- surgery to treat endometriosis or uterine fibroids without removing the uterus
- procedures that shrink uterine fibroids
Most people can return to their regular daily activities 3–6 weeks after a hysterectomy. Rest and light exercise can help make the recovery process easier and prevent blood clots and other complications.
Although rare, some people may experience heavy bleeding or develop infections or heart complications after a hysterectomy. People should seek immediate medical attention if they:
A hysterectomy is a common surgical procedure that involves the partial or complete removal of the uterus. A surgeon can also remove one or both fallopian tubes and ovaries during a hysterectomy.
People may feel weak, fatigued, or nauseated immediately after the procedure.
It is important to get plenty of rest and avoid strenuous exercise during the first few weeks of recovery. However, doctors may recommend that people walk a little every day.