A hysterectomy is the primary treatment for endometrial cancer. It involves the removal of the uterus and cervix and possibly the ovaries and fallopian tubes, depending on the cancer stage and type.
Surgery is the
This article provides an overview of the types of hysterectomy procedures available for those with endometrial cancer, including the outcomes and potential risks of each type of surgery.
A total hysterectomy bilateral salpingo-oophorectomy (TH/BSO) is the
The goal is to eliminate cancerous tissue and prevent cancer from spreading or recurring.
Depending on the cancer stage and the person’s individual health needs, doctors may use one of several types of hysterectomy for endometrial cancer:
- Total hysterectomy: This is the removal of the uterus and cervix.
- Total hysterectomy with bilateral salpingo-oophorectomy: This is the removal of the uterus, cervix, fallopian tubes, and ovaries.
- Radical hysterectomy: This is the removal of the uterus, the cervix, the upper part of the vagina, and surrounding tissues. The surgeon may also remove the ovaries, fallopian tubes, and surrounding lymph nodes.
Surgery done alongside hysterectomy
During a hysterectomy, surgeons may perform additional procedures to ensure the best possible outcome for the person.
Additional procedures may include:
- Lymph node dissection: The is the removal of lymph nodes in the pelvic or abdominal area.
- Omentectomy: This procedure involves removing part or all of the omentum, a layer of fatty tissue covering the abdominal organs. Doctors reserve this procedure for
more advancedcases of cancer that are beyond the uterus and nearby structures.
- Peritoneal washing cytology: In this diagnostic procedure, surgeons use a saltwater solution to “
wash” the abdomen and pelvis. They then collect the solution for examination under a microscope to detect cancer cells or other abnormalities in the peritoneal cavity. Surgeons commonlyperform this procedure during ovarian cancer surgeries but may also perform it during endometrial cancer surgeries.
- Bilateral salpingo-oophorectomy: This involves removing both the fallopian tubes (salpingectomy) and ovaries (oophorectomy).
Surgeons can perform a hysterectomy using a variety of techniques, such as:
- Abdominal hysterectomy: This technique involves making a large incision in the abdomen to access the uterus. It is the
most commontechnique for this surgery in the United States.
- Vaginal hysterectomy: This involves removing the uterus through the vagina without any incisions in the abdomen. The American College of Obstetricians and Gynecologists recommends it because it may cause less pain and scarring than other methods. It requires a shorter hospital stay and less recovery time. However, it may not be suitable for all people, particularly those with a large uterus or other complications.
- Laparoscopic hysterectomy: In this minimally invasive technique, surgeons insert a laparoscope — a thin, lighted tube with a camera on the end — and other surgical instruments through a small incision in the belly button.
- Robotic-assisted hysterectomy: Similar to laparoscopic hysterectomy, this technique involves using a robotic system to control surgical instruments. The robotic system provides enhanced visualization and dexterity for more precise and efficient surgery.
Doctors will ask people to follow specific instructions to ensure a successful surgery and recovery.
These guidelines may vary depending on the surgical approach and the individual’s health status but may include:
- stopping certain medications, such as blood thinners and aspirin, before the procedure
- fasting for at least 6 hours before the surgery
- avoiding smoking and alcohol consumption, if applicable, leading up to the surgery
- arranging for transportation to and from the hospital
- packing an overnight bag with comfortable clothing and personal hygiene items in case a doctor recommends an extended hospital stay
Most people preparing for a hysterectomy will have a preoperative appointment with their surgeon to review the procedure, the risks and benefits, postoperative care, and other concerns.
This appointment may also involve additional tests or evaluations to ensure that the person is ready for surgery.
Doctors may advise a person to bring a list of questions and concerns to the appointment and to follow any instructions that healthcare professionals provide.
Recovery times vary depending on the type of surgery.
Patients who undergo minimally invasive procedures such as laparoscopic or vaginal hysterectomy may have a shorter recovery period and spend less time in the hospital.
According to the
The outcome of a hysterectomy depends on various factors, including the surgical approach, the cancer stage, and the person’s health status.
A 2020 randomized clinical trial published in the International Journal of Gynecological Cancer found that, out of 2,949 patients, the overall 5-year survival rate was:
- 77.6% in robotic hysterectomy
- 76.8% in laparoscopic hysterectomy
- 72.5% in open hysterectomy
Can the cancer return after the hysterectomy?
People with endometrial cancer should have a physical exam every 3–6 months for the first 2–3 years after treatment and every 6–12 months after that.
Those with more advanced cancer may need frequent checkups and additional imaging tests to monitor their condition naturally after the removal of the uterus.
Additionally, people who had not yet experienced menopause before surgery may have symptoms of menopause after TH/BSO,
- hot flashes
- night sweats
- vaginal dryness
- mood changes
- trouble sleeping
Hysterectomy may also lead to an increased risk of
- wound healing problems
- blood clots
- excessive bleeding
- ovary failure
- injury to nearby organs and nerves
- urinary incontinence
- bowel damage
- complications due to anesthesia
The cost of a hysterectomy can vary greatly depending on the type of surgery, the surgeon, and the person’s insurance coverage.
Medicare covers endometrial cancer preventive screenings, diagnostic testing, and inpatient and outpatient care.
Learn more about Medicare cover for endometrial cancer.
Financial help for cancer treatment
Below is a list of resources that provide financial assistance for cancer treatment:
Hysterectomy is the primary treatment for endometrial cancer. Doctors can perform it through various methods, such as open surgery and laparoscopy.
Regular checkups are necessary after surgery to monitor for any cancer recurrence.
A hysterectomy carries potential risks and can result in infertility and symptoms of menopause.