Frequently Asked Questions for Hysterectomy Patients
Here are some questions about hysterectomy. They can help you decide with your doctor whether a hysterectomy is the best choice for you.
What is Removed During a Hysterectomy?
The answer depends on which type of hysterectomy you have.
In a total hysterectomy, the surgeon removes the uterus and cervix but leaves the ovaries and fallopian tubes. Many people wrongly assume that a total hysterectomy includes removal of the ovaries and fallopian tubes.
In a hysterectomy with bilateral salpingo-oophorectomy (BSO), the uterus, cervix, ovaries, and fallopian tubes are removed.
How is a Hysterectomy Performed?
A hysterectomy can be done in several different ways. It will depend on your health history and the reason for your surgery. Talk to your doctor about the different options, including:
Your doctor makes a cut in your abdomen. In one method, the surgeon cuts along the pubic hairline (sometimes called a "bikini" cut). In the other method, the surgeon cuts downwards from just below the belly button to just above the pubic hairline. This type of cut makes it easy for the surgeon to work inside the pelvis. There will be a vertical scar from belly button to lower abdomen.
This is done through a small cut at the top of vagina. This type of hysterectomy is mainly limited to patients who have a uterus that is not enlarged and no history of previous pelvic surgery.
A laparoscope is an instrument with a thin, lighted tube and a small camera that allows your doctor to see your pelvic organs. The doctor makes very small cuts to put the laparoscope and surgical tools inside the abdomen. During a laparoscopic hysterectomy the entire surgery is performed through these tiny incisions. This type of hysterectomy can be used to handle all types of problems (ie. fibroids, endometriosis, adhesions, etc.). After the surgery there will be very small scars on the abdomen.
Your doctor guides a robotic arm to do the surgery through small cuts in your lower abdomen, like a laparoscopic hysterectomy. Same as laparoscopic hysterectomy, after the surgery there will be 4 small scars on the abdomen.
What Can I Expect After Surgery?
This depends on a number of things, including your age, condition, whether you are still having periods, and what type of hysterectomy you have. If you were still having periods before surgery, they will stop after the operation.
If your ovaries are not removed, you will continue to produce hormones after surgery, but you will not have bleeding. If your ovaries are removed, you will go through changes like menopause. These might include hot flashes, vaginal dryness, night sweats, or other symptoms.
Similar to any type of surgery, there will be a recovery period after your hysterectomy, and that time will depend on the type of hysterectomy you have and your doctor’s orders. Abdominal hysterectomy requires the longest recovery (between six and 12 weeks) due to the large incision whereas, vaginal, laparoscopic and robotic hysterectomy have a much shorter recovery (between two and four weeks) due to much smaller incisions. After your surgery, your doctor will provide general guidelines regarding when you can lift, drive, or continue your regular physical activities.
What About Pain After the Operation?
Your doctor can give you medication to relieve the pain caused by surgery. Abdominal hysterectomies are usually associated with more pain than vaginal, laparoscopic, or robotic approaches because the incision on the abdomen is larger. No matter the type of hysterectomy, though, your physician will be able to keep you comfortable after the surgery.
What Are the Risks of Surgery?
Infections: As with any type of operation, there is always a risk of infection. Your doctor will give you an antibiotic with your surgery to reduce this risk.
Bleeding: There is a small risk that you might bleed too much during an operation and need a blood transfusion. This is uncommon and having a hysterectomy rarely requires a blood transfusion.
Injury to nearby organs: It is possible that during the operation a part of your body (intestines, bladder, and ureter) near the uterus might be injured. Although this is unlikely, it can happen with any type of surgery and your surgeon may need to do more surgery to fix what was injured.