What Is a Hysterectomy?
During a hysterectomy, a doctor surgically removes your uterus. In some cases, they also remove other organs and tissues near the uterus.
The uterus has a lining of blood. If you’re not pregnant, you shed that lining of blood during your period. If you're pregnant, the fetus attaches to the lining to form a placenta and grows in your uterus.
Once your uterus is gone, you can’t have a period anymore. You also can’t get pregnant.
Your ovaries produce the hormones estrogen and progesterone. If doctors remove your ovaries during a hysterectomy, you'll begin menopause. Even if doctors don’t remove your ovaries, having a hysterectomy still increases your risk of early menopause.
Types of hysterectomy
They are:
- Radical hysterectomy with bilateral salpingo-oophorectomy — Doctors remove your uterus, cervix, ovaries, fallopian tubes, part of your vagina, and lymph nodes. Doctors usually perform this surgery to remove cancer in the pelvic area.
- Supracervical hysterectomy — Doctors only remove the upper part of your uterus and leave your cervix.
- Total hysterectomy — Doctors remove your uterus and cervix but leave your ovaries and fallopian tubes.
- Total hysterectomy with bilateral salpingo-oophorectomy — Doctors remove your uterus, cervix, ovaries, and fallopian tubes.
There are also different ways doctors can perform hysterectomies. Most of the time, UPMC doctors do minimally invasive hysterectomies.
Minimally invasive hysterectomy surgery
UPMC offers three types of minimally invasive hysterectomy:
- Laparoscopic hysterectomy — Doctors make small cuts in your pelvic area and use a tool called a laparoscope to see your pelvic organs. They then use surgical tools to remove your uterus (and, in some cases, other organs).
- Robotic hysterectomy — Similar to a laparoscopic surgery but your doctor uses a computer to guide a robotic arm that performs the surgery. Robotic hysterectomies give doctors a better view of your uterus.
- Vaginal hysterectomy — Your doctor will make a small cut at the top of your vagina to remove your uterus. You can only have this type of hysterectomy if your uterus isn’t enlarged and you haven’t had another pelvic surgery, like a cesarean section.
The benefits of minimally invasive surgery include:
- A faster recovery and quicker return to your everyday activities.
- Shorter hospital stay.
- Less pain after surgery.
- Reduced risk of complications like infection and scar tissue.
Traditional hysterectomy surgery
In some cases, doctors recommend a traditional hysterectomy surgery, called an abdominal hysterectomy. This is when your doctor makes a larger cut in your abdomen to remove your uterus.
Doctors only perform abdominal hysterectomies when necessary because they come with a higher risk for complications and increased recovery time. For example, if they're removing cancer that’s spread throughout the pelvic area, they may do an abdominal hysterectomy.
Conditions we treat with hysterectomy
Doctors perform hysterectomies to treat symptoms caused by conditions affecting your pelvic area.
These include:
- Cancer — Including uterine and cervical cancer.
- Endometriosis — When cells from the uterus grow in your pelvic area or belly.
- Abnormal uterine bleeding — From hormone issues, cancer, fibroids, infection, or other health problems.
- Adenomyosis — A benign (noncancerous) condition where the lining of the uterus grows into the muscular layer of the uterine wall.
- Uterine fibroids— Benign (noncancerous) tumors that grow in the uterus.
Why Would I Need a Hysterectomy?
If you have conditions that haven't responded to other treatments, you may need a hysterectomy. For some conditions, a hysterectomy may be the recommended treatment.
A hysterectomy may also be a part of gender-affirming care.
Who’s a candidate for a hysterectomy?
Doctors only recommend a hysterectomy to those who don't plan on having children or are finished building their families. Once you have your uterus removed, you won't have a period or be able to get pregnant.
What Are the Risks and Complications of a Hysterectomy?
All surgeries come with a risk of certain complications during and after surgery, depending on your age, health history, and the extent of the issue doctors are treating.
The risks of having a hysterectomy include:
- Blood clots (venous thromboembolism or VTE) in your veins, which can travel to the lungs.
- Complications from anesthesia, such as breathing and heart problems, vomiting, and allergic reactions.
- Heavy bleeding. Although rare during a hysterectomy, you may need a blood transfusion if you lose a lot of blood.
- Infections at or near the area where you had surgery, or elsewhere in your body. Your doctor will give you antibiotics to reduce this risk.
- Injury to organs near your pelvic area, such as your intestines or bladder, during surgery.
What Should I Expect Before, During, and After a Hysterectomy?
Before your hysterectomy
Your doctor will do a physical exam before your hysterectomy and run certain tests, like blood tests, to make sure it’s safe for you to have surgery.
Your doctor will also give you specific instructions, which will depend on the type of hysterectomy you’re having and your health history.
You’ll learn how to prepare for surgery, including:
- When to arrive at the hospital.
- When to stop eating and drinking before your surgery.
- What to bring to the hospital, such as a list of your medications, your ID, and your insurance card.
- What to expect from your surgery.
During your hysterectomy
You’ll receive anesthesia during your surgery. A nurse or doctor will insert an IV into your vein to give you pain medication that makes you sleep through the surgery.
Doctors use two different types of anesthesia during minimally invasive surgery:
- Sedation, also known as deep intravenous (IV) sedation — You'll sleep through the procedure. Although you won’t be fully conscious or remember the surgery, your muscles aren’t completely relaxed, so you’ll be able to breathe without a machine. Doctors may still use a small nasal cannula (a device that sits under your nose) to help you breathe.
- General anesthesia — When doctors use medication that affects your whole body, you aren't awake during surgery, and your muscles relax, too. Doctors will give you a special airway device to help you breathe. Side effects, like nausea and drowsiness, can last longer than if you had sedation.
Most hysterectomies take one to three hours. Minimally invasive hysterectomies are often outpatient surgeries, and you may be able to go home a few hours after the surgery.
Abdominal hysterectomies are inpatient procedures. Most people who have an abdominal hysterectomy stay in the hospital for several days.
Regardless of the type of hysterectomy you have, you’ll need a ride home from the hospital afterward.
Recovery after your hysterectomy
How long it takes you to recover will depend on the type of hysterectomy you had. Your age and health history will play a role in your recovery, too.
If you had a minimally invasive hysterectomy, you might be able to move around as usual in just a couple of weeks. If you had an abdominal recovery, it may take two to three months to recover.
After your hysterectomy, you might experience:
- Pain — It’s normal to have some discomfort and mild pain the first few days after your hysterectomy. Your doctor will prescribe medication to help manage the pain.
- Discharge and bleeding — You’ll probably have some discharge and light bleeding from your vagina. This may last several days to a few weeks after surgery. You can use sanitary pads (maxi pads), but don’t use tampons until your doctor tells you it’s OK.
- Constipation — Your doctor will give you a stool softener to help you have a bowel movement without straining.
- Urinary issues — It may take you a while to empty your bladder right after your surgery. Tell your doctor or nurse if you can’t pee.
- Fatigue — You’ll feel tired and will need to rest for at least several days after your hysterectomy.
- Sadness or mood swings — Some people feel happy after a hysterectomy because the surgery has treated their health issues. But if you feel sad or upset, that’s normal, too.
- Menopause-related symptoms — You may have hot flashes and night sweats, vaginal dryness, and mood swings. If doctors removed your ovaries along with your uterus, you’ll enter menopause right away. But even if your ovaries aren’t removed, your body may begin menopause early after a hysterectomy.
Be sure to follow your doctor’s instructions about when you can:
- Drive.
- Lift heavy objects.
- Exercise.
- Have sex.
- Put anything in your vagina.
Why Choose UPMC for Hysterectomy?
UPMC’s highly skilled team will guide you through every step of your hysterectomy. We'll help you prepare for surgery and take steps to heal faster and with less pain, too. Our goal is for you to get relief from your symptoms and feel better.
Last reviewed by Nicole Michelle Donnellan, MD on 2024-09-05.
