A hysterectomy is a surgical procedure to remove the uterus.

A hysterectomy is an operation for a woman that will only be recommended if other treatment options have been unsuccessful.
Causes for Hysterectomy

The most common reasons for having a hysterectomy include:

Heavy periods (menorrhagia), due to fibroids for example
Pelvic pain, due to endometriosis, unsuccessfully treated pelvic inflammatory disease (PID) or fibroids for example
Prolapse of the uterus
Cancer of the uterus, ovaries or cervix

Procedure

Vaginal hysterectomy illustration key

Removing uterus through vagina
Pelvic bone
Bladder
Fallopian tubes and ovaries

Performing a hysterectomy

The most common reasons for having a hysterectomy include:

There are three ways that a hysterectomy can be performed. They are:

Open Hysterectomy:
vaginal hysterectomy
abdominal hysterectomy
laparascopic hysterectomy

Open hysterectomy

During an open hysterectomy, the uterus and cervix are removed through an incision that is made.After the uterus and cervix have been removed, the incision will be sewn up. The operation usually takes about an hour to complete.After your uterus has been removed, the incision is stitched up.

The operation will take about an hour to perform and a general anaesthetic is used.An abdominal hysterectomy may be recommended if your uterus is enlarged by fibroids or pelvic tumours and it is not possible to remove it through your vagina.

Laparoscopic hysterectomy

Laparoscopic surgery is also known as keyhole surgery. Nowadays, a laparoscopic hysterectomy is the preferred treatment method for removing the organs and surrounding tissues of the reproductive system. A laparoscopic hysterectomy is less invasive than a vaginal or abdominal hysterectomy because the incisions that are made are much smaller. This means that the wounds will be smaller and the recovery time will be quicker.

During the procedure, a small tube containing a telescope (laparoscope) and a tiny video camera will be inserted through a small incision in your abdomen.Laparoscopic hysterectomies are usually carried out under general anaesthetic.
Preoperative care

If you need to have a hysterectomy, it’s important to be as fit and healthy as possible.Good health before your operation will help reduce your risk of developing complications and speed up your recovery.

As soon as you know that you are going to have a hysterectomy, take the following steps:

Stop smoking (if you smoke).
Eat a healthy, balanced diet.
Exercise regularly.
Lose weight (if you are overweight).

Some blood tests and a general health check is done a few days before the operation to ensure that you are fit for surgery
Postoperative care

You will be given painkillers to help reduce any pain and discomfort.

The day after your operation, you will be encouraged to take a short walk. After the catheter has been removed, you should be able to pass urine normally. Any stitches that need to be removed will be taken out five-to-seven days after your operation.As a laparoscopic hysterectomy is a less invasive operation, you will usually be in hospital for a shorter period of time, providing there are no complications.

It takes about six-to-eight weeks to fully recover after having a hysterectomy. During this time, you should rest as much as possible and not lift anything heavy, such as bags of shopping. Your abdominal muscles and the surrounding tissues need time to heal.
Complications of a hysterectomy
General anaesthetic

It is very rare for serious complications to occur after having a general anaesthetic (1 in 10,000 anaesthetics given).

Bleeding
Bladder or bowel damage
Infection
Thrombosis
Vaginal problems
Ovary failure
Early menopause

Side effects

After having a hysterectomy, you may experience some temporary side effects as outlined below.

Bowel and bladder disturbances
Vaginal discharge

Getting back to normal
Returning to work

How long it will take for you to return to work will depend on how you feel and what sort of work you do.
Driving

Don’t drive until you’re comfortable wearing a seatbelt and can safely perform an emergency stop.
Exercise and lifting

After having a hysterectomy, the hospital will give you information and advice about suitable forms of exercise while you recover.Don’t lift any heavy objects during your recovery period. If you have to lift light objects, make sure that your knees are bent and your back is straight.
Sex

After a hysterectomy, it’s generally recommended that you don’t have sex until any vaginal discharge has stopped and you feel comfortable and relaxed, or after a minimum of six weeks.
Contraception

You no longer need to use contraception to prevent pregnancy after having a hysterectomy. However, you will still need to use condoms to protect yourself against sexually transmitted infections (STIs).