Approximately 600,000 women get a hysterectomy each year according to the Centers for Disease Control and Prevention. Even though this is the second most frequent surgical procedure among reproductive-aged women, there are still a lot of questions surrounding the procedure. The following are some of the most commonly asked questions and answers.
What is a hysterectomy?
A hysterectomy is when a woman's uterus is surgically removed.
Are all hysterectomies the same?
There are three main types of hysterectomy:
- A total hysterectomy is when the entire uterus and cervix is surgically removed.
- A partial hysterectomy, also called a supracervical hysterectomy, is when the uterus is surgically removed but the cervix is not.
- A third type of hysterectomy, a radical hysterectomy, is the removal of the uterus but would also include removal of both the fallopian tubes and the ovaries.
Hysterectomies can be performed vaginally, abdominally or laparoscopically.
In a vaginal hysterectomy, a surgical incision is made in the vagina. This type of surgery usually has less pain during recovery and can have shorter hospital stays than removing the uterus abdominally.
Abdominal surgery may be required if there are large tumors or cancer present to allow the doctor to view the uterus and other organs.
A laparascope is a thin instrument which is inserted into a small incision in the abdomen, around the navel. The laparascope has a light to allow the surgeon to look around the abdomen. The uterus is then removed either in small pieces through the incision or through the vagina.
What health conditions can lead to hysterectomy?
There are a number of women's health conditions that may lead to a recommendation of a hysterectomy:
- Uterine fibroids
- Pelvic adhesions
- Uterine prolapsed
- Abnormal uterine bleeding that has not been helped through non-surgical means
- Cancer of the cervix, uterus or ovaries
What are the risks of hysterectomy?
As in all surgeries, there are certain risks involved in having a hysterectomy, even though it is a commonly performed surgery and considered to be one of the safest surgical procedures. Some possible problems include:
- Bleeding during or after surgery
- Deep vein thrombosis (a blood clot in a deep vein, usually the leg)
- Blocking of the bowels due to scarring from surgery
- Blood clots around the wound
You may also experience anesthesia related problems and, as with all surgeries, there is a risk of death.
How long is the recovery?
Doctors will encourage you to begin walking around as soon as possible after your surgery, normally within a day or two, to help prevent deep vein thrombosis. You will probably experience pain for the first few days and may have bleeding or vaginal discharge for up to six weeks. During this time, you will not be able to put anything into your vagina, including abstaining from sex, not using tampons and not douching.
You should be able to resume most of your daily activities in four to eight weeks after surgery.
You may find for the first few months after surgery you are more tired than usual and that you need to stop periodically through the day to rest. Allow yourself this time and take advantage of friends and family who are willing to help you in the first few weeks. Talk with your doctor about exercises you can do that can help to speed your recovery.
What are the hormonal changes due to hysterectomy?
Depending on the type of hysterectomy you have, you body may or may not still produce estrogen. If your ovaries were removed during surgery, your body will stop producing estrogen and you may experience symptoms similar to menopause, such as hot flashes, vaginal dryness and sleep problems. If your ovaries were not removed, your body will still continue to produce estrogen and you may not experience any hormonal changes.
Will I experience emotional or sexual changes after hysterectomy?
Some women do not notice any difference in sexual response, while others report they enjoy sex even more, possibly because their previous health problem is no longer interfering with their sexual relationship. They may also be able to relax and enjoy sexual relationships without the possibility of pregnancy.
If you felt uterine contractions during orgasm, you will no longer feel those as you no longer have a uterus. If these contractions added to your sexual pleasure, you may feel less enjoyment from sex.
If your ovaries have been removed and you are no longer producing estrogen, you may experience vaginal dryness that interferes with sex. Using gels or lubricants can help to reduce the dryness and increase your enjoyment.
Some women may feel depressed after a hysterectomy. Some will have difficulty with no longer being able to have children or feel as if they have suffered a loss. Depression may last only a few weeks. If you find depression is lasting for several weeks or months, you should speak with your doctor.
"Hysterectomy," Revised 2010, Jan, Staff Writer, New York State Department of Health
"Hysterectomy," 2011, August, Staff Writer, American College of Obstetricians and Gynecologists
"Women's Health Care: Hysterectomy," 2004, Staff Writer, Thomsom Micromedex, The CareNotes