Hysterectomy

What is a hysterectomy?

Hysterectomy is surgery to remove the uterus, an organ that is a part of the female reproductive system.

Different types of hysterectomy include:

• Subtotal hysterectomy: Removal of the uterus, but not of the cervix.
• Total hysterectomy: Removal of the entire uterus, including the cervix.
• Radical hysterectomy: Removal of the entire uterus and the lymph nodes. This is often done for cancer.

Why does a hysterectomy need to be performed?

There are many reasons why the uterus may need to be taken out. In some cases, it's because of uterine cancer. You may also have heard of fibroids, which are common, non-cancerous tumors in the uterus. If you have fibroids that begin to cause problems, your doctor may recommend a hysterectomy. Other reasons for hysterectomy include endometriosis and severe bleeding problems. These are just a few examples. It is important to note that, except in the case of uterine cancer, conservative treatment (such as medication) should generally be attempted prior to considering hysterectomy.

How is a hysterectomy performed?

There are several ways to remove the uterus. The surgeon may choose to make an incision in the lower abdomen. Another method is to remove the uterus through a cut in the vagina. Some surgeons may even use laparoscopy (inserting a fiber-optic scope through a small incision) for part of the surgery. You should discuss with your doctor which type of hysterectomy you prefer. Keep in mind that it can really depend on why it is being performed.

The ovaries and fallopian tubes may also be taken out during a hysterectomy. Sometimes the lymph nodes are removed.

A hysterectomy may be done as an emergency if someone is bleeding severely. This may happen right after delivering a baby, and a hysterectomy could be life-saving.

How long does the procedure take?

The surgery time depends on the type of operation. Usually, it takes about an hour. General anesthesia (being put to sleep) may be used. Sometimes an epidural (which numbs the area) is used.

Many patients go home after a few days if there are no major problems. The type of scar you get depends on what type of incision was made.

What are the risks?

Bleeding is the most common problem. If severe, you may need a blood transfusion. Blood clots in the legs and lung can also be a serious problem. Bleeding and infection are possible at the incision. The risk of injury to other internal organs is very small. Other risks, including death, are very rare.

Talk to your doctor if you are thinking about a hysterectomy.

Sources:

American College of Surgeons

American College of Obstetricians and Gynecologists

National Institutes of Health (NIH)

Centers for Disease Control and Prevention (CDC)

This article was reviewed and updated June 2007.