What is hysterectomy?

Hysterectomy: Before Your Surgery

Hysterectomy

Hysterectomy is the surgical removal of the uterus. It is done to treat certain gynecological conditions, such as endometriosis, fibroids, cancer, uterine bleeding that hasn't responded to other treatments, and childbirth complications. It can also be done as part of gender-affirming surgery.

A total (complete) hysterectomy is removal of the uterus and cervix. A subtotal (also called partial or supracervical) hysterectomy is the surgical removal of the uterus. In this case, the cervix is left in place.

A radical hysterectomy is done for some cancers. It removes the uterus, the cervix, part of the vagina, and some tissues around these organs. The ovaries, fallopian tubes, and nearby lymph nodes may also be removed.

What are the types of hysterectomy?

There are three major types of hysterectomy. Total hysterectomy removes the uterus and cervix. Supracervical (subtotal) hysterectomy removes just the uterus. Radical hysterectomy removes the uterus, cervix, part of the vagina, and some surrounding tissues. Which type you have depends on the reason for the surgery.

Managing vaginal dryness to make sex less painful

You may have vaginal dryness around the time of menopause. Or if your ovaries were removed during a hysterectomy (oophorectomy), you may have vaginal dryness from low estrogen levels.

If sex is painful because of vaginal dryness, there are steps you can take to make it more comfortable.

  • Use a vaginal lubricant.

    Try using K-Y Jelly, Astroglide, or a polyunsaturated vegetable oil that doesn't contain preservatives. If you use condoms, use a water-based lubricant. Don't use an oil-based lubricant. Oil can weaken the condom so that it breaks. Avoid petroleum jelly (for example, Vaseline) as a lubricant. It increases the risk of vaginal irritation and infection.

  • Use a vaginal moisturizer.

    Moisturizers such as Replens or Lubrin can be used on a regular basis.

  • Use a low-dose vaginal estrogen cream, ring, or tablet.

    These can reverse vaginal dryness and irritation. The estrogen affects only the vaginal area.

Talk with your doctor if you have any problems during intercourse after a hysterectomy. If you have other symptoms of menopause, talk to your doctor about systemic estrogen therapy (ET) and other treatment options.

What are the risks of a hysterectomy?

Hysterectomy poses some risks of major and minor complications. But most people don't have these problems after the surgery.

Your risk of problems after surgery may be higher or lower than average. This may depend in part on your overall health and how experienced the surgeon is.

Complications after the surgery include:

  • Heavy blood loss.
  • Bladder or bowel injury.
  • Blood clot to the lung.
  • Infection.

Possible ongoing problems include:

  • Trouble urinating. This is more common after removal of lymph nodes, ovaries, and structures that support the uterus (radical hysterectomy).
  • Weakness of the pelvic muscles and ligaments that support the vagina, bladder, and rectum.
  • Early menopause if your ovaries are removed.
  • Scar tissue (adhesions) in the pelvic area.

What is a hysterectomy?

A hysterectomy is surgery to take out your uterus. This is the organ in your lower belly where a fetus grows during pregnancy. After a hysterectomy, you won't be able to get pregnant.

Other organs might also be removed if you have severe problems such as endometriosis or cancer. These organs include the cervix, ovaries, and fallopian tubes.

What can you expect as you recover from a hysterectomy?

You might go home the day of your hysterectomy or stay in the hospital for several days. Recovery can take 4 to 6 weeks. It depends on which type of surgery you have and your overall health. You will have to take it easy for a few weeks and avoid heavy lifting.

Hysterectomy: Returning Home

How is a hysterectomy done?

There are many different ways to do hysterectomy surgery. The most common procedures are:

Abdominal hysterectomy.

In this procedure, the doctor makes a cut in your belly. The doctor takes out the uterus through this cut.

Vaginal hysterectomy.

The doctor takes out the uterus through your vagina. The doctor makes a small cut in the vagina instead of the belly.

Laparoscopic hysterectomy.

The doctor puts a lighted tube (laparoscope) through small cuts in your belly. The doctor can see your organs with the scope. The doctor can insert surgical tools to remove the uterus through the belly or the vagina.

Why is a hysterectomy done?

Most often, a hysterectomy is done to treat problems with the uterus. These problems include pain and heavy bleeding caused by endometriosis or uterine fibroids. The surgery may also be needed if there is cancer in the uterus, cervix, or ovaries. And it may be done as life-saving surgery if there is heavy bleeding during childbirth that can't be stopped.

In most cases, hysterectomy is an elective surgery. You can choose to have it to treat noncancerous female reproductive system conditions that haven't improved with medical treatment. If you don't plan to get pregnant and have tried other treatment options without success, it may be a reasonable treatment choice.

Other reasons for hysterectomy include:

  • Heavy menstrual bleeding.
  • Pelvic organ prolapse.
  • Adenomyosis.
  • Chronic pelvic pain. (But surgery is done only when the pain is caused by a diagnosed condition that can be corrected with a hysterectomy.)
  • A severe infection of the uterus.
  • Gender-affirming surgery.

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