Everything you need to know about removal of Uterus - Hysterectomy

A hysterectomy is a surgical procedure to remove a woman’s uterus. The uterus, also known as the womb, is where a baby grows when a woman is pregnant. The uterine lining is the source of menstrual blood.

A woman may have a hysterectomy for different reasons, including:

• Uterine fibroids that cause pain, bleeding, or other problems


• Uterine prolapse, which is a sliding of the uterus from its normal position into the vaginal canal


• Cancer of the uterus, cervix, or ovaries


• Endometriosis


• Abnormal vaginal bleeding


• Chronic pelvic pain


• Adenomyosis, or a thickening of the uterus

Hysterectomy for noncancerous reasons is usually considered only after all other treatment approaches have been tried without success.

Why Is a Hysterectomy Performed?

Your doctor may suggest a hysterectomy if you have any of the following:

• Chronic pelvic pain


• Uncontrollable vaginal bleeding


• Cancer of the uterus, cervix, or ovaries


• Fibroids, which are benign tumors that grow in the uterus


• Pelvic inflammatory disease, which is a serious infection of the reproductive organs


• Uterine prolapse, which occurs when the uterus drops through the cervix and protrudes from the vagina


• Endometriosis, which is a disorder in which the inner lining of the uterus grows outside of the uterine cavity, causing pain and bleeding


• Adenomyosis, which is a condition in which the inner lining of the uterus grows into the muscles of the uterus

The most common reason hysterectomy is performed is for uterine fibroids.

Types of Hysterectomy:

Depending on the reason for the hysterectomy, a surgeon may choose to remove all or only part of the uterus. Patients and health care providers sometimes use these terms inexactly, so it is important to clarify if the cervix and/or ovaries are removed:

• In a supracervial or subtotal hysterectomy, a surgeon removes only the upper part of the uterus, keeping the cervix in place.


• A total hysterectomy removes the whole uterus and cervix.


• In a radical hysterectomy, a surgeon removes the whole uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina. Radical hysterectomy is generally only done when cancer is present.

The ovaries may also be removed -- a procedure called oophorectomy -- or may be left in place. When the tubes are removed that procedure is called salpingectomy. So, when the entire uterus, both tubes, and both ovaries are removed, the entire procedure is called a hysterectomy and bilateral salpingectomy-oophorectomy.

Surgical Techniques for Hysterectomy:

Surgeons use different approaches for hysterectomy, depending on the surgeon’s experience, the reason for the hysterectomy, and a woman's overall health. The hysterectomy technique will partly determine healing time and the kind of scar, if any, that remains after the operation.

Abdominal Hysterectomy:

During an abdominal hysterectomy, your doctor removes your uterus through a large cut in your abdomen. The incision may be vertical or horizontal. Both types of incisions tend to heal well and leave little scaring.

Vaginal Hysterectomy:

During a vaginal hysterectomy, your uterus is removed through a small incision made inside the vagina. There are no external cuts, so there won’t be any visible scars.

Laparoscopic Hysterectomy:

During a laparoscopic hysterectomy, your doctor uses a tiny instrument called a laparoscope. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through incisions in the abdomen. Three or four small incisions are made instead of one large incision. Once the surgeon can see your uterus, they’ll cut the uterus into small pieces and remove one piece at a time.

What Are the Risks of a Hysterectomy?

A hysterectomy is considered to be a fairly safe procedure. As with all major surgeries, however, there are associated risks. Some people may have an adverse reaction to the anesthetic. There is also the risk of heavy bleeding and infection around the incision site.

Other risks include injury to surrounding tissues or organs, including the:

• Bladder


• Intestines


• Blood vessels

These risks are rare. However, if they occur, you may need a second surgery to correct them.