Learn why surgery to remove the uterus, known as a hysterectomy, might be done and what to expect if you need this surgery.
An abdominal hysterectomy is an operation that removes the uterus through a cut in the lower belly, also called the abdomen. This is known as an open procedure. The uterus, also called the womb, is where a baby grows when someone is pregnant. A partial hysterectomy removes the uterus, leaving the neck of the womb in place. The neck of the womb is the cervix. A total hysterectomy removes the uterus and the cervix.
A hysterectomy also can be done through a cut in the vagina. This is called a vaginal hysterectomy. Or you may have laparoscopic or robotic surgery, which uses long, thin instruments passed through small cuts in the belly.
You may need an abdominal hysterectomy instead of other types of hysterectomy if:
A partial hysterectomy, shown top left, removes the uterus. A total hysterectomy, shown top right, removes the uterus and cervix. The surgeon also may remove the ovaries and fallopian tubes, shown on the bottom.
You may need a hysterectomy to treat:
After hysterectomy, you can no longer get pregnant. If there's a chance you might want to become pregnant in the future, ask your health care provider about other treatment options. In the case of cancer, a hysterectomy might be your only option. But for conditions such as fibroids, endometriosis and uterine prolapse, there may be other treatments.
During hysterectomy surgery, you might have a related procedure to remove the ovaries and the fallopian tubes. If you're still having periods, removal of both ovaries leads to what's known as surgical menopause.
With surgical menopause, menopause symptoms often begin quickly after having the procedure. Short-term use of hormone therapy can help ease symptoms that really bother you.
The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system.
A hysterectomy is generally safe, but with any major surgery comes the risk of complications.
Risks of an abdominal hysterectomy include:
You may feel anxious about having a hysterectomy. Being prepared before surgery may help calm your nerves. To get ready for your procedure:
You may need tests to check for cancer and other diseases. Test results could change the surgeon's approach to the operation. Tests may include:
The day before and the morning of the surgery, you'll bathe or shower using a special soap. This can help reduce the risk of infection. Your care team also may have you clean the vagina with a vaginal douche and the rectum with an enema.
You'll receive general anesthesia before the procedure. This means you will not feel pain during the surgery. The procedure itself generally lasts about 1 to 2 hours.
You'll have a urinary tube, called a catheter, passed through the urethra to empty the bladder. The catheter remains in place during surgery and for a short time afterward. Your care team uses a sterile solution to clean the abdomen and vagina before surgery. You also will receive antibiotic medicine through a vein in your arm to lower your risk of infection.
Next, the surgeon makes a cut in the lower abdomen. This cut is called an incision. You may have:
What type of incision you'll need depends on many factors. These include the reason for the hysterectomy, the need to explore the upper abdomen, the size of the uterus and whether you have any scars from prior surgeries.
After surgery, you're moved into the recovery room and then to your hospital room. Your care team will:
You may be in the hospital for 1 to 2 days, but it could be longer. Sanitary pads can help control vaginal bleeding and discharge. You may have bloody vaginal drainage for several days to weeks after a hysterectomy. Let your care team know if you have bleeding that is as heavy as a period or bleeding that won't stop.
Over time, your incision will heal. But you will have a visible scar on your lower abdomen.
During abdominal hysterectomy, your surgeon makes a vertical or a horizontal cut, called an incision, in the lower abdomen. A vertical cut, shown left, gives the surgeon more access to the pelvis. A horizontal cut, shown right, follows the skin's natural lines, usually leaving a thinner scar.
It may take several weeks before you feel like you're back to your usual self. During that time:
A hysterectomy changes some aspects of life. For instance:
Other parts of your life likely will return to how they were before surgery or get better. For example:
But you may have a sense of loss after a hysterectomy. Premenopausal women who need to have a hysterectomy to treat gynecologic cancer may grieve the loss of fertility. If sadness or negative feelings interfere with your enjoyment of everyday life, talk with a health care provider.