An abdominal hysterectomy is a surgical procedure that removes your uterus through an incision in your lower abdomen. Your uterus — or womb — is where a baby grows if you're pregnant. A partial hysterectomy removes just the uterus, leaving the cervix intact. A total hysterectomy removes the uterus and the cervix.
Sometimes a hysterectomy includes removal of one or both ovaries and fallopian tubes, a procedure called a total hysterectomy with salpingo-oophorectomy (sal-ping-go-o-of-uh-REK-tuh-me).
A hysterectomy can also be performed through an incision in the vagina (vaginal hysterectomy) or by a laparoscopic or robotic surgical approach — which uses long, thin instruments passed through small abdominal incisions.
An abdominal hysterectomy may be recommended over other types of hysterectomy if:
A partial hysterectomy (top left) removes just the uterus, and the cervix is left intact. A total hysterectomy (top right) removes the uterus and cervix. At the time of a total hysterectomy, your surgeon may also remove the ovaries and fallopian tubes (bottom).
You may need a hysterectomy to treat:
A hysterectomy ends your ability to become pregnant. If you think you might want to become pregnant, ask your doctor about alternatives to this surgery. In the case of cancer, a hysterectomy might be the only option. But for other conditions — including fibroids, endometriosis and uterine prolapse — you may be able to try less invasive treatments first.
During hysterectomy surgery, your surgeon might also perform a related procedure that removes both of your ovaries and your fallopian tubes (bilateral salpingo-oophorectomy). You and your doctor should discuss ahead of time whether you need this procedure, which results in what's known as surgical menopause.
With surgical menopause, menopause symptoms often begin suddenly for women after having the procedure done. Depending on how much these symptoms affect your quality of life, you may need short-term treatment with hormones.
The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system.
A hysterectomy is generally very safe, but with any major surgery comes the risk of complications.
Risks associated with an abdominal hysterectomy include:
It's normal to feel anxious about having a hysterectomy. Here's what you can do to prepare:
During abdominal hysterectomy, your surgeon detaches your uterus from the ovaries, fallopian tubes and upper vagina, as well as from the blood vessels and connective tissue that support it. The lower part of your uterus (cervix) is usually removed (total hysterectomy) but may sometimes be left in place (partial hysterectomy). If necessary, your surgeon may remove additional pelvic organs and tissue, such as your ovaries or fallopian tubes.
Before surgery, you may have tests done to check for cancer, which could change your surgeon's approach to surgery. Tests may include:
The day before and morning of your surgery, you will be instructed to shower using soap provided by your surgeon to reduce your risk of infection. A preoperative cleansing of your vagina (vaginal douche) or preoperative cleansing of your rectum (enema) also may be done. Immediately before surgery, you'll receive an intravenous antibiotic medication to minimize your risk of infection after the procedure.
A hysterectomy typically is performed under general anesthesia, so you won't be awake during the surgery. The procedure itself generally lasts about one to two hours, although you'll spend some time beforehand getting ready to go into the operating room.
To begin the procedure, a member of your surgical team passes a urinary catheter through your urethra to empty your bladder. The catheter remains in place during surgery and for a short time afterward. Your abdomen and vagina are cleaned with a sterile solution before surgery.
To perform the hysterectomy, your surgeon makes a cut (incision) in your lower abdomen, using one of two approaches:
The type of incision depends on many factors, including the reason for your hysterectomy, the need to explore the upper abdomen, the size of your uterus and the presence of any scars from prior abdominal surgeries. For instance, hysterectomies performed for endometriosis, large fibroids and gynecologic cancers are done mainly through a vertical incision.
After surgery, you'll remain in the recovery room for a few hours. Your health care team will:
An abdominal hysterectomy usually requires a hospital stay of one to two days, but it could be longer. You'll need to use sanitary pads for vaginal bleeding and discharge. It's normal to have bloody vaginal drainage for several days to weeks after a hysterectomy. However, let your surgeon know if you have bleeding that's as heavy as a menstrual period or bleeding that's persistent.
The abdominal incision will gradually heal, but a visible scar on your abdomen will remain.
During abdominal hysterectomy, your surgeon makes a vertical or a horizontal incision in your lower abdomen. A vertical incision (left) gives the surgeon greater access to your pelvis. A horizontal incision (right) follows your skin's natural lines, usually leaving a thinner scar.
It takes time to get back to your usual self after an abdominal hysterectomy — about six weeks for most women. During that time:
A hysterectomy permanently changes some aspects of your life. For instance:
Other parts of your life will likely return to normal or perhaps improve once you've recovered from your hysterectomy. For example:
On the other hand, you may feel a sense of loss after hysterectomy. Premenopausal women who must have a hysterectomy to treat gynecologic cancer may experience grief and possibly depression over the loss of fertility. If sadness or negative feelings begin to interfere with your enjoyment of everyday life, talk with your doctor.