What is a hysterectomy?
A hysterectomy is an operation to remove your uterus (womb). Your cervix (neck of your womb) is usually also removed. Your fallopian tubes and ovaries may need to be removed at the same time.
What are the benefits of surgery?
There are common reasons for having an abdominal hysterectomy.
- Heavy or painful periods.
- Fibroids, where part of the muscle of your womb becomes overgrown.
A hysterectomy may cure or improve your symptoms. You will no longer have periods.
Are there any alternatives to an abdominal hysterectomy?
- Symptoms may be improved by doing pelvic floor exercises.
- Heavy periods can be treated using a variety of non-hormonal and hormonal oral (by mouth) medications. Other alternatives include an IUS (intra-uterine system – an implant containing a synthetic form of the hormone progesterone that fits in your womb) or ‘conservative surgery’ to remove the lining of your womb.
- Depending on the size and position of fibroids, you can take medication to try to control the symptoms. Other treatments include surgery to remove the fibroids only (myomectomy) or to shrink the fibroids by reducing their blood supply.
What does the operation involve?
The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible. The operation usually takes about an hour.
Your gynaecologist may examine your vagina. They will make a cut on your abdomen, usually on your ‘bikini’ line or sometimes on your midline.
Your gynaecologist will remove your womb and fallopian tubes, usually along with your cervix, through the cut. To remove your cervix, they will also need to make a cut at the top of your vagina.
How soon will I recover?
You will be able to go home when your gynaecologist decides you are medically fit enough, which is usually after 3 to 5 days.
Rest for 2 weeks and continue to do the exercises that you were shown in hospital.
You can return to work once your doctor has said you are well enough to do so (usually after 6 to 8 weeks, depending on your type of work). You should be feeling more or less back to normal after 3 months.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.
Most women make a good recovery and return to normal activities.
What complications can happen?
Some of these can be serious and can even cause death.
General complications of any operation
- Pain
- Feeling or being sick
- Bleeding
- Unsightly scarring of your skin
- Developing a hernia in the scar
- Infection of the surgical site (wound)
- Blood clot in your leg
- Blood clot in your lung
Specific complications of this operation
- Pelvic infection or abscess
- Vaginal cuff dehiscence
- Developing an abnormal connection (fistula) between your bowel, bladder or ureters and your vagina
- Damage to structures close to your womb
- Developing a collection of blood (haematoma) inside your abdomen
Long-term problems
- Developing a prolapse
- Continued bleeding from your cervix
- Your pain may continue
- Difficulty or pain having sex
- Tissues can join together in an abnormal way
- Passing urine more often, having uncontrolled urges to pass urine or urine leaking from your bladder when you exercise, laugh, cough or sneeze
- Feelings of loss as a hysterectomy will make you infertile
- Going through menopause
