Hysterectomy

A hysterectomy can be the chosen procedure for any problem that causes significant pain or symptoms to a woman’s reproductive system, affecting their quality of life. Examples here include heavy periods (caused by fibroids or adenomyosis), endometriosis (when tissue from the womb starts growing in other places), ovarian cancer, cervical cancer, and uterine cancer. With cancer, a hysterectomy may be the only reasonable treatment option but for other causes, a hysterectomy may be the last consideration and will only be undertaken if other less invasive treatments have been tried.

There are 4 types of hysterectomy.

• Total hysterectomy is where the womb and cervix (neck of the womb) are removed.
• Subtotal hysterectomy is where the womb is removed but the cervix (neck of the womb) is left in place.
• Total hysterectomy with bilateral salpingo-oophorectomy is where the womb, cervix, fallopian tubes, and ovaries are removed.
• Radical hysterectomy is where the womb and surrounding tissues are removed, including the cervix, fallopian tubes, ovaries, part of the vagina, lymph glands, and fatty tissue.

Hysterectomies can be performed laparoscopically (also known as keyhole surgery, where the organs are removed through small cuts in the abdomen. It can be performed via a cut at the top of the vagina or through a cut in the lower tummy.

There is a small risk of bleeding, infection, and damage to surrounding organs when undergoing a hysterectomy. Your surgeon will discuss this with you in detail before you undergo any surgery.

After a hysterectomy you will be given painkillers for any discomfort but can usually eat and drink within a few hours. You are likely to have a catheter going into your bladder to drain urine for a day or two. (Some women may also have a drain coming out of their tummy (abdomen) close to the wound.) There may be some light bleeding from the vagina afterwards too, which can last for a month or so. If you have any stitches which need taking out this usually occurs five and seven days after the operation.

Without your female reproductive organs you will not be able to have children. This is something that some women may need counselling about, especially if they have not had children before and so it is important to consider all your options thoroughly.

If your ovaries are removed during a hysterectomy, you will go through a menopause immediately after the operation. If your ovaries are left behind, you will probably go through menopause within 5 years of the operation. When this occurs you will be offered hormone replacement therapy (HRT to replace the hormones affected by the operation.