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Hysterectomy

A hysterectomy surgically removes a woman’s uterus, where a baby grows during a pregnancy. It is the second most common surgery among women in the United States.

A hysterectomy may be used to treat cervical, ovarian and uterine cancers. The procedure may involve removing the ovaries and fallopian tubes in a surgery called a salpingo-oophorectomy. If you have not yet reached menopause, a hysterectomy that removes the ovaries will cause your menstrual periods to stop. Ask your doctor about taking estrogen after the surgery to help lower your risk of heart disease and relieve menopausal symptoms.

A hysterectomy may also be used to treat other conditions, including:

  • Fibroids are non-cancerous, muscular tumors that grow in the wall of the uterus.
  • Endometriosis occurs when the tissue that lines the uterus grows outside the uterus and on other organs.
  • Prolapse of the uterus occurs when the uterus slips down from its usual place into the vagina.
  • Adenomyosis occurs when the tissue that lines the uterus grows inside the walls of the uterus.
  • Chronic pelvic pain may be treated with a hysterectomy, particularly if it is clear the pain comes from the uterus.
  • Abnormal vaginal bleeding may be caused by multiple factors, including changes in hormone levels, infection, cancer or fibroids.

In some cases, only part of the uterus is removed. The type of hysterectomy performed depends on your individual situation. There are three types of hysterectomies:

  • Partial hysterectomy: The upper part of the uterus is removed and the cervix is left intact. This type is also called subtotal or supracervical.
  • Total hysterectomy: The entire uterus and the cervix are removed.
  • Radical hysterectomy: The entire uterus, the tissue on both sides of the cervix and the upper part of the vagina are removed. This type of surgery is performed mainly to treat cancer.

Surgeons may choose from a number of techniques to perform a hysterectomy, including:

  • Abdominal surgery: The surgeon makes a 5- to 7-inch incision in the lower part of the belly. The incision, or cut, may be up and down or across the belly.
  • Vaginal surgery: To perform the procedure, the surgeon makes an incision in the vagina near the cervix, enabling the surgeon to access the uterus. The surgeon detaches the uterus from blood vessels and connective tissue, in addition to the ovaries, fallopian tubes and the upper vagina, and removes the uterus through the vagina. In many cases, the cervix is also removed during the surgery.
  • Laparoscopic surgery: The surgeon makes three or four small incisions in the belly and inserts surgical tools and a special camera called a laparoscope inside the body. The surgeon operates while watching the video from the laparoscope on high-resolution monitors in the operating room. The uterus is cut into small pieces and removed through the incisions.
  • Laparoscopically assisted vaginal surgery: The surgeon removes the uterus through the vagina without making an incision, using a laparoscope to guide the procedure.
  • Robotic-assisted surgery: Similar to a laparoscopic hysterectomy, the surgeon inserts a surgical tool and a laparoscope through small incisions in the belly. The surgeon uses specialized robotic technology to perform the surgery.

Following a hysterectomy, a woman will no longer have periods and cannot get pregnant. Having a hysterectomy may result in changes to your body and may affect how you feel about yourself. It’s important to discuss potential changes with your doctor or nurse, as well as trusted family members and friends, before the surgery.