Hysterectomy

A hysterectomy is a surgery performed to remove a woman’s uterus. It is one of the most common surgeries for women in the United States.

Hysterectomies may be recommended to treat conditions that include:

• Uterine fibroids
• Endometriosis
• Uterine prolapse (sagging or fallen uterus) and other pelvic support issues 
• Abnormal uterine bleeding
• Chronic pelvic pain 
• Gynecologic cancer, such as uterine, ovarian, endometrial, and cervical cancer 
• Uterine (endometrial) polyps
• Severe menstrual cramps, when conservative therapies are ineffective

Following a hysterectomy, a woman will no longer have periods and will be unable to get pregnant. A hysterectomy is not recommended for women who wish to become pregnant in the future. Talk with your OB/GYN about your treatment options. 

Depending on the individual patient and their condition, a hysterectomy may involve removing:

• The uterus and the cervix (total hysterectomy)
• Only part of the uterus, leaving the cervix in place (partial or supracervical hysterectomy)
• The uterus, cervix, and other surrounding tissues (radical hysterectomy, typically used when cancer is present)

There are several different surgical methods used to perform a hysterectomy. Discuss your options with your OB/GYN to determine the safest, most conservative approach for your unique needs.

• Total vaginal hysterectomy. A vaginal hysterectomy is the least invasive hysterectomy procedure because it does not involve an abdominal incision. In this procedure, an incision is made inside the vagina and surgical instruments are inserted to remove the uterus and cervix through the vaginal opening. The fallopian tubes and ovaries can also be removed, if needed.
• Laparoscopically assisted vaginal hysterectomy (LAVH). In this vaginal approach, a small incision is made in the abdomen to insert a laparoscope, a thin, lighted telescope, enabling the surgeon to view the pelvic structures on a monitor and guide their removal through the vagina.
• Laparoscopic hysterectomy. In this minimally invasive approach, a laparoscope and small surgical instruments are inserted through three or four small incisions in the abdomen. Images from inside the patient are transmitted to high-definition monitors enabling the surgeon to view and remove the uterus. Laparoscopic hysterectomies can also be performed using the da Vinci robotic surgical system.
• Single-incision hysterectomy. Today, laparoscopic surgeons can remove the uterus in small pieces through a single medium-size incision in the belly button, leaving a barely visible scar.
• Abdominal hysterectomy. In this approach, the uterus is removed through a large (6 to 8 inch) incision in the lower abdomen. This open surgery typically requires a longer hospital stay and recovery time compared to vaginal and laparoscopic procedures.

Vaginal and laparoscopic hysterectomies offer numerous benefits compared to traditional open hysterectomies, including:

• Shorter hospital stays 
• Faster recovery and return to normal activities
• Less pain after surgery
• Minimal or no visible scarring
• Less blood loss
• Fewer complications
• Fewer infections and blood clots in the legs and lungs (venous thromboembolism)