Hysterectomy

Removal of the uterus

Parts of the Body Involved

  • Uterus (a partial or subtotal hysterectomy)
  • Uterus and cervix, which is the opening of the uterus leading to the vagina (a total, complete, or simple hysterectomy)
  • Uterus, ovaries, fallopian tubes, upper part of the vagina, and the pelvic lymph nodes (a radical hysterectomy)
  • Ovaries and fallopian tubes (a salpingo-oophorectomy; may be combined with any of the above procedures)

Reasons for Procedure

A hysterectomy is performed in almost all cases of uterine cancer that have not spread beyond the uterus (metastasized).

Although controversial, a hysterectomy may also be done to treat these conditions of the uterus when they do not respond to other methods of treatment:
  • Uterine fibroids (myomas) - non-cancerous growths in the uterus that, if they grow large enough, can cause pain and irregular or heavy bleeding.
  • Abnormal uterine bleeding - may be caused by fibroids, hormonal changes, infection, or cancer.
  • Endometriosis

Risk Factors for Complications during the Procedure

  • Obesity
  • Smoking
  • Iron-deficiency anemia
  • Heart or lung disease
  • Diabetes
  • Previous pelvic surgery or serious infection
  • Use of some prescription and nonprescription drugs; inform your doctor of any drugs, medications, or supplements you are using or have used in the last month

What to Expect

Prior to Procedure

Your doctor will likely do the following:
  • Blood and urine tests
  • X-ray of abdomen and kidneys
  • Pelvic ultrasound

Outcome

Physical

Removing the uterus ends abnormal bleeding, reduces pelvic pressure, and removes fibroids. Some other conditions, though, such as cancer, endometriosis, and pelvic adhesions may continue or return.

After a hysterectomy, you will no longer have monthly periods and you can no longer get pregnant; birth control is not necessary. If your ovaries have been left in place, though, you will still produce hormones and eggs, but they will dissolve in your abdomen.

If the ovaries are removed (oophorectomy), your body's main source of estrogen and other sex hormones is gone. If you were not already postmenopausal, this sends your body into an instant menopause and you will experience typical menopausal symptoms, such as hot flashes. Hormone replacement therapy is usually recommended.

Emotional

Some women have strong emotional reactions, including depression, in response to the loss of their uterus.

Sexual

Some women notice a change in their sexual response after a hysterectomy. Because the uterus has been removed, uterine contractions you may have felt during orgasm will no longer occur. If the ovaries have been removed, vaginal dryness may be a problem, but is usually relieved with the use of estrogen.

Some women report an increase in their sexual enjoyment, possibly because they are relieved of the pain from the condition that prompted this procedure, or no longer need to worry about an unintended pregnancy.

Call Your Doctor If Any of the Following Occurs

  • Signs of infection, including fever and chills
  • Persistent or heavy vaginal bleeding or discharge, or foul-smelling vaginal discharge
  • Calf pain
  • Severe pain
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision sites
  • Problem with urination or bowel movements
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine
  • Pain and/or swelling in your feet, calves or legs, sudden shortness of breath or chest pain