A hysterectomy is the surgical removal of the uterus, the major female reproductive organ that's also known as the womb. A patient that has experienced a hysterectomy - which is a non-reversible procedure -- can no longer bear children nor menstruate.
A hysterectomy is the second-most common female surgery in the United States, with more than 500,000 procedures recorded each year.
The most common type is a total hysterectomy (which includes removing the uterus and cervix). Other procedures include partial (removing the upper part of the uterus but leaving the cervix in place) and radical (removing the uterus, cervix, the upper part of the vagina and supporting tissues). In addition, one or both ovaries and fallopian tubes are often removed during hysterectomies.
The procedure is recommended for a variety of conditions, including cancer (uterine, cervical or ovarian), endometriosis (when the tissue lining inside the uterus grows outside the organ on the ovaries, fallopian tubes or other pelvic organs), uterine prolapsed (when the uterus moves down into the vagina), persistent vaginal bleeding, constant pelvic pain and fibroids (tumors that grow on the uterine wall).
With the exception of cancer, other treatments may substitute for a hysterectomy, and women should have a discussion with their doctors to determine if a non-surgical strategy is appropriate. Before any type of hysterectomy is undertaken, patients should have a complete pelvic exam, Pap smear, a complete blood count, and a pregnancy test.
For many years, hysterectomies were performed by making incisions through the abdomen, but a laparoscopic procedure performed through the vagina has become increasingly preferred as it requires less recovery time. Unless the uterus is unusually large, the procedure - whether done through the abdomen or vagina - generally takes about two hours.
After surgery, patients often remain in the hospital for at least a day or two. Total recovery from an abdominal hysterectomy can take from four to eight weeks while recovery from a vaginal hysterectomy commonly takes one or two weeks.
After a hysterectomy, a patient may experience diminished sexual desire (which may be an instance of the loss of some hormones) with ovary removal. Emotional sensitivity is not uncommon for the first few weeks after the procedure but could be problematic if depression or other strong emotions occur. In these instances, patients should consult their doctors.
As is the case with most surgical procedures, the possibilities for major and minor risks are in play, although risks for this particular surgery are among the lowest of any major operation.
Potential complications include significant blood loss, blood clots, bladder or bowel injuries, wound infection, pelvic pain and the early onset of menopause.