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Hysterectomy -- Open Surgery

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Click here to view an animated version of this procedure.

Definition

Hysterectomy is the surgical term for the removal of the uterus (womb). This results in the inability to become pregnant.

There are different types of surgeries, such as:

  • Supracervical hysterectomy—removal of the uterus only
  • Total hysterectomy—removal of the uterus and cervix (the opening of the uterus leading to the vagina)
  • Radical hysterectomy—removal of the uterus, ovaries, fallopian tubes, upper part of the vagina, and the pelvic lymph nodes
  • Salpingo-oophorectomy —removal of the ovaries and fallopian tubes (may be combined with any of the above procedures)

Reasons for Procedure

A hysterectomy may be done if the uterus is causing health problems that cannot be treated by other means. Some reasons a woman may have a hysterectomy are to:

  • Treat cancers, such as uterine , endometrial, and ovarian cancers
  • Remove uterine fibroids
  • Treat conditions, such as chronic pelvic pain or heavy bleeding

Explore your options before having a hysterectomy. There are other treatments for many of these problems.

Possible Complications

If you are planning to have hysterectomy, your doctor will review a list of possible complications, which may include:

Some factors that may increase the risk of complications include:

  • Obesity
  • Smoking
  • Heart or lung disease
  • Diabetes
  • Previous pelvic surgery or serious infection
  • Use of prescription and nonprescription drugs during the past month

Be sure to discuss the risks with your doctor before surgery.

What to Expect

Prior to Procedure

Your doctor may do the following:

  • Blood and urine tests
  • X-ray of abdomen and kidneys
  • Pelvic ultrasound —a test that uses sound waves to visualize organs in the abdomen
  • Dilation and curettage (D&C)—surgical removal of tissue from the lining of the uterus (to check for cancer)

You should do the following:

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
  • If instructed, take enemas to clean out your intestines.
  • Arrange for a ride home and for help at home.
  • Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.

Anesthesia

General anesthesia is usually used for this surgery. Anesthesia blocks pain and keeps you asleep through the surgery. It is given through an IV in your hand or arm.

Description of the Procedure

You may be given antibiotics just before surgery. There are two different methods that are described here.

Open Abdominal Hysterectomy

An incision will be made in the lower abdomen. This is done to expose the tissue and blood vessels that surround the uterus. The tissue will then be cut. The blood vessels will be tied off. The uterus will be removed. Next, the tissue will be sewn back together and the skin will be closed with stitches or staples. If the cervix is also removed, stitches will be put in the back of the vagina.

Abdominal Hysterectomy
IMAGE
The uterus is removed through the abdomen.
Copyright © Nucleus Medical Media, Inc.
Open Vaginal Hysterectomy

This method will not involve any outside incisions. The vagina will be stretched and kept open with special tools. Next, the uterus and cervix will be cut free. The connecting blood vessels will be tied off. The uterus and cervix will be removed through the vagina. Lastly, the top of the vagina will be closed with stitches.

Vaginal Hysterectomy
Vaginal Hysterectomy
The uterus is removed through the vagina.
Copyright © Nucleus Medical Media, Inc.

With each procedure, a vaginal packing (sterile gauze) is placed in the vagina. This will be removed after 1-2 days.

Immediately After Procedure

In the recovery room, you will have IV fluids and medications.

How Long Will It Take?

1-3 hours

Will It Hurt?

You will not have pain during the surgery because of the anesthesia. During your recovery time, you will be given pain medication.

Average Hospital Stay

  • Abdominal hysterectomy: 3-5 days
  • Vaginal hysterectomy: 1-2 days

Your doctor may choose to keep you longer if you have any complications.

Post-procedure Care

At the Hospital

While you are recovering at the hospital, you may receive the following care:

  • On the first night, you may be instructed to sit up in bed and to walk a short distance.
  • During the next morning, the IV will probably be removed if you are eating and drinking well.
  • You may need to wear special stockings or boots to help prevent blood clots.
  • To help you urinate, you may have a Foley catheter in your bladder.
At Home

During the first few days, you may have pain, bloating, vaginal bleeding, and vaginal discharge.

When you return home, do the following to help ensure a smooth recovery:

  • Follow your doctor's instructions.
  • During the first two weeks, rest and avoid lifting.
  • Ask your doctor when you can use tampons. Also ask about Kegel exercises .
  • Wait six weeks before resuming sexual activity.
  • If you still have a cervix, you will still need regular Pap smears .

Recovery from open abdominal hysterectomy usually takes 6-8 weeks.

Call Your Doctor

After you leave the hospital, call your doctor if any of the following occur:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, leakage, or any discharge from the incision site
  • Incision opens up
  • Nausea and/or vomiting that you cannot control with the medications you were given or that last longer than two days
  • Lightheadedness or fainting
  • Cough, shortness of breath, or chest pain
  • Heavy bleeding
  • Pain that you cannot control with the medications you have been given
  • Pain, burning, urgency or frequency of urination, or persistent blood in the urine
  • Swelling, redness, or pain in your leg

If you think you have an emergency, call for emergency medical services right away.

Revision Information

  • The American College of Obstetricians and Gynecologists

    http://www.acog.org

  • National Uterine Fibroids Foundation

    http://www.nuff.org

  • The Society of Obstetricians and Gynaecologists of Canada

    http://www.sogc.org

  • Women's Health Matters

    http://www.womenshealthmatters.ca

  • Hysterectomy. Women's Health—US Department of Health and Human Services website. Available at: http://www.womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.html. Updated July 16, 2012. Accessed October 30, 2014.

  • Hysterectomy. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/Patients/FAQs/Hysterectomy. Published August 2011. Accessed October 30, 2014.

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