An abdominal hysterectomy is a surgical procedure that removes your uterus (womb) through an incision in your lower abdomen. A partial hysterectomy removes just the uterus, leaving the cervix intact. A total hysterectomy removes the uterus and the cervix.
A hysterectomy can also be performed through an incision in the vagina (vaginal hysterectomy) or by a laparoscopic or robotic surgical approach — which uses long, thin instruments passed through small abdominal incisions.
An abdominal hysterectomy may be recommended over other types of hysterectomy if:
You have a large uterus.
Your doctor wants to check other pelvic organs for signs of disease.
Your surgeon feels it’s in your best interest to have an abdominal hysterectomy.
Why hysterectomy?
You may need a hysterectomy to treat:
Gynecologic cancer. A hysterectomy may be the best treatment option for cancers of the uterus or cervix. Depending on the specific cancer and how advanced it is, other options might include radiation or chemotherapy.
Fibroids. A hysterectomy is the only certain, permanent solution for fibroids. Nonsurgical treatments of fibroids are a possibility, depending on your discomfort level and tumor size. Many women with fibroids have minimal symptoms and require no treatment.
Endometriosis. When medication or conservative surgery doesn’t improve endometriosis, a hysterectomy along with removal of your ovaries and fallopian tubes (bilateral salpingo-oophorectomy) might be needed.
Uterine prolapse. Descent of the uterus into the vagina can happen when supporting ligaments and tissues weaken. Uterine prolapse can lead to urinary incontinence, pelvic pressure or difficulty with bowel movements. A hysterectomy may be necessary to treat these conditions.
Abnormal vaginal bleeding. If your periods are heavy, irregular or prolonged each cycle, a hysterectomy may bring relief when the bleeding can’t be controlled by other methods.
A hysterectomy ends your ability to become pregnant. If you think you might want to become pregnant, ask your doctor about alternatives to this surgery. In the case of cancer, a hysterectomy might be the only option. But for other conditions — including fibroids, endometriosis and uterine prolapse — you may be able to try less invasive treatments first.
RISKS
A hysterectomy is generally very safe, but with any major surgery comes the risk of complications.
Risks associated with an abdominal hysterectomy include:
Blood clots
Infection
Excessive bleeding
Adverse reaction to anesthesia
Damage to your urinary tract, bladder, rectum or other pelvic structures during surgery, which may require further surgical repair
Earlier onset of menopause even if the ovaries aren’t removed
Rarely, death
It takes time to get back to your usual self after an abdominal hysterectomy — about six weeks for most women. During that time:
Get plenty of rest.
Don’t lift anything heavy for a full six weeks after the operation.
Stay active after your surgery, but avoid strenuous physical activity for the first six weeks.
Wait six weeks to resume sexual activity.
Follow your doctor’s recommendations about returning to your other normal activities.
LIFE AFTER A HYSTERECTOMY
A hysterectomy permanently changes some aspects of your life. For instance:
You’ll no longer have menstrual periods.
Most of the time, you’ll get relief from the symptoms that made your surgery necessary.
You won’t be able to become pregnant.
If you’re premenopausal, having your ovaries removed along with a hysterectomy starts menopause.
If you have a hysterectomy before menopause and you keep your ovaries, you may experience menopause at a younger than average age.
If you have a partial hysterectomy, your cervix remains in place, so you’re still at risk of cervical cancer. You need regular Pap tests to screen for cervical cancer.
Other parts of your life will likely return to normal or perhaps improve once you’ve recovered from your hysterectomy. For example:
If you had a good sex life before a hysterectomy, chances are you’ll maintain it afterward. Some women even experience more sexual pleasure after a hysterectomy. This may be due to relief from the chronic pain or heavy bleeding that was caused by a uterine problem.
The relief of symptoms may greatly enhance your quality of life. You may have an improved sense of well-being and a chance to get on with your life.
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