Hysterectomy is the surgical removal of the uterus. In consultation with her gynaecologist, a woman may consider having a hysterectomy for a number of reasons.
The operation is performed only when other treatments are unsuitable or have been tried without success. After the uterus is removed:
- No more periods occur
- Pregnancy is not possible
- Pain or tension previously associated with periods may be reduced
- The “change of life” or climacteric (commonly called menopause) may start a year or so earlier than expected.
Reasons For Hysterectomy
Sometimes a hysterectomy is important in the treatment of cancer and can be a life-saving procedure. Common reasons for a hysterectomy include:
- Uterine fibroids
- Unexplained heavy or irregular menstrual bleeding
- Prolapse of the uterus- this is a condition where the uterus and cervix protrude into the vagina
- Endometriosis (and adenomyosis)- Endometriosis is a condition where the cells that line the inside of the uterus grow outside the uterus and within the abdomen or pelvis
- Chronic and intense uterine pain not relieved by other treatments
- Pelvic inflammatory disease (PID )- this is a chronic infection in the reproductive organs that often causes permanent scarring and chronic pain
- Cancer of the endometrium (uterine lining) or uterus
- Cancer of the cervix (neck of the uterus)
- Cancer of one or both ovaries - a hysterectomy may be required when surgery for ovarian cancer is performed.
- Chronic, disabling pain.
Surgical Removal of the Uterus
An incision about 10 to 20 centimetres long is made in the lower abdomen. This may be a horizontal cut quite low on the abdomen (“bikini line”) or vertical cut from the naval to the pelvic bone.
The operation is performed through the vagina. In most cases a hysterectomy can be performed vaginally.
A hysterectomy can be performed using a laparoscope, a thin telescope-like tube with miniature video equipment that allows the gynaecologist to see the uterus and other organs. The laparoscope and other surgical instruments are inserted through several small incisions in the abdomen and manipulated by the gynaecologist.
Recovery After Hysterectomy
Recovery times after a hysterectomy will depend on factors such as your age, general health, and the type of operation you have had.
- Abdominal hysterectomy - generally requires three to five days, and full recovery may take four to six weeks.
- Vaginal hysterectomy - may have a shorter stay in hospital and recover more quickly.
- Laparoscopic hysterectomy - may result in a shorter stay in hospital (from one to four days) and sometimes a faster recovery at home. Pain or discomfort may occur in the abdomen and pelvis, which may require a pain killer.