A hysterectomy is a surgery performed to remove a woman’s uterus and cervix. A supracervical hysterectomy only removes the uterus. In all cases, menstruation stops and a woman loses the ability to bear children.
Extremely. According to the CDC, more than 500,000 women undergo a hysterectomy every year and one in three will have a hysterectomy by age 60. (1)
A hysterectomy removes a woman’s uterus and cervix only, and does not include removal of the ovaries. The removal of the ovaries and tubes is called an oopherectomy.
Because hormone production is sourced at the ovaries, menopause or “the change” does not occur after a hysterectomy is performed. This means that menopausal symptoms such as hot flashes, night sweats, mood swings, anxiety, depression, osteoporosis (bone loss), vaginal dryness, and sexual dysfunction will not usually occur with a hysterectomy.
About Your Body
Although many women (45%) still undergo invasive open abdominal hysterectomy in a hospital setting, new forms of laparoscopic hysterectomy are less invasive, leave little visible scarring, have a shorter recovery period, and allow the patient to go home the same day.
Today, approximately one-third of U.S. hospitals perform all hysterectomies through open surgery.
As with any other type of surgery, hysterectomy is associated with certain risks, but the potential for complications depends on the type of procedure. In women undergoing an open abdominal hysterectomy, risks include blood clots, infection, excessive bleeding, adverse reactions to anesthesia, and in some instances, damage to the ureter (which is the tube that transports urine from the kidney to the bladder), bladder, rectum or other pelvic structures during surgery. When this happens, additional corrective surgery is required.
Compared with abdominal hysterectomy, laparoscopic surgery has a lower risk of infection. However, when surgeries are performed by physicians that do not specialize in GYN surgery, there is the also potential to injure the surrounding vital structures, again, requiring corrective surgery. Other risks include excessive blood loss, surgical site infections, and the potential for the closure of the top of the vagina coming undone.
Because there are many types of hysterectomy, recovery times vary. It can take from one week to 6-8 weeks to recover depending on the procedure. This chart details the average recovery time for a variety of hysterectomy techniques.
The number and size of the incisions involved in the surgery determines the amount of scarring. This chart details the location, number and size of incisions by hysterectomy procedure.
Before undergoing surgery, you will likely have many questions for your doctor or OB-GYN. Below are some recommended questions to ask – and background information to help you weigh the answers. You can also download a printable version of these questions.
Sixty percent of all the hysterectomies performed in the U.S. are still open abdominal surgeries. This procedure can result in severe pain, higher complication rates, and a longer recovery period than new minimally invasive procedures. Other clinics use robotics, which require more incisions and more scarring. If your physician recommends these options, consider seeking a second opinion before agreeing to surgery.
When it comes to any form of surgery, training, skill and practice matter, which is why GYN surgeons who specialize in minimally invasive surgery are the most qualified. The reality is that OB-GYNs are highly skilled obstetric practitioners, but very few perform GYN surgeries often enough to be surgical specialists. This is borne out by studies, which find that GYN surgery is commonly a secondary component of what an OB-GYN does.
Robotic, open and conventional laparoscopic hysterectomies can lead to longer recovery times, increased blood loss and larger scars than newer procedures. Make sure your surgeon is trained in the latest minimally invasive techniques, such as The Center for Innovative GYN Care’s DualPortGYN, that prevent injury to the pelvic structures and minimize blood loss – resulting in reduced complication rates and improved recovery times compared to other types of hysterectomy.
While most OB-GYNs are highly trusted generalists, they spent most of their time focusing on obstetrics and basic GYN care and therefore, perform hysterectomy and other specialized GYN surgeries rarely. Be sure to choose a surgeon who has received comprehensive training and performs many minimally invasive hysterectomies each year.
This is an important question when considering a hysterectomy. The reason is because hidden uterine cancer called sarcoma can be spread through the abdomen and pelvis during surgery when the small motorized blades in these devices spin at high speed to cut the fibroids into small strips for removal. The Food and Drug Administration (FDA) now requires all surgeons to tell women in advance if the surgery involves a power morcellator and to get written consent before the surgery takes place. Today, new minimally invasive surgical options are available that do not involve power morcellation, such as DualPortGYN.
Although the American Medical Association and other leading medical societies have issued statements discouraging robotic techniques due to dramatically higher costs to patients without any medical advantages, robotics continue to be used in hysterectomy and other GYN surgeries. This is because robotic procedures “enable” an OB-GYN not well trained in laparoscopic GYN surgical techniques to complete a hysterectomy through a “minimally invasive” approach. This is why women need to ask if robotics will be used during a GYN surgery and to seek a specially trained surgeon able to perform the latest minimally invasive surgical techniques, such as DualPortGYN and retroperitoneal dissection that do not use robotics.
New minimally invasive techniques require, on average, only a week to recover. Other procedures such as open abdominal surgery can take up to 8 weeks.
Ask your physician if he or she is aware of new, minimally invasive procedures.