hysterectomy
What is Hysterectomy?
Hysterectomy is the surgical removal of the uterus, together with either the cervix or ovaries if required. It is one of the most commonly performed surgical operations in women.
The procedure may be advised for uterine problems such as abnormal bleeding that does not respond to medication, fibroids, endometriosis, uterine prolapse, or certain cancers involving the uterus, ovaries or cervix.
If you have been advised to undergo hysterectomy, discuss the benefits, possible risks and suitable alternative treatments with your gynaecologist.
Treatment is selected according to the patient's condition, health and surgical requirements.
Why is a Hysterectomy Performed?
Hysterectomy may be recommended when other treatments are ineffective or when surgery provides the most appropriate treatment for a gynaecological condition.
Uterine Fibroids
Uterine myoma or fibroids are non-cancerous tumours of the uterus that can cause pain, pressure or heavy bleeding.
Gynaecological Cancer
Surgery may be part of treatment for endometrial, cervical, ovarian or other gynaecological cancers.
Pelvic Organ Prolapse
A condition where the uterus, bladder or rectum may protrude into or outside the vagina.
Severe Endometriosis
Endometrial tissue growing outside the uterus can cause significant pelvic pain and heavy or painful periods.
Different Types of Hysterectomy
The term hysterectomy comes from “hyster”, meaning uterus. The exact organs removed depend on the condition being treated and the desired surgical outcome.
Supracervical Hysterectomy
Only the uterus is removed while the cervix is left intact. It may be considered for certain benign conditions such as abnormal bleeding or fibroids.
Total Hysterectomy
This involves removal of both the uterus and cervix and is one of the most commonly performed forms of hysterectomy.
Radical Hysterectomy
A more extensive operation involving removal of the uterus, cervix and surrounding tissues. Depending on the disease, additional structures may also need removal. It is generally performed for selected gynaecological cancers.
Surgical Techniques for Hysterectomy
Removal of the uterus may be performed through an abdominal incision, minimally invasive keyhole surgery or through the vaginal route.
Total Abdominal Hysterectomy (TAH)
The uterus is removed through an incision in the abdomen. This approach may be used when the uterus is very large, adhered to neighbouring organs, or when certain gynaecological cancers are suspected.
Total Laparoscopic Hysterectomy (TLH)
The uterus is removed using small abdominal incisions and laparoscopic instruments. This minimally invasive approach often allows earlier recovery and may be used for fibroids, abnormal bleeding and selected cancers.
Minimally Invasive ApproachLaparoscopic Assisted Vaginal Hysterectomy (LAVH)
Laparoscopic instruments are used to assist the surgeon, while the uterus is ultimately removed through the vagina.
Total Vaginal Hysterectomy (TVH)
The uterus is removed through the vagina without an abdominal incision. It is commonly used for uterine prolapse and may also be considered for fibroids, endometriosis or other benign conditions.
Non-Descent Vaginal Hysterectomy (NDVH)
This is a vaginal route hysterectomy performed even when uterine prolapse is not present, where the patient's anatomy and clinical condition make the approach suitable.
Possible Risks of Hysterectomy
Depending on the surgical approach and individual health, possible complications may include bleeding, infection or injury to nearby organs. Your surgeon will discuss individual risks before the procedure.
What Happens After a Hysterectomy?
Recovery instructions are personalised according to the type of surgery and the patient's overall health. Healing takes time, but gradual movement is generally encouraged.
- Basic daily activities and walking may gradually begin within the first few days as advised.
- Light stretching or gentle activity may be permitted depending on the surgical approach.
- Heavy lifting and strenuous exercise should be avoided until your doctor confirms that healing is complete.
- Return to work depends on recovery, the surgical method and the nature of your occupation.
How Long Does Recovery Take?
Light walking and simple daily activity may gradually begin after surgery according to medical advice.
Many patients experience considerably faster recovery compared with open abdominal surgery.
Complete recovery may take approximately six weeks, although individual recovery times can vary.
Age, weight, other medical conditions and any surgical complications can affect recovery time.
Have You Been Advised to Undergo a Hysterectomy?
Understand your diagnosis, available surgical approaches, expected recovery and possible alternative treatments with an experienced gynaecologist before deciding on surgery.
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