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There are several different types of hysterectomy, and this guide walks you through each of them. It also provides insight into what you can expect before, during, and after the surgery, helping to ease any uncertainties along the way.

What is a hysterectomy?

Hysterectomy is a surgical procedure that involves removing the uterus and cervix, often accompanied by the removal of other structures like the fallopian tubes and the ovaries. The various types of hysterectomy include laparoscopic hysterectomy, vaginal hysterectomy, and open hysterectomy, each with its own method and recovery time.

Tens of thousands of women undergo hysterectomies annually across the UK, making this a relatively common procedure. It can dramatically improve a patient’s quality of life, easing or eliminating many symptoms affecting their reproductive system. However, it is a permanent and irreversible procedure, immediately ending a patient’s menstruation, as well as making it impossible for them to get pregnant.

What are the reasons for hysterectomy?

There are numerous reasons for a hysterectomy, including:

  • Fibroids: Fibroids are non-cancerous growths or tumours that form within or around the uterus, sometimes causing pain, abnormal bleeding, and pressure symptoms. They can significantly impair the quality of life. Hysterectomy is not the first-line treatment for fibroids, but it is the treatment of choice in severe cases.
  • Endometriosis: Endometriosis is a condition in which the lining of the womb-like tissue grows in other areas of the reproductive or other systems where it should not be. It can cause pelvic pain, heavy bleeding, bloating, subfertility and bowel or bladder dysfunction.
  • Cancer: Multiple forms of cancer may impact the female reproductive system, such as endometrial, ovarian or cervical cancer. Very often, a hysterectomy is part of the treatment.
  • Chronic Pain or Bleeding: Patients who suffer from recurring or heavy vaginal bleeding and/or pelvic pain may strongly benefit from a hysterectomy.
  • Prolapse: Uterine prolapse occurs when the uterus slips down into the vaginal canal due to weakened pelvic support. It may cause pelvic pressure, urinary or bowel issues, and discomfort.
  • Prevention: To prevent cancer or other serious health conditions from developing, particularly in high-risk individuals with a family history of such conditions.

Hysterectomy surgery overview

Before your hysterectomy, your doctor will explain what to expect and what is involved in the procedure, as well as detail any possible risks and side effects. You will be encouraged to ask questions about the procedure and recovery. Preoperative assessment includes a detailed assessment of your health, review of any medication you are on and routine blood tests.

On the day of the hysterectomy, you will be given either general or regional anaesthesia and an IV line to supply essential medicines and fluids.

 

The surgeon will then perform the operation—the exact specifics of this will depend on the type of hysterectomy procedure you have had.

The duration of a hysterectomy also varies depending on the type, size of the uterus, previous operations in that area, and severity of the pathology. Still, most surgeries are typically completed within one to three hours.

Some patients may be discharged from the hospital the same day, while others must remain under observation for 2-3 days. Hysterectomy recovery time varies depending on the patient’s health and the type of surgery.

What kinds of hysterectomy procedures exist?

As touched on earlier, there are several types of hysterectomy.

Total hysterectomy

This removes the uterus and cervix but leaves the ovaries in place. It is a common type of hysterectomy and does not immediately induce menopause.

Supracervical hysterectomy

This removes the uterus, without taking out the cervix. It is also sometimes referred to as a subtotal hysterectomy.

Total hysterectomy with bilateral salpingo-oophorectomy

One of the most comprehensive forms of hysterectomy, this removes not only the uterus but also the cervix, ovaries, and fallopian tubes.

Radical hysterectomy with bilateral salpingo-oophorectomy

This removes the uterus, cervix, fallopian tubes, ovaries, and the upper part of the vagina. Additionally, some sections of tissue and lymph nodes are also taken out. This is often employed to treat or prevent cancer.

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How can it be performed?

Various surgical methods are employed for a hysterectomy, including:

  • Abdominal: This involves an incision in the abdomen to provide access to remove the womb. It is stitched up at the end. This is one of the best methods for removing enlarged wombs, but it typically results in a longer recovery period than other methods.
  • Vaginal: Incision is made at the top of the vagina, providing access to the womb and cervix. The incision is closed with dissolvable stitches that will dissolve over time. This method is less invasive than the abdominal approach and has a shorter recovery time.
  • Laparoscopic: Also known as keyhole surgery, this procedure utilises a specialised device called a laparoscope, a miniature tube equipped with a video camera at its end. It is inserted into a small incision in the abdomen along with small instruments to remove organs and tissue. This procedure has the fastest recovery time, and patients usually go home the next day.
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Hysterectomy recovery

Some patients are discharged from the hospital on the day of their procedure, while others may need to stay for up to four nights. Even if you are discharged the same day, recovery from a hysterectomy is a relatively lengthy process that can take up to six weeks.

During that time, you may experience pain, discomfort, and fatigue, among other symptoms. Your healthcare providers will advise you on how to care for your wounds and manage your symptoms.
They may also advise you on exercises and lifestyle adjustments during your recovery, such as getting plenty of rest and avoiding heavy lifting.

When can I get back to my normal activities?

Every patient’s hysterectomy recovery journey is different, and it is important to listen to your body and avoid doing too much before you are ready.

You can resume daily activities like driving within two to six weeks and return to work within approximately four to eight weeks. You can engage in light exercise, such as walking, early after your procedure, but avoid more rigorous activities until fully healed. Sexual activity should also be avoided for the first four to six weeks.

Our doctors will advise on the best times to schedule follow-up appointments and are available for advice or review at any stage during the recovery period.

What are the side effects and complications of the surgery?

Possible side effects include:

  • Changes to bowel and bladder functions, such as constipation
  • Vaginal bleeding and discharge
  • Menopause symptoms, like hot flushes
  • Emotional effects, which could include depression and anxiety

There are also some risks of complications during surgery, like bleeding, infection, or damage to nearby organs. However, these risks are minimal when working with well-trained and highly experienced surgeons.

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