A hysterectomy is an operation to remove the uterus (womb). There are many reasons for having a hysterectomy including endometriosis, severe pelvic pain, heavy and/or continuous bleeding or cancer.
Except when there is cancer or uncontrollable bleeding, making the decision to have a hysterectomy can be difficult. Here is some information on what is involved in having a hysterectomy and questions you can ask yourself and your doctor if you are faced with this decision.
What is a hysterectomy?
Why a hysterectomy might be performed
Ways to perform a hysterectomy
Risks & complications
Outcomes of hysterectomy
Should you have a hysterectomy?
A hysterectomy is an operation to remove the uterus (womb). The various types of operation are:
There are different ways to perform a hysterectomy, and they can be done under spinal or general anaesthesia.
| Abdominal | The surgery is performed via an incision in the abdomen |
| Vaginal | The surgery is performed via the vagina |
| Laparoscopic | The surgery is keyhole surgery. This is an examination using a thin telescope, performed under general anaesthesia. Through small cuts in the abdomen, the doctor is able to look at or operate on the pelvic organs, such as the uterus, ovaries and fallopian tubes. |
The most appropriate method of hysterectomy depends on:
The risk of complications is low for women having a hysterectomy.
Compared to abdominal hysterectomy, vaginal and laparoscopic hysterectomies have:
In general, potential risks with any surgery include:
With pelvic surgery such as hysterectomy, there is a risk of damage to other pelvic organs such as bowel, bladder, ureter (the tube carrying urine from the kidneys to the bladder), nerves and blood vessels.
With laparoscopy, there is a risk of gas embolism (a bubble of the laparoscopic gas entering the circulation and blocking major blood vessels, with effects similar to a clot).
Studies have reported hysterectomy is associated with a small but significant increased risk of cardiovascular disease (including heart disease and stroke), regardless of whether the ovaries are retained.
Studies have shown that for many women, hysterectomy relieves symptoms, mood and quality of life. These positive outcomes do not depend on a particular surgical method. Often women say, “I wish I had done this years ago”.
Average time to full recovery after vaginal or laparoscopic hysterectomy can be three to four weeks, and five to six weeks after abdominal hysterectomy, but individual factors need to be taken into consideration.
A small number of women take longer to recover. This may be for many reasons including:
For more information on recovery after hysterectomy go here.
Unless there is an urgency to your situation, such as cancer or uncontrollable life-threatening bleeding, it is appropriate to take time making the decision. That decision is ideally made jointly by you and your doctor based upon severity of symptoms, childbearing plans, response to medical treatment, alternative options, and finally being sure that the risks of the procedure are outweighed by the expected benefits.
You should feel comfortable asking questions so that you make a fully informed choice.
It is also important to think about how you may feel about losing your uterus and whether you need support coping with those feelings.
It may help you to have a list of questions to be answered by your specialist. Taking questions with you, and being able to write down answers, will be helpful for both you and your doctor.
You may like to consider the following questions when thinking about whether or not to have a hysterectomy:
If your doctor has recommended hysterectomy, and you are still unsure, it is a good idea to have a further discussion with your specialist. Alternatively, you could seek a second opinion.
