Hysterectomy

What Is a Hysterectomy?

A hysterectomy involves surgical removal of the uterus, and may include the cervix, fallopian tubes, or ovaries depending on the condition.

Three main approaches exist:

• Vaginal: No external incisions
• Laparoscopic/Robotic: Small abdominal incisions
• Abdominal/Open: Larger 4-6 inch incision

Minimally invasive techniques are now standard, with surgery typically lasting 1-3 hours.

Why It's Done

The procedure addresses non-cancerous gynecological issues including:

• Uterine fibroids causing pain or heavy bleeding
• Abnormal uterine bleeding unresponsive to medication
• Endometriosis or adenomyosis with chronic pelvic pain
• Pelvic organ prolapse
• Chronic pelvic infections or benign ovarian tumors
• Occasionally for early uterine or cervical cancer

Conservative treatments are attempted first; hysterectomy is considered when these fail.

Risks & Complications

Overall complication rates range from 3-15% depending on surgical approach and patient health.

Common risks include:

• Bleeding requiring transfusion: 1-2%
• Infection: 2-5% (lower with minimally invasive methods)
• Urinary tract injury: 0.2-1%
• Blood clots/VTE: 0.2-0.5%
• Conversion to open surgery: 1-3%
• Mortality: less than 0.1% in benign cases

Recovery Timeline

• Hospital stay: 1-3 days depending on approach
• Light activities: Several days
• Return to desk work: 2-3 weeks (minimally invasive) or 6-8 weeks (open)
• Lifting restrictions: 10 lbs limit
• Abstinence from intercourse: 6 weeks
• Full recovery: 6-8 weeks typically

Surgeon Specialists

OB-GYNs typically perform this procedure, with complex cases handled by minimally invasive gynecologic surgeons or urogynecologists.