Hysterectomy

A hysterectomy is surgery to remove the uterus. Other organs such as the cervix, ovaries, fallopian tubes, lymph nodes and parts of the vagina may also be removed at the same time.

A hysterectomy may be done:

• to treat cancers of the female reproductive organs
• to treat precancerous conditions of the cervix that have not gone away after other types of treatment
• to find out how far a cancer has spread
• to treat non-cancerous conditions of the female reproductive organs that have not responded well to other types of treatment

There are different types of hysterectomies. The type recommended to you as part of your cancer treatment depends on the type and size of the tumour, the stage of the cancer, your age, other treatments you’ve had and your overall health.

A total hysterectomy removes the uterus and the cervix.

A supracervical hysterectomy removes the uterus but leaves the cervix in place. A supracervical hysterectomy is also called a subtotal or partial hysterectomy.

A radical hysterectomy removes the uterus, cervix, the uppermost part of the vagina next to the cervix and the surrounding ligaments that support the uterus. The ovaries, fallopian tubes and nearby lymph nodes may also be removed.

Sometimes one or both of the ovaries and fallopian tubes are removed during a hysterectomy. The removal of the ovaries and fallopian tubes is called a salpingo-oophorectomy. If one ovary and one fallopian tube are removed, it’s called a unilateral salpingo-oophorectomy. If both ovaries and both fallopian tubes are removed, it’s called a bilateral salpingo-oophorectomy.

A salpingo-oophorectomy is used to treat ovarian and fallopian tube cancer. It’s also used to find out the stage of uterine cancer.

A hysterectomy is most often done in the hospital using a general anesthetic (you will be asleep) or a spinal or epidural anesthetic (you will be awake but not able to feel the surgery). There are different ways a hysterectomy can be done. The following are the most common procedures.

An abdominal hysterectomy is done through an incision (cut) in the lower belly. The surgeon removes the uterus through the incision.

A laparoscopic hysterectomy is done using a laparoscope, which is a thin, tube-like instrument with a light and lens. It allows the surgeon to see the organs to be removed. The surgeon passes the laparoscope and surgical tools through small incisions in the belly. The uterus is removed through one of the small incisions or through the vagina. In some cases, a laparoscopic hysterectomy is done robotically. In a robotic surgery, the surgeon sits at a station a short distance away from the operating table and uses a computer to move robotic arms that are connected to the surgical instruments.

A vaginal hysterectomy is done through small incisions in the upper part of the vagina. The uterus is removed through the vagina.

You may go home the same day after a hysterectomy or stay in the hospital for a few days. It usually takes less time to recover from a vaginal or laparoscopic hysterectomy than it does to recover from an abdominal hysterectomy.

It’s important to get plenty of rest for the first 2 to 4 weeks after a hysterectomy and to avoid any heavy lifting. Check with your doctor about when it’s safe for you to increase your level of activity.

Side effects can occur with any type of treatment, but not everyone has them or experiences them in the same way. Side effects of surgery will depend mainly on the type of hysterectomy you have and your overall health.

Short-term side effects can happen during, immediately after or a few weeks after a hysterectomy. They are usually temporary. Short-term side effects of a hysterectomy include:

• pain
• bleeding
• infection
• pneumonia
• bladder problems
• constipation
• blood clots in the legs or in the lungs

Long-term side effects can develop months or years after having a hysterectomy and can last a long time. If you have a hysterectomy, you will not be able to become pregnant. You may also experience:

• a buildup of lymph fluid in the legs or abdomen if lymph nodes in the pelvis are removed (called lymphedema)
• weakness of the muscles and ligaments that support the vagina, bladder and rectum
• vaginal shortening (after a radical hysterectomy)
• blockage of the intestine caused by bands of scar tissue (adhesions)
• treatment-induced menopause if you are premenopausal and your ovaries have been removed

Find out more about sexuality and cancer, sexual problems for women and treatment-induced menopause.