Hysterectomy is the second most common surgery for women in their reproductive years, right after cesarean section.
Nearly 68 percent of these surgeries are done to address non-cancerous conditions such as abnormal uterine bleeding, uterine fibroids and endometriosis, according to Michigan Medicine. The U.S. Centers for Disease Control and Prevention says 1 in 3 women have a hysterectomy by age 60. What's more, Black women are twice as likely to have their uterus removed as white women.
Here is what a hysterectomy entails, the different types of hysterectomy, the advantages and disadvantages of each, potential side effects and the recovery process.
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What is a hysterectomy?
A hysterectomy involves the surgical removal of the uterus and, in most cases, the cervix, according to the Cleveland Clinic.
"In some cases, the hysterectomy is done with the simultaneous removal of other female reproductive organs," Dr. Juan Jose Diaz Quinones, an obstetrician-gynecologist at the University of Miami Health System, said in a university release.
The fallopian tubes and ovaries may also be removed, depending on the circumstances. After a hysterectomy, a woman no longer gets a monthly period and pregnancy is not possible.
Types of hysterectomy
There are three types of hysterectomy:
- "Partial hysterectomy" refers to the removal of the uterus while preserving the ovaries.
- "Total hysterectomy" involves the removal of both the uterus and cervix.
- A "radical hysterectomy" entails the removal of the uterus, cervix, and a portion of the vagina.
Although there are other treatment options, radical hysterectomy is the most common treatment for early-stage cervical cancer, and cure rates are around 80 percent, according to the U.S. National Cancer Institute.
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Some patients may be able to have a laparoscopic hysterectomy, a minimally invasive surgical procedure that involves the removal of the uterus through small incisions in the abdomen, according to Mount Sinai Health in New York City. This technique utilizes specialized instruments and a laparoscope, resulting in potentially shorter hospital stays and faster recovery times.
Another approach is the vaginal hysterectomy, a surgical procedure in which the uterus is removed through the vagina without making any external incisions. The surgeon accesses and detaches the uterus through the vaginal opening and then removes it.
Vaginal hysterectomy offers advantages such as shorter hospital stay, lower expenses and quicker recovery compared to abdominal hysterectomy, which involves an incision in the lower abdomen, according to the Mayo Clinic. The feasibility of a vaginal hysterectomy depends on factors such as the size and shape of the uterus and the specific reason for the surgery.
Pros and cons of hysterectomy
Each year U.S. doctors perform about 600,000 hysterectomies. Despite the frequency of these surgeries, the Cleveland Clinic points to some pros and cons.
Pros
- Provides relief from constant pelvic pain and irregular bleeding
- Can reduce your risk for cancer
Cons
- Hysterectomy is permanent and ends childbearing
- Depending on the type of surgery and her age, a woman may go into premature menopause or experience symptoms such as hot flashes and vaginal dryness
- Requires one to three days in the hospital and four to six weeks to recover.
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Hysterectomy side effects
Hysterectomy brings about significant changes for women who have not yet reached menopause. Monthly periods cease, and the possibility of pregnancy is eliminated. Removing ovaries can lead to a drop in estrogen levels, potentially causing early menopause symptoms.
Dr. Susan Maayah, an ob-gyn with the Sutter Health system in Northern California, points to another potential side effect.
"It is quite common after having a complete hysterectomy and removal of the ovaries for women to feel a loss of libido," she noted in a Sutter Health release. "The ovaries produce hormones such as estrogens, progesterones, and androgens, which are partially responsible for sexual desire in females."
As with any surgery, hysterectomy has risks. Short-term risks are typically mild and minimal, according to Stanford Medicine, and primarily occur within the first 30 days after surgery. These risks include:
- Blood loss and the potential need for a blood transfusion
- Possible damage to nearby structures, such as the bladder, urethra, blood vessels and nerves
- Risk of blood clots forming in the legs or lungs
- Potential for infection
- Side effects related to anesthesia.
In addition, women with a history of multiple abdominal surgeries or previous pelvic prolapse or relaxation may be at a higher risk of developing pelvic prolapse again.
Hysterectomy recovery
Hysterectomy recovery involves a period of healing and adjustment. According to the Cleveland Clinic, the recovery process can vary depending on the surgical approach and individual factors. Generally, patients can expect to spend a few days in the hospital. During the initial recovery phase, it is normal to experience some discomfort, fatigue and vaginal bleeding.
Pain medication and rest are typically prescribed to manage these symptoms. Patients who have just undergone a hysterectomy should avoid strenuous activities and heavy lifting during recovery, which may last several weeks. Gradually, patients can resume light activities and increase their physical exertion. Follow-up appointments with the health care provider are crucial to monitor progress and address concerns.
Know that each person's recovery experience may differ, so consult your healthcare provider for personalized guidance and support throughout the healing journey.
Self-care tips for your hysterectomy recovery
While following your physician's recommendations is critical in ensuring your hysterectomy recovery goes as smoothly as possible, there are some self-care tips you can explore. Consider these hysterectomy recovery recommendations from the Dana-Farber Cancer Institute:
- Follow your healthcare provider's postoperative instructions
- Take prescribed pain medications as directed to manage discomfort
- Gradually increase your activity level and engage in light exercises as approved by your doctor
- Prioritize rest and ensure you get enough sleep to support the healing process
- Maintain a nutritious diet to promote healing and support overall well-being
- Keep your incision site clean and dry
- Avoid heavy lifting or strenuous activities during the initial recovery phase
- Contact your support network for assistance with daily tasks and emotional support
- Attend follow-up appointments and communicate any concerns or questions with your healthcare provider
- Take time for self-care activities that promote relaxation and stress relief, such as gentle stretching, deep breathing exercises or meditation.
Weigh the pros and cons before your hysterectomy procedure
A hysterectomy is a surgical procedure performed on women for various conditions. It offers the potential for symptom relief and improved quality of life. If you are considering a hysterectomy, carefully weigh the pros and cons, understand the potential side effects, and be aware of the recovery process. Receiving personalized guidance from a healthcare professional is essential.
