A hysterectomy is a surgical procedure to remove the uterus. Your gynaecologist may perform this via an open surgery or minimally-invasive surgery.
Your gynaecologist may advise that you undergo this surgery if you have:
- Uterine fibroids that cause pain, heavy menstrual bleeding, or other problems
- Uterine prolapse
- Cancer of the uterus, cervix or ovaries
- Endometriosis
- Abnormal vaginal bleeding
- Chronic pelvic pain.
What are the types of hysterectomy?
During a hysterectomy, your gynaecologist may do a partial or total removal of the uterus. The types of hysterectomy are as follow:
Supracervical or subtotal hysterectomy
Only the upper part of the uterus is removed, keeping the cervix in place.
Total hysterectomy
The whole uterus and cervix is removed.
Radical hysterectomy
Radical hysterectomy is generally done when cancer is present. During this procedure, the entire uterus, tissues on the sides of the uterus, the cervix and the top part of the vagina is removed.
How is an open surgery hysterectomy done?
The most common approach to hysterectomy is an abdominal hysterectomy (open hysterectomy). During this procedure, your gynaecologist will make a five to seven inch incision across the belly to remove the uterus.
After the abdominal hysterectomy, you will be required to spend two to three days in the hospital. The abdominal incision will gradually heal, but a visible scar on your abdomen will remain.
How is minimally-invasive hysterectomy done?
Minimally invasive hysterectomy, also known as a laparoscopic hysterectomy, is performed using a laparoscope. A tube with a lit camera and surgical tools will be inserted through small incisions made across the belly. Your gynaecologist will view the operation on a video screen while he or she performs the hysterectomy. The uterus is then removed through the vagina.
Minimally invasive hysterectomy allows patients to recover faster, with less pain and scarring. There is also a lower chance of infection compared to abdominal hysterectomy (open hysterectomy). The hospital stay is also shorter.
Patients who have undergone a minimally invasive hysterectomy are generally able to resume normal activities within three to four weeks, compared to abdominal hysterectomy that requires up to four to six weeks.
To determine the best treatment method for your condition, discuss with your gynaecologist to assess the treatment options that can provide you with the best clinical outcome.
What can I expect after a hysterectomy?
If your ovaries were removed, you may experience symptoms of menopause such as hot flashes and mood swings, as your body adjusts to the changes in hormone levels. You may want to consider hormone replacement therapy (HRT) to ease your symptoms.
Reviewed by Dr Karolyn Goh, Specialist in Obstetrics and Gynaecology, and Consultant of Raffles Women’s Centre.
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