What is a hysterectomy?
In a hysterectomy (from the ancient Greek hystera meaning uterus and ektome meaning to cut out), the uterus is removed either completely (total extirpation) or only partially (subtotal extirpation). The cervix remains intact. If the ovaries are also removed, this is referred to as hysterectomy with adnexa.
Hysterectomy is one of the most common procedures in gynecology. There are different types of hysterectomy depending on the method used. Your doctor will decide which method of hysterectomy to use depending on the disease, how large and mobile the uterus is, whether there are concomitant diseases and, of course, your own wishes.
Abdominal hysterectomy
Abdominal hysterectomy is mainly used when the uterus is very large. The uterus is removed via an abdominal incision.
Vaginal hysterectomy
A vaginal hysterectomy uses the vagina to remove the uterus. This shortens both the operation time and the recovery period after removal of the uterus.
Laparoscopic hysterectomy
The removal of the uterus irrevocably ends the ability to bear children, and menstrual bleeding no longer occurs after total extirpation. Only in the case of subtotal extirpation can slight cyclical bleeding still occur.
When is a hysterectomy performed?
A hysterectomy is usually only necessary for benign diseases:
- Benign tumors such as fibroids (muscle tumors)
- Uterus myomatosus (enlargement of the uterus due to multiple fibroids)
- Menstrual irregularities
- Endometriosis (uterine lining that occurs outside the uterine cavity and can cause pain)
- Uterine prolapse (prolapse of the uterus)
However, malignant diseases or emergency operations are very rare:
- cancer of the cervix, uterus or ovaries
- serious injuries or inflammations
- Unstoppable bleeding after birth
What is done during a hysterectomy?
First of all, your doctor will give you a detailed personal consultation and explain the possible risks and surgical alternatives. In addition, contraindications such as an existing desire to have children or infections are ruled out and a blood test is carried out.
In preparation for the operation, the anesthetist will inform you about the planned anesthesia and its risks. You must come to the operation fasting. This means that you must not eat or drink for several hours before the hysterectomy. The bladder is emptied with the help of a bladder catheter, which is removed immediately after the hysterectomy or a few days later.
Abdominal hysterectomy
As the surgeon removes the uterus via an abdominal incision, abdominal hysterectomy usually requires a general anesthetic. If malignant diseases are detected, the operation can be extended and additional tissue removed. Abdominal hysterectomy is also used if the uterus is very large or overgrown.
Vaginal hysterectomy
Vaginal hysterectomy can be performed under general or local anesthesia. It is the procedure of choice for benign diseases. The surgeon removes the uterus through the vagina using special instruments so that there are no visible scars. If the vagina is too narrow or the uterus is too large, the surgeon can also remove the uterus in several parts (morcellation).
Laparoscopic hysterectomy
If the uterus is removed via the vagina, this is referred to as a laparoscopically assisted hysterectomy. If parts of the uterus are removed via the abdominal incisions, the procedure is called laparoscopically assisted supracervical hysterectomy.
What are the risks of a hysterectomy?
As with any operation, a hysterectomy can cause heavy bleeding, injury to neighboring organs and problems due to the anaesthetic. Possible problems after a hysterectomy include temporarily restricted urinary bladder function, secondary bleeding, infections, proliferating scarring and adhesions.
What should I be aware of after a hysterectomy?
Slight tiredness and minor pain after hysterectomy are normal in the first few weeks. Sexual intercourse should only take place after four to six weeks so as not to strain the vaginal closure. You should also not resume heavy physical exertion until six weeks after the hysterectomy.
Author & source information
This text complies with the requirements of medical literature, medical guidelines and current studies and has been reviewed by medical professionals.
