A hysterectomy is a surgical procedure to remove the womb (uterus). It’s considered to be a safe, low-risk surgery. It shouldn’t be performed on women who still want to have children unless no other alternatives are possible.

If you haven't already gone through the menopause you'll no longer have periods, regardless of your age. The menopause is when a woman's monthly periods stop, which usually occurs from the ages of to 45 to 55.

Reasons for a hysterectomy?

Hysterectomies are carried out to treat conditions that affect the female reproductive system, including:

 • long-term /chronic pelvic pain

• uncontrollable vaginal bleeding /heavy periods

• fibroids, which are benign tumors that grow in the uterus

• pelvic inflammatory disease, which is a serious infection of the reproductive organs

• uterine prolapse, which occurs when the uterus comes down through the cervix and protrudes from the vagina

• endometriosis, which is a disorder in which the inner lining of the uterus grows outside of the uterine cavity, causing pain and bleeding

• Adenomyosis, which is a condition in which the inner lining of the uterus grows into the muscles of the uterus

• Gynecologic cancer of the uterus, cervix, ovaries or of the fallopian tubes 

A hysterectomy is a major operation and is only considered after alternative, less invasive, treatments have been tried.

Things to consider

If you have a hysterectomy, you may have to decide whether to also have your cervix or ovaries removed.

Your decision will usually be based on your personal feelings, medical history and any recommendations your doctor may have.

Types of hysterectomy

There are various types of hysterectomy. The type you have depends on why you need the operation and how much of your womb and surrounding reproductive system can safely be left in place.

The main types of hysterectomy are:

• Total hysterectomy – the womb and cervix (neck of the womb) are removed; this is the most commonly performed operation
• Subtotal or Supracervical hysterectomy – the main body of the womb is removed, leaving the cervix in place
• Total hysterectomy with bilateral salpingo-oophorectomy – the womb, cervix, fallopian tubes (salpingectomy) and the ovaries (oophorectomy) are removed
• Radical hysterectomy – the womb and surrounding tissues are removed, including the fallopian tubes, part of the vagina, ovaries, lymph glands and fatty tissue

There are three ways to carry out a hysterectomy:

• Vaginal hysterectomy – where the womb is removed through a cut in the top of the vagina
• Abdominal hysterectomy – where the womb is removed through a cut in the lower abdomen
• Minimal Invasive hysterectomy (keyhole surgery) laparoscopic or robotic – where the womb is removed through several small cuts in the abdomen

Laparoscopic surgery requires only a few small (about one-half inch long) incisions in the abdomen. A laparoscope inserted through one of these incisions allows the surgeon to see the pelvic organs. Other surgical instruments are used to perform the surgery through separate small 5 mm incisions. The uterus can be removed in small pieces through the incisions, through a larger incision made in your abdomen, or through the vagina.

Benefits of laparoscopic hysterectomy?

Compared with abdominal hysterectomy, laparoscopic surgery results in less pain, has a lower risk of infection, and requires a shorter hospital stay. You may be able to return to your normal activities sooner.

Complications of a hysterectomy

There's a small risk of complications, including:

•  heavy bleeding
• infection
• damage to your bladder or bowel
• Anaestheisa risks

Alternatives to hysterectomy?

In some cases, medications or other procedures that allow you to become pregnant now or in the near future can be tried before having a hysterectomy. Some women wait to have a hysterectomy until after they have completed their families. If you choose another option besides hysterectomy, keep in mind that you may need additional treatment later.

Recovery after Hysterectomy.

You may need to stay in the hospital for one to a few days after surgery. The length of your hospital stay will depend on the type of hysterectomy one had and how it was done.If it is a keyhole surgery then one may be discharged within 24 hours. You can expect to have some pain for the first few days after the surgery. There will be medication given to relieve pain. You will have discharge from your vagina for several weeks. Sanitary pads can be used after the surgery.

Some important things about recovery

Follow your health care provider’s instructions. Be sure to get plenty of rest, but you also need to move around as often as you can. Take short walks and gradually increase the distance you walk every day. You should not lift heavy objects until your doctor says you can. Do not put anything in your vagina during the first 6 weeks. That includes douching, having sex, and using tampons.

After you recover, you should continue to see your health care provider for routine gynecologic exams and general health care. Depending on the reason for your hysterectomy, you still may need pelvic exams and cervical cancer screening.