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Hysterectomy—Open Surgery

Authors:
  • Cynthia M. Johnson, MA
Publication Type:

Procedure

Hysterectomy—Open Surgery

(Surgical Removal of the Uterus [or Womb]; Abdominal Hysterectomy; Vaginal Hysterectomy)

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Definition

Hysterectomy is surgery to remove the uterus (womb). Periods will stop. Pregnancy will no longer be possible.

There are different types of this surgery:

  • Supracervical hysterectomy—removal of the uterus only
  • Total hysterectomy—removal of the uterus and cervix (the opening of the uterus leading to the vagina)
  • Radical hysterectomy—removal of the uterus, ovaries, fallopian tubes, upper part of the vagina, and the pelvic lymph nodes
  • Salpingo-oophorectomy—removal of the ovaries and fallopian tubes (may be combined with any of the above procedures)

Reasons for Procedure

This procedure may be done if the uterus is causing health problems that cannot be treated by other means. It may also be done to:

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

Things that may raise the risk of problems are:

  • Smoking
  • Drinking alcohol
  • Chronic diseases, such as diabetes or obesity
  • Previous pelvic surgery or serious infection

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Whether you need to clean the bowels with an enema the night before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Arranging a ride to and from surgery
  • Tests that will need to be done before surgery, such as images of the area

Anesthesia

The doctor may give:

  • A sedative—you will feel relaxed
  • Local anesthesia—the area will be numbed
  • General anesthesia—you will be asleep
  • Spinal anesthesia —you will be numb from the belly down
  • Regional anesthesia —pain will be blocked without causing sleep

Description of the Procedure

This surgery will be done in one of two ways:

Abdominal Hysterectomy

A cut will be made in the lower abdomen. This will expose the tissue and blood vessels that surround the uterus. The supporting tissue will then be cut. The blood vessels will be tied off. The uterus will be removed. Next, the abdominal wall will be sewn back together and the skin will be closed with stitches or staples. If the cervix is also removed, stitches will be put in the top of the vagina. Bandages will be placed over the abdomen.

Abdominal Hysterectomy

The uterus is removed through the abdomen.

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Vaginal Hysterectomy

This method will not involve any outside cuts. The vagina will be stretched and kept open with special tools. Next, the uterus and cervix will be cut free. The connecting blood vessels will be tied off. The uterus and cervix will be removed through the vagina. Lastly, the top of the vagina will be closed with stitches. The vagina will be packed with gauze. This will be removed in 1 to 2 days.

Vaginal Hysterectomy

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How Long Will It Take?

1 to 3 hours

Will It Hurt?

Pain, bloating, and vaginal discharge and bleeding are common in the first few days. Medicine and home care can help.

Average Hospital Stay

The usual length of stay is 1 to 3 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, the staff may:

  • Give you pain medicine
  • Encourage you to walk

At Home

It will take about 3 to 8 weeks to fully heal, depending on which procedure was done. Physical activity and sex will be limited during this time. Tampons will need to be avoided. Ask for help with daily activities and delay your return to work.

Problems to Look Out For

Call the doctor if you are not getting better or you have:

  • Signs of infection, including fever and chills
  • Redness, swelling, increased pain at the wound sites
  • Increased bleeding or other leakage from the wound sites
  • Pain that you cannot control with medicine
  • Pain, burning, urgency or frequency of urination, or lasting blood in the urine
  • Swelling, redness, or pain in the legs

If you think you have an emergency, call for medical help right away.

RESOURCES:

CANADIAN RESOURCES

CANADIAN RESOURCES

References

  • Hysterectomy. American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/womens-health/~/link.aspx?_id=38BFB30FBDF24ABBB6B8AF4406E9100D&_z=z.
  • Hysterectomy. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/hysterectomy.
  • Hysterectomy. Women's Health—US Department of Health and Human Services website. Available at: https://www.womenshealth.gov/a-z-topics/hysterectomy.
Last Updated:
2023-03-01

(C) Copyright 2023 EBSCO Information Services

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.