What is a hysterectomy?
A hysterectomy is an operation to remove the uterus. Usually the cervix is also removed. If necessary the ovaries can be removed at the same time (see figure 1).
The common reasons for having an abdominal hysterectomy include heavy periods, fibroids, endometriosis, chronic pelvic inflammatory disease and ovarian cysts.
What are the benefits of surgery?
A hysterectomy may cure or improve your symptoms. You will no longer have periods.
Are there any alternatives to surgery?
Heavy periods can be treated using oral medications, a hormonal coil in the uterus, or by removing only the lining of the womb.
Depending on the size and position of fibroids, medication can be taken to try to control the symptoms. Other treatments include surgery to remove the fibroids only or uterine artery embolisation to reduce the blood flow to the fibroids.
What does the operation involve?
An abdominal hysterectomy is usually performed under a general anaesthetic. The operation usually takes about an hour.
Your gynaecologist will make a cut on your abdomen, usually in the ‘bikini’ line.
They will remove your womb and cervix through the cut. They will also need to make a cut at the top of your vagina so they can remove your cervix.
What complications can happen?
1. General complications of any operation
- Blood clots
- Unsightly scarring
2. Specific complications of this operation
- Damage to internal organs
- Developing a haematoma
- Long-term problems
- Continued pain
- Menopause, even if your ovaries are not removed
How soon will I recover?
You will usually be able to go home after four to six days.
For the first two weeks at home you should rest and continue to do the exercises that you were shown in hospital. You can usually go back to work after six to twelve weeks.
After three months you should be feeling more or less back to normal.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice.
A hysterectomy is a major operation usually recommended after simpler treatments have failed.
Paying for your operation
Abdominal hysterectomy costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the operation will be explained and confirmed in writing when you book the operation. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.
Author: Mr Jeremy Hawe MBChB MRCOG
Illustrations: LifeART image copyright 2007 Lippincott Williams & Wilkins. All rights reserved.
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