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Total laparoscopic hysterectomy (womb removal)

Total laparoscopic hysterectomy (womb removal) is an operation used to treat a range of gynaecological conditions that affect your reproductive system

Total-laparoscopic-hysterectomy-womb-removal
A hysterectomy describes the surgical removal of your womb (also known as your uterus).  

A total hysterectomy involves the removal of both your womb and cervix. Both procedures are most commonly performed to treat problems that affect the female reproductive system. A total hysterectomy is the preferred option over a subtotal hysterectomy, because removing your cervix eliminates the risk of you developing cervical cancer at a later stage. 

After having a hysterectomy, you will no longer experience periods or be able to get pregnant. Some women will experience symptoms of the menopause, but not all. It can eliminate chronic pelvic pain, bloating, and heavy bleeding, among other symptoms.

On this page, we share more information about a total laparoscopic hysterectomy, which involves the removal of your womb and cervix through keyhole surgery. A total hysterectomy will typically be performed by a consultant gynaecologist, who might also be referred to as a gynaecological surgeon. Gynaecology is the branch of medicine that deals with the female reproductive system.

We're here for you

At Circle Health Group, we understand that the reason for undergoing a total hysterectomy, or any kind of hysterectomy, often causes immense emotional challenges as well as physical, and that the prospect of having a hysterectomy can be unnerving.

Our network of consultant gynaecologists is here to support you emotionally and physically throughout your journey to better health, ensuring you experience outstanding care before, during and after surgery. You will be treated by a consultant-led, multidisciplinary team of healthcare professionals who are all committed to delivering excellent, tailored-to-you care that puts your needs first.

A total laparoscopic hysterectomy starts from £8,775.*

Our fixed-price packages includes the cost of your surgery and all appropriate aftercare appointments. Our costs include all surgery fees and aftercare appointments with our consultants. However, any pre-surgery diagnostic tests and your consultant’s outpatient appointment consultation fee are charged separately.

We offer flexible payment options that can help you to spread the cost of treatment; you can choose to pay over a period of one to five years with no deposit required. If you decide to pay over 10 months, you will pay interest-free. If you are paying for a longer period, you will pay 14.9% APR.

*This is a guide price for patients who are paying for their own treatment. The actual cost of your treatment will be confirmed in writing at the time of booking.

Symptoms that can indicate the need for a total laparoscopic hysterectomy include: 

  • Heavy periods (where other treatment options have not helped)
  • Painful periods
  • Chronic pelvic pain 
  • Pain during sex
  • Abnormal bleeding

If you are experiencing one or more of these symptoms, and they're significantly impacting your quality of life, it could be that a total hysterectomy could help you. A hysterectomy is a major procedure, and for most conditions it won't be recommended unless other, more conservative treatments have been tried and have not been able to sufficiently improve your symptoms.

The symptoms above can be caused by various gynaecological conditions, including:

Cancer of your uterus, cervix, or ovaries

Many women with cancer of the womb are treated with a total hysterectomy to remove the organs affected and therefore the cancer. Depending on where your cancer has spread, your consultant surgeon might also remove your fallopian tubes.

Endometriosis

Endometriosis is a condition where cells from the uterine lining (the endometrium) are found outside your womb. It can cause a variety of distressing symptoms, including chronic pain, fatigue, and infertility. A total hysterectomy is sometimes used to treat severe endometriosis.

Uterine fibroids

Uterine fibroids are benign (non-cancerous) growths that develop in your uterus. They can lead to feelings of heaviness and pressure across your pelvic area. If left untreated, uterine fibroids will continue to grow. They can cause heavy menstrual bleeding and pelvic pain.  

There are several types of uterine fibroids. Each is determined by its location in your womb. The three main types are: 

Intramural fibroids: These grow within the muscle wall of your womb and are the most common type of fibroid. 

Subserosal fibroids: These develop on the outside of your womb and can grow into your pelvis. 

Submucosal fibroids: These form in the muscle layer that sits beneath the inner lining of your womb. 

Most people with uterine fibroids are unaware that they have them, because for many women they do not produce any symptoms. However, in other cases uterine fibroids can result in distressing symptoms that can only be alleviated through treatment such as a hysterectomy.

Prolapse of your uterus

This occurs when your uterus slips down from its normal position and bulges into your vagina. It can cause significant pain and discomfort and result in urinary incontinence (leaking urine when you cough, sneeze or exercise). It can also cause discomfort and numbness during sex. A prolapse of the uterus can often occur after you give birth. 

Pelvic inflammatory disease (PID)

This is a bacterial infection of the female reproductive system. If detected early, it can be effectively treated with antibiotics. If not, it can spread, causing damage to your womb and fallopian tubes, resulting in long-term pain. A hysterectomy to remove your womb and fallopian tubes might be recommended if you experience extreme pain from PID that has not been alleviated through other treatment options. 

The above conditions, along with many other gynaecological health problems, don’t necessarily mean you need a total hysterectomy. Other treatment options might include hormonal or pain medication, heat therapy, pelvic health physiotherapy, or less major surgical options. However, these options do not suit everyone.  

A total hysterectomy is often recommended when other treatment options have not successfully resolved your gynaecological condition(s). 

You can usually see a consultant gynaecologist for your initial consultation within 48 hours of booking your appointment with us.  

At this first appointment, your consultant will ask about your general health and examine your medical history. They will want to know about existing medical conditions you suffer from, as well as the current symptoms you are experiencing. They will also want to know how these symptoms impact your everyday life, how often they occur, and whether you have tried treatment options for them already.  

Next, your consultant will gently carry out a physical examination of your pelvis to check for any points of tenderness or visible problems, such as lesions or cysts. If a problem is found, your consultant will organise further testing.  

This might include an ultrasound scan, which offers your consultant the best digital view of your reproductive organs. Or you may need to have a laparoscopy, which allows your consultant to look inside your stomach, using a very small camera. The latter procedure is necessary to conclusively diagnose conditions including endometriosis and ovarian cysts. It’s a surgical procedure that our gynaecologists perform very regularly at Circle Health Group. 

It is important to remember that your initial consultation is a positive step in your journey toward better health. Your consultant is there to answer any questions you might have about your condition(s) and ease any concerns you might experience about undergoing hysterectomy surgery. We understand that making the decision to have a hysterectomy is a major one, and we welcome any questions you might have about the procedure, however trivial they might seem. 

The wait between your initial consultation and undergoing treatment depends on your individual circumstances and whether you have been diagnosed with a gynaecological condition. When you go private with Circle health Group, our team will book you in for surgery as soon as is necessary, and we don’t cancel or rearrange operations except in extreme circumstances.  

After your initial consultation, our multidisciplinary team of healthcare professionals will ensure you understand the next steps in your journey and how to prepare for surgery, if needed. 

There is not a lot you can do to physically prepare for a hysterectomy, so just focus on looking after yourself. Remaining generally healthy and fit in the run-up to surgery helps reduce your risk of developing complications from the procedure and speed up your recovery.

In preparation for the procedure, we recommend that you: 

  • Stop smoking
  • Eat a healthy, balanced diet
  • Exercise regularly
  • Lose weight (if you are overweight)

You will have blood tests and a general health check with your consultant before surgery to ensure you are healthy enough for the procedure. You will be able to ask your consultant as many questions as you would like about the procedure and how to prepare for it. They will offer tailored advice based on your circumstances.

Preparing emotionally for a hysterectomy

A hysterectomy can be an emotional experience. The sudden change to your hormones caused by the removal of one or more parts of your reproductive system can cause mood swings and feelings of depression. The loss of fertility can also take an emotional toll on some women. But there are ways you can prepare emotionally for the surgery to protect your mental wellbeing afterwards. 

Ensure you have a strong support system around you who will be there to support you physically and emotionally after surgery. 

Consider trying talking therapy, such as cognitive behavioural therapy (CBT), before and after surgery to help you manage your emotions by changing the way you think and behave. Your therapist can work with you to develop coping mechanisms to manage how you feel after having a hysterectomy.

You can discuss techniques for coping emotionally with a hysterectomy with your consultant, who is there to answer any questions you might have about any aspect of your experience. 

Laparoscopic surgery is also known as keyhole surgery, which means it is minimally invasive and performed through small cuts made into your skin, as opposed to traditional 'open' surgery which uses larger cuts.

A total laparoscopic hysterectomy typically takes one to three hours. It is performed under general anaesthetic, which means you will not be awake during it. 

Your consultant will begin the surgery by making two or three small incisions across your tummy. They will then insert a laparoscope (a long thin tube with a camera attached to the end of it) through one of these incisions. The laparoscope is connected to a monitor that displays images of inside your reproductive system, so your consultant can see clearly as they perform the procedure. 

Your consultant will remove your womb and cervix using specialist instruments inserted through the laparoscope. These organs will be carefully detached and removed from your body. Next, your consultant will close the incisions using either specialist glue or staples. Dressing will be applied to your incisions to protect them from becoming infected. 

Your consultant will ensure you understand the exact technique they will use before your surgery so you can feel prepared and informed.

Will I have my ovaries removed?

A total hysterectomy does not necessarily include the removal of the ovaries. In some instances your consultant will judge that it's better to keep your ovaries. In other cases, and in particular if you are at high risk of certain cancers, your ovaries will be removed during your hysterectomy operation.

The surgical removal of the ovaries is called an oophorectomy.

When you wake up following surgery, you will experience some pain and discomfort across your tummy and pelvic area. This is normal and you will be offered painkillers to reduce the pain.

When you wake up, you will have:

  • Dressings placed over your wounds to protect them
  • A catheter, which is a small tube that drains urine from your bladder into a plastic collection bag
  • A drainage tube in your abdomen to take away any blood from beneath your wound.

The day after your surgery, your physiotherapist will encourage you to get out of bed and walk to help your blood flow. They will also show you a series of pelvic floor exercises that you can perform at home to reduce your pain and improve your mobility as you recover. 

Six to eight weeks after surgery

You will be able to return home between one and four days after your operation. It takes around six to eight weeks to fully recover after having a total laparoscopic hysterectomy. During this time, you should continue to perform the exercises your physiotherapist has taught you in hospital. Rest as much as possible and avoid heavy lifting and high-impact sport. Try brisk walks and gentle swimming for exercise but be gentle with yourself as you recover. 

Drink plenty of fluids and increase your fibre intake to help with bowel and bladder movements (some people experience constipation after surgery).

Returning to work


If your job does not involve manual work or heavy lifting, it may be possible to return to work after four to eight weeks. Your consultant will be able to offer tailored advice on how quickly you will be able to return to work.  

Driving after surgery


Do not drive until you can comfortably wear a seatbelt and safely perform an emergency stop. This can be anything from three to eight weeks after surgery.

Expect vaginal discharge

After a hysterectomy, you will experience some vaginal bleeding and discharge that can last up to six weeks. This is normal. Your consultant will explain this to you before surgery so that it isn’t a cause for concern during your recovery period. 

Expect symptoms associated with the menopause

If your ovaries are removed, you will usually experience menopausal symptoms after your operation. These can include: 

  • Sweating 
  • Difficult sleeping 
  • Hot flushes 
  • Low mood and anxiety 
  • Vaginal dryness 
  • Reduced sex drive 

You may be recommended hormone replacement therapy (HRT) after your operation to combat these symptoms. This can be given in the form of an implant, injections, or tablets. 

Your consultant can discuss this treatment option with you. 

It is important to remember that complications can occur during any surgery, not just a total hysterectomy.  

Potential complication during any surgical procedure include:  

  • Scarring 
  • Blood clotting 
  • Excessive bleeding 
  • Chest infection 
  • Difficulty passing urine 
  • Heart attack 
  • Stroke 

Specific complications that can occur during a total hysterectomy include:  

  • Blood clots 
  • Difficulty passing urine
  • Infection 
  • Scarring 
  • Bladder damage 
  • Bowel damage 
  • Ureter damage 
  • Early menopause 

If you have any concerns about these, speak with your consultant. They will be able to discuss their likelihood with you in more detail and put your worries at ease. 

Can you have sex after a hysterectomy?

You will be advised not to have sex for around four to six weeks following surgery. This allows time for your scars to heal and any discharge and/or vaginal bleeding to alleviate.  

It is okay to not feel ready to have sex again after six weeks. People feel ready at different times, and some people experience low libido after surgery. This is due to a drop in oestrogen, which is important for sexual desire. Many of these hormones are produced by the ovaries, which are often removed during a hysterectomy. 

It is common to feel a sense of mourning for your sexuality and womanhood after surgery, because the female reproductive system is so often associated with femininity and sexual function in society.  

Not everybody feels this way, and many people find their sexual function improves after surgery.  

Studies published by The NCBI show that most people who are sexually active before a hysterectomy experience the same or better sexual functioning after the surgery.

Can you get pregnant after a hysterectomy?

You will not be able to have a pregnancy after a hysterectomy. 

When you have a hysterectomy, your uterus (womb) is removed. Often your other reproductive organs are removed too (the ovaries and fallopian tubes). During the conception of a baby, the egg and sperm fuse to form an embryo. The womb acts as the vessel where the embryo attaches and grows, making these organs critical in the process of conceiving a baby.  

However, there are other ways that you can have a baby following a hysterectomy, such as through surrogacy or adoption.  

How many incisions do you need for a total laparoscopic hysterectomy?

Your consultant will usually make two or three small incisions in your lower tummy. These are between 0.5cm and 1cm long.

What is removed in a total laparoscopic hysterectomy?

During a total laparoscopic hysterectomy your consultant will remove your uterus and the opening to your cervix. Sometimes other parts of your reproductive system might be removed, including your fallopian tubes and ovaries.

How long will your stomach be swollen after a hysterectomy?

The swelling in your tummy will take several weeks to dissipate (between four and six). Any discomfort caused by the swelling can be managed with over-the-counter painkillers.

When you choose to go private with Circle Health Group, you can expect:   

  • Flexible appointment times and locations to fit your routine  
  • The freedom to choose which hospital and Consultant suit your needs  
  • Personalised, Consultant-led treatment plans tailored to your individual needs  
  • Comfortable and safe private facilities maintained by expert multidisciplinary teams  
  • Support by the same compassionate clinical team from beginning to end  
  • Affordable, fixed-price packages with aftercare included  
  • Flexible payment options to spread the cost of your care

If you would like to learn more, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in August 2022. Next review due August 2025.

  1. Total Laparoscopic Hysterectomy (TLH), University Hospitals Coventry and Warwickshire NHS
  2. How it's performed - Hysterectomy, NHS
  3. Total Laparoscopic Hysterectomy: 10 Steps Toward a Successful Procedure, NIH
  4. Laparoscopic hysterectomy – recovering well patient information leaflet, Royal College of Obstetricians and Gynaecologists
  5. Total Laparoscopic Hysterectomy, St George's Foundation Trust NHS

Specialists offering Total laparoscopic hysterectomy (womb removal)

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