A hysterectomy is the surgical removal of the uterus (womb). Different portions of the uterus, as well as other organs, may be removed at the same time. Serving Greater Boston communities, the gynecologic surgeons at Newton-Wellesley Hospitals Minimally Invasive Gynecological Surgery Department (MIGS) perform hysterectomies to treat a wide range of conditions, including Fibroid Tumors, Endometriosis and in some cases gynecological cancer. If you would like to learn more about hysterectomy continue reading. If you would like to discuss having a hysterectomy at MIGS, contact us to arrange for a consultation.
- Fibroid tumors: Non-malignant tumors arising from the muscle of the uterus may grow and become large, causing pressure on other organs and possibly heavy bleeding or pelvic pain.
- Endometriosis: Endometrial cells sometimes grow outside of the uterus, attach themselves to other organs in the pelvic cavity, and bleed each month in accordance with the ovarian cycle. This can result in chronic pelvic pain, pain during sex and prolonged or heavy bleeding.
- Endometrial hyperplasia: A cause of abnormal bleeding, this over-thickening of the uterine lining is often due to the presence of very high levels of estrogen.
- Cancer: Approximately 10 percent of hysterectomies are performed to treat cancer of the cervix, ovaries or endometrium.
- Blockage of the bladder or intestines: A hysterectomy may be performed if there is a blockage of the bladder or intestines by the uterus or a growth.
- Total Hysterectomy
- Subtotal/Supracervical Hysterectomy
- Hysterectomy with Salpingo-Oophorectomy
- Total Hysterectomy and Bilateral Salpingo-Oophorectomy
- Subtotal Hysterectomy and Bilateral Salpingo-Oophorectomy
A hysterectomy can be performed with or without removing the ovaries. If a woman has not yet gone through menopause when she has a hysterectomy and leaves the ovaries in place, she will NOT need hormone replacement or become menopausal due to the surgery.
- Laparoscopic hysterectomy: The uterus is removed using a laparoscope, a thin tube containing a video camera. Thin tubes are inserted through small incisions in the navel and in the lower part of the abdomen. The laparoscope and other instruments are passed through these tubes in order to perform the hysterectomy.
The uterus is then removed in sections through the tubes or through the vagina. A total hysterectomy and a subtotal (supracervical) hysterectomy, with or with out removal of the ovaries, can be performed laparoscopically.
- Vaginal hysterectomy: The uterus is removed through the vaginal opening.
This procedure is often used in cases of uterine prolapse, or when vaginal repairs are necessary for related conditions.
No external incision is made, which means there is no visible scarring.
Only a Total hysterectomy (removal of uterus and cervix) can be done with a vaginal hysterectomy.
- Laparoscope-assisted vaginal hysterectomy: Vaginal hysterectomy is performed with the aid of laparoscopy.
- Abdominal hysterectomy: The uterus is removed through the abdomen via a surgical incision about six to eight inches long.
The main surgical incision can be made either vertically, from the navel down to the pubic bone, or horizontally, along the top of the pubic hairline.
This is only recommended in limited circumstances.
What is the expected recovery after a hysterectomy?
Most patients can go home from the recovery room several hours after the completion of the hysterectomy. There is also the option to stay in the hospital overnight.
Patients typically require several days of oral narcotics in addition to non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen.
After the first few days, most women do not have significant pain but have less energy than they normally do. It is usually about 2 weeks before women feel back to normal. Most women can return to work following a 2 week post-operative recovery.
What happens after the procedure?
After the procedure, the patient is taken to the recovery room for observation. The recovery process will vary depending upon the type of procedure performed and the type of anesthesia that is given. Once blood pressure, pulse, and breathing are stable and the patient is alert, they will be discharged home or taken to their hospital room. Most women are able to go home after a laparoscopic hysterectomy.
|Laparoscopic Supracervical Hysterectomy
|Laparoscopically-Assisted Vaginal Hysterectomy
|Open vs. Minimally Invasive Hysterectomy
|Total Abdominal Hysterectomy
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