A hysterectomy is a surgical procedure aimed to alleviate symptoms of gynaecological conditions such as endometriosis, chronic pelvic pain, and more.

A hysterectomy is a procedure that involves the surgical removal of the uterus, often recommended to address severe gynaecological conditions, such as cervical cancer. Depending on the reason for the surgery, a hysterectomy may also include removing the cervix, fallopian tubes, and ovaries.

This is a life-changing procedure, as removal entails no longer menstruating or being able to conceive. However, it can provide lasting relief for patients who need it.

What is a hysterectomy?

A hysterectomy is a surgical procedure that is often recommended to address severe gynaecological conditions such as uterine fibroids, endometriosis, chronic pelvic pain, abnormal bleeding or cancer. In more complex cases, the surgery may also include the removal of the cervix, ovaries, and fallopian tubes. However, this will depend on the underlying medical condition, and the patient’s needs.

Unlike temporary or less invasive treatments, a hysterectomy provides a definitive solution to many gynaecological issues, particularly when other interventions – like medication or non-surgical procedures – have been ineffective. By removing the uterus, the procedure eliminates symptoms such as severe pain, heavy bleeding, and discomfort. This ultimately helps to significantly improve the patient’s quality of life.

Be that as it may, a hysterectomy is typically performed using minimally invasive techniques, such as laparoscopic or robotic-assisted surgery. These approaches are associated with faster recovery, smaller scars, and less post-operative discomfort. As hysterectomy is a permanent solution, it offers lasting relief from debilitating symptoms while addressing the root cause of persistent gynaecological problems.

Types of hysterectomy

The type of hysterectomy will be dependent on the complexity of your condition, and desired outcomes.

A hysterectomy is a surgical procedure involving the removal of the uterus, often performed using various approaches tailored to the patient’s medical needs. It is a significant operation that may involve the removal of the surrounding structures, depending on the surgical goals, and the type of hysterectomy.

This includes:

Subtotal (Partial) Hysterectomy – a partial hysterectomy involves removing only the upper part of the uterus, leaving the cervix intact. This may be suitable for cases of fibroids or bleeding disorders where cervical preservation is desired.
Total Hysterectomy – a total hysterectomy involves the complete removal of the uterus, and cervix. This is commonly recommended for conditions such as persistent abnormal bleeding, chronic pain or precancerous changes in the cervix.
Radical Hysterectomy – a radical hysterectomy refers to the removal of the uterus, cervix, part of the vaginal canal, and surrounding tissues. This is typically performed for certain types of cancer, such as cervical or uterine cancer.
Hysterectomy with Salpingo-Oophorectomy – this type of hysterectomy involves removal of the uterus along with one or both ovaries and fallopian tubes, often recommended for cancer, severe endometriosis, or risk-reducing surgery in patients with genetic predispositions.

How does hysterectomy work?

As it is a structured surgical procedure aimed at removing the uterus, hysterectomies can only be performed by a highly skilled, and qualified gynaecological surgeon. The procedure can be approached in different ways, depending on the patient’s medical needs. This includes:

Abdominal Hysterectomy: an abdominal hysterectomy involves an incision that is made across the lower abdomen for direct access.
Vaginal Hysterectomy: a vaginal hysterectomy indicates that the uterus is accessed, and removed through the vaginal canal, often preferred for prolapse-related cases.
Laparoscopic or Robotic-Assisted Hysterectomy: for this approach, small incisions are made in the abdomen, allowing for the use of specialised tools and cameras for minimally invasive removal.

Generally, the procedure entails:

Pre-operative Preparations	Prior to the surgery, the patient is placed under general anaesthesia to ensure they are fully unconscious, and comfortable throughout the operation. The surgical team will then prepare the area by sterilising the abdomen or vagina (depending on the surgical approach) to minimise the risk of infection.
Accessing the Surgical Site	The surgeon makes the incisions based on the type of hysterectomy. For an abdominal hysterectomy, a vertical or horizontal incision is made on the lower abdomen. In a vaginal hysterectomy, the uterus is accessed through an incision in the vaginal wall, while a laparoscopic or robotic-assisted hysterectomy involves small incisions in the abdomen to insert surgical tools, and a camera.
Detaching the Uterus	The surgeon then carefully separates the uterus from surrounding tissues. This includes detaching it from the fallopian tubes, ovaries (if preserved), blood vessels, and supportive ligaments. During this step, specialised instruments are used to control bleeding, and to ensure precision during the detachment.
Removing the Uterus	Once the uterus is detached, it is removed from the body. In abdominal or vaginal hysterectomies, it is taken out in one piece. For laparoscopic or robotic-assisted procedures, it may be divided into smaller sections (morcellation) to fit through the small incisions.
Assessing the Surrounding Structures	The surgeon proceeds to inspect the nearby organs, and tissues, such as the ovaries, bladder, and bowel, to ensure there is no unintended damage. If additional tissue, such as the fallopian tubes or ovaries, is being removed, this is done at this stage.
Closing the Incisions	After the uterus, and any additional structures have been removed, the surgeon closes the incisions using sutures, staples, or surgical glue. For laparoscopic or robotic-assisted procedures, dissolvable sutures are often used for the small abdominal incisions.
Post-operative Care	The patient is moved to a recovery room where vital signs are monitored as they wake from anaesthesia. Additionally, pain management, and instructions for postoperative care are provided, including advice on physical activity, wound care, and follow-up appointments.

What are the benefits of hysterectomy?

There are numerous benefits that a hysterectomy offers, particularly for those experiencing persistent symptoms or health risks associated with their reproductive system. The advantages include:

Symptom Relief — by removing the uterus, a hysterectomy effectively eliminates symptoms such as chronic pelvic pain, heavy menstrual bleeding or pressure caused by an enlarged uterus.
Improved Quality of Life — patients often report enhanced physical, and emotional well-being after the procedure, as it alleviates conditions that significantly impacted their daily activities.
Definitive Treatment — unlike other therapies that manage symptoms temporarily, a hysterectomy provides a permanent solution, particularly for non-cancerous conditions that are resistant to less invasive treatments.
Cancer Prevention — for individuals at high risk of developing uterine or ovarian cancers due to genetic factors or pre-cancerous conditions, a hysterectomy can serve as a preventive measure.
No More Menstrual Cycles — after the removal of the uterus, patients no longer experience menstruation, which can be a significant relief for those with painful or disruptive periods.
Reduced Reliance on Medication — many patients no longer need hormonal or pain-management treatments, leading to fewer medication-related side effects or risks.

When is hysterectomy often recommended?

Certain gynaecological conditions, such as endometriosis, menstrual problems, and fibroids can cause severe symptoms that impact a woman’s quality of life.

At Dr Ma Li’s clinic, a hysterectomy is needed when certain gynaecological conditions significantly impact a patient’s health or quality of life.

Some of the common reasons for considering hysterectomy include:

Abnormal or Heavy Vaginal Bleeding — persistent or excessive bleeding that does not respond to other treatments, impacting daily activities and overall health.
Severe Pelvic Pain — chronic or debilitating pelvic pain, often linked to conditions such as endometriosis or adenomyosis, that has not improved with non-surgical therapies.
Uterine Fibroids or Other Noncancerous Tumours — large or symptomatic growths in the uterus that cause pain, heavy bleeding, or pressure on surrounding organs.
Severe Endometriosis — advanced cases where endometrial tissue grows extensively outside the uterus, leading to severe pain or fertility issues.
Uterine Prolapse — when the uterus descends into the vaginal canal, causing discomfort, urinary incontinence, or even fecal incontinence in severe cases.
Cervical, Ovarian, or Uterine Cancer — hysterectomy is a critical treatment option for various gynaecological cancers, often performed alongside other therapies like chemotherapy or radiation.
Conditions Affecting the Uterine Lining — issues such as hyperplasia or adenomyosis that result in pain, heavy bleeding, or other complications may necessitate a hysterectomy.
Serious Complications of Childbirth — rare but life-threatening situations like uterine rupture or uncontrolled postpartum bleeding may require immediate surgical intervention.

What are the side effects of undergoing hysterectomy?

Although a hysterectomy is a common surgical procedure with generally low risks, it may lead to specific side effects. This will be dependent on the type of hysterectomy performed. Generally, the potential side effects associated with each type are:

Subtotal (Partial) Hysterectomy

In a subtotal hysterectomy, only the upper part of the uterus is removed, leaving the cervix intact. Potential side effects include:

Pain or discomfort — mild to moderate abdominal or pelvic pain, which typically resolves during recovery.
Spotting or light bleeding — some women may experience occasional spotting due to the retained cervix.
Cervical health concerns — the cervix remains, so regular Pap smears are still necessary.

Total Hysterectomy

A total hysterectomy involves the complete removal of the uterus and cervix. Common side effects may include:

Vaginal changes — shortening or dryness of the vagina, which may impact sexual function.
Urinary symptoms — temporary changes in urination, such as urgency or frequency.
Hormonal shifts — if the ovaries are not removed, some women report subtle hormonal changes.

Radical Hysterectomy

This extensive procedure removes the uterus, cervix, parts of the vagina, and surrounding tissues, often performed for certain cancers. Side effects can include:

Bladder or bowel dysfunction — temporary difficulty in urination or bowel movements due to proximity to these organs.
Lymphatic swelling — swelling in the legs or pelvis (lymphedema) if nearby lymph nodes are removed.
Reduced sexual function — alterations in vaginal length or sensation due to the removal of tissue.

Hysterectomy with Salpingo-Oophorectomy

In this procedure, the uterus, ovaries, and fallopian tubes are removed. Potential side effects include:

Immediate menopause — sudden loss of ovarian hormones may cause hot flashes, night sweats, and mood swings.
Bone health risks — increased risk of osteoporosis due to decreased oestrogen levels.
Cardiovascular changes — a higher likelihood of heart-related issues in some women post-surgery.

What can you expect from a hysterectomy?

A hysterectomy is a life-changing procedure that often improves a woman’s quality of life, specifically for those who previous experienced severe gynaecological conditions.

At Dr Ma Li’s clinic, we focus on delivering personalised care to support you throughout your hysterectomy journey. From your initial consultation, we provide a thorough understanding of the procedure, addressing your questions, and ensuring you feel confident in your decision. On the day of the surgery, our compassionate team will guide you through pre-operative preparation, which includes assessments, and ensuring your comfort every step of the way.

Once the surgery is complete, the results you can expect will depend on the reason for the hysterectomy. For instance, if the procedure addresses persistent uterine bleeding, many patients experience immediate relief, and an end to menstruation. In cases of fibroids or pelvic organ prolapse, a hysterectomy can alleviate pain, and restore comfort in daily life.

The recovery process varies by individual, but patients often benefit from improved quality of life due to the resolution of their symptoms. Minimally invasive techniques contribute to faster healing, reduced post-operative pain, and smaller scars, helping you return to normal activities sooner. Beyond the physical outcomes, our team is committed to supporting your emotional well-being through follow-up care to monitor your recovery and ensure all your concerns are addressed.

How many hysterectomy sessions are needed?

Hysterectomy is generally performed as a single surgical procedure designed to fully address the intended medical goals, such as the removal of the uterus or associated structures. In most cases, the operation is completed in one session, with no need for repeat surgeries. This comprehensive approach ensures that the targeted condition is resolved effectively during the initial procedure.

However, the specifics may vary depending on the type of hysterectomy, the surgical approach, and individual patient circumstances. Factors such as the presence of complications, the condition of surrounding tissues, or concurrent procedures (such as removal of ovaries) might influence the complexity of the surgery, and post-operative care.

Every treatment plan begins with a detailed consultation to assess your medical history, and specific needs. Post-operative follow-up appointments are scheduled to monitor your recovery, address any concerns, and ensure optimal outcomes. While additional surgical sessions are rarely required, any need for further intervention will be discussed openly, and thoroughly with you.

Schedule a consultation with us for a detailed diagnosis and a personalised treatment plan.

FAQs

Frequently asked questions

How painful is a hysterectomy?

The hysterectomy procedure itself will be painless as you will be put to sleep and kept as comfortable as possible throughout the surgery.

After a hysterectomy, it is common to experience discomfort or mild pain at the surgical site, especially in the first few days. However, modern techniques, and pain management strategies ensure that most patients feel manageable levels of discomfort. You may notice soreness, fatigue, or a pulling sensation during recovery, but these feelings will gradually diminish over time. Our team will provide personalised guidance, and medications to help you stay as comfortable as possible throughout the healing process.

How long does a hysterectomy usually take?

The duration of a hysterectomy varies depending on the type of surgery, and individual circumstances. Typically, the procedure takes between one to three hours. Factors such as the complexity of the condition, the surgical approach, and whether additional procedures are required can influence the time.

How long does it take to recover from a hysterectomy?

Recovery from a hysterectomy usually takes six to eight weeks for most patients. Those undergoing minimally invasive procedures, such as laparoscopic or vaginal hysterectomies, may find their recovery is quicker, often within four to six weeks. It is essential to allow your body the time it needs to heal, avoid heavy lifting, and follow your doctor’s recommendations for post-surgery care.

What does the recovery period entail?

The recovery period after a hysterectomy involves rest, gentle activities, and attentive care to help your body heal. You may feel tired or sore during the first week, but this is normal. Your doctor may recommend light walking to improve circulation, but strenuous activities and heavy lifting should be avoided for several weeks. Incisions, if present, will require care to prevent infection, and follow-up appointments are essential to monitor your progress. Emotional support is also crucial, as the recovery process can be both physical and emotional.

Are there any risks or complications associated with hysterectomy?

As with any surgery, hysterectomy carries some risks, including bleeding, infection, or blood clots. Rare complications may involve injury to surrounding organs, such as the bladder or bowel. Some patients might experience hormonal changes or emotional challenges, particularly if the ovaries are removed. Rest assured, these risks are minimal in most cases, and your surgeon will take every precaution to ensure your safety. Open communication with your healthcare provider can help address any concerns and guide you through a smooth recovery.

Will I be able to live a normal life after removing my womb?

Yes, you can live a full and meaningful life after a hysterectomy. The surgery often relieves symptoms that have been affecting your quality of life, such as pain or heavy bleeding, allowing you to focus on the things that matter most. While there may be emotional adjustments, especially if the procedure affects fertility, many people find that their overall health and well-being improve significantly after recovery.

Why will my stomach appear bigger after a hysterectomy?

A slight increase in abdominal size after a hysterectomy can occur due to temporary swelling, gas retention, or changes in your body’s anatomy during healing. This is normal and usually resolves as your body recovers. Gentle movement and proper hydration can help reduce bloating. If the swelling persists or worsens, contact us immediately to rule out complications. Rest assured, with time and care, your body will adapt, and any changes should become less noticeable.

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