Hysterectomy is a surgical procedure used to treat conditions of the female reproductive system. It is one of the most common surgeries carried out today, with around 30,000 hysterectomies performed in England between 2012 and 2013. Once the uterus is removed, a woman can no longer have periods or become pregnant, irrespective of her age.
Hysterectomies are performed to resolve various different conditions, some of which include heavy periods, persistent pelvic pain, uterine fibroids, and cancer of the ovary, cervix, fallopian tube or womb.
Hysterectomy is a major surgery, that can take at least six weeks to recover from. In some cases, it may be necessary to remove the cervix, fallopian tubes, ovaries or other surrounding structures, as well as the womb. There are several types of hysterectomy and the type of procedure chosen depends on the patient’s condition and how much of their womb and surrounding structures needs to be removed and how much the surgeon is trying to leave in place.
Types of hysterectomy
The main types of hysterectomy include:
- Total hysterectomy – Here, both the womb and the cervix are removed. This is the most common form of hysterectomy.
- Subtotal hysterectomy – This surgery involves removal of the main body of the womb, but leaves the cervix in place.
- Total hysterectomy with bilateral salpingo-oophorectomy – In this procedure, the womb, cervix, fallopian tubes and ovaries are all removed.
- Radical hysterectomy – This surgery involves removing the womb, cervix, fallopian tubes and ovaries, as well as part of the vagina, the fatty tissue and the lymph glands.
Approach to hysterectomy
There are three different approaches to carrying out a hysterectomy and these are described below.
- In a vaginal hysterectomy, the uterus is removed through an incision made in the upper part of the vagina.
- In an abdominal hysterectomy, an incision made in the lower abdomen is used to remove the womb
- In laparoscopic hysterectomy, several small incisions are made in the abdomen for removing the uterus.
Reviewed by Sally Robertson, BSc