Questions to Ask Before Hysterectomy

A hysterectomy is the removal of the uterus. The uterus may be removed for a variety of reasons such as abnormal uterine bleeding, uterine fibroids causing bleeding, pain or other difficulties, ongoing pelvic pain, uterine prolapse where the uterus has moved into the vaginal canal, endometriosis, thickening of the uterus, and cancer. Physicians recommend a hysterectomy for a woman usually after other alternatives for resolving her medical condition have been unsuccessful.

Hospital discharge after a hysterectomy may happen the same day or a few days later and recovery time can be as short as 2 weeks up to 8 weeks long, depending on the type of hysterectomy that is performed. During the recovery time, walking is usually encouraged but you shouldn’t do any lifting until you’ve fully recovered or at the doctor’s instructions.

6 Types of Hysterectomy Procedures

There are six different types of hysterectomy procedures and your recovery time in hospital and at home depends on the type of procedure you have.

1.  Abdominal hysterectomy

During an abdominal hysterectomy, an incision is made in the lower abdomen to remove the uterus. This is the most invasive type of hysterectomy and requires the longest recovery time of 6 to 8 weeks. In a total hysterectomy, both the uterus and cervix are removed which may or may not include the tube and ovaries. With a partial, subtotal, or supracervical hysterectomy, only the uterus is removed, and the cervix is left in place. Your surgeon may recommend this procedure if you have a large uterus, your surgeon wants to inspect the organs in your pelvis for signs of disease, or they believe it’s the most suitable procedure for you.

2.  Vaginal hysterectomy

With a vaginal hysterectomy, an incision is made in the vaginal wall. Using long instruments through the vagina, the uterus is separated from its ligaments and surrounding structures and removed. Recovery time is approximately 3 to 6 weeks.

3.  Laparoscopic hysterectomy

In this procedure, the surgeon makes small incisions in the abdomen to insert a viewing device called a laparoscope and other instruments to remove the uterus in small pieces. Because these are very small incisions, they require less healing time than an abdominal hysterectomy that requires a much larger incision.

4.  Laparoscopic assisted vaginal hysterectomy (LAVH)

In LAVH, a laparoscope and other small instruments are inserted through very small incisions in the abdomen. The uterus is removed from the ligaments that hold it in place and it is removed through the vagina by making a small incision in the vaginal wall. Recovery time varies greatly from just 2 weeks to 4 to 6 weeks.

5.  Laparoscopic supracervical hysterectomy (LSH)

LSH is performed by making very small incisions in the abdomen to insert a laparoscope and other small instruments to remove only the uterus while leaving the cervix in place to support the vagina and other structures.

This is the least invasive type of hysterectomy with a recovery time of 6 days to 2 weeks.

6.  Robotic hysterectomy

During a robotic hysterectomy, the surgeon inserts surgical instruments including a camera through small abdominal incisions similar to a laparoscopic hysterectomy, but he/she performs the surgery by controlling the instruments through a computer. By performing the surgery this way, the surgeon can access smaller areas and view the area better than with a traditional laparoscope.

Your physician will determine the type of hysterectomy that is best for you based on your condition, the reason you need a hysterectomy, and your medical history.

What to Expect Before a Hysterectomy

Before your hysterectomy, your physician will discuss the procedure with you and any potential risks and complications. Consider the layout of your home and where you will want to sleep during your recovery because climbing stairs may be difficult for you. You may also want to stock up on any prescriptions, groceries, and easy to prepare meals for your recovery time. You will be advised not to eat or drink anything for 24 hours before your surgery.

What to Expect During a Hysterectomy

To prepare for the procedure, you will lie on your back similar to the position used when you have a Pap test. A long flexible tube called a catheter may be put into your bladder to drain your urine during and immediately after your surgery. You will have an intravenous (IV) started in one of your arms and you will be put to sleep with general anesthesia for the procedure. Your uterus will be removed using the procedure your physician described to you.

What to Expect After a Hysterectomy

After your hysterectomy, you may have pain, redness, swelling, bruising, burning, and itching at your incision site. Some women also have a feeling of numbness near the incision or down their leg.

You will need to arrange to have someone drive you home after you are discharged from hospital since your physician will likely recommend that you don’t drive for a couple weeks after surgery. If you are discharged home the same day of your surgery, you will have had general anesthesia so you will not be able to drive. Your physician will tell you how long your recovery should take which will vary depending on the type of hysterectomy you’ve had. You will be advised to not do any lifting, exercise, or have sex until you have healed.