Abdominal Hysterectomy Procedure: Purpose, Risks, Treatment and Results | Fortis Healthcare

Abdominal hysterectomy

Abdominal hysterectomy is a surgical procedure that removes your uterus through an incision in your lower abdomen. Your uterus — or womb — is where a baby grows if you're pregnant. A partial hysterectomy removes just the uterus, and a total hysterectomy removes the uterus and the cervix.

Sometimes a hysterectomy includes removal of one or both ovaries and fallopian tubes, a procedure called total hysterectomy with salpingo-oophorectomy (sal-ping-go-o-of-uh-REK-tuh-me).

Hysterectomy can also be performed through an incision in the vagina (vaginal hysterectomy) or by a laparoscopic or robotic surgical approach — which uses long, thin instruments passed through small abdominal incisions. Abdominal hysterectomy may be recommended over other types of hysterectomy if you have a large uterus or if your doctor wants to check other pelvic organs for signs of disease.


Why it's done Risks How you prepare What you can expect

Hysterectomy may be needed if you have one of the following conditions:

  • Gynecologic cancer. If you have a gynecologic cancer — such as cancer of the uterus or cervix — a hysterectomy may be your best treatment option. Depending on the specific cancer you have and how advanced it is, your other options might include radiation or chemotherapy.
  • Fibroids. Hysterectomy is the only certain, permanent solution for fibroids — benign uterine tumors that often cause persistent bleeding, anemia, pelvic pain or bladder pressure. Nonsurgical treatments of fibroids are a possibility, depending on your discomfort level and tumor size. Many women with fibroids have minimal symptoms and require no treatment.
  • Endometriosis. In endometriosis, the tissue lining the inside of your uterus (endometrium) grows outside the uterus on your ovaries, fallopian tubes, or other pelvic or abdominal organs. When medication or conservative surgery doesn't improve endometriosis, you might need a hysterectomy along with removal of your ovaries and fallopian tubes (bilateral salpingo-oophorectomy).
  • Uterine prolapse. Descent of the uterus into your vagina can happen when the supporting ligaments and tissues weaken. Uterine prolapse can lead to urinary incontinence, pelvic pressure or difficulty with bowel movements. Hysterectomy may be necessary to achieve satisfactory repair of these conditions.
  • Abnormal vaginal bleeding. If your periods are heavy, irregular or prolonged each cycle, a hysterectomy may bring relief when the bleeding can't be controlled by other methods.
  • Chronic pelvic pain. Occasionally, surgery is a necessary last resort for women who experience chronic pelvic pain that clearly arises in the uterus. However, hysterectomy provides no relief from many forms of pelvic pain, and an unnecessary hysterectomy may create new problems. Seek careful evaluation before proceeding with such major surgery.

Hysterectomy ends your ability to become pregnant. If you think you might want to become pregnant, ask your doctor about alternatives to this surgery. In the case of cancer, hysterectomy might be the only option. But for other conditions — including fibroids, endometriosis and uterine prolapse — you may be able to try less invasive treatments first.

During hysterectomy surgery, your surgeon might also perform a related procedure that removes both of your ovaries and your fallopian tubes (bilateral salpingo-oophorectomy). You and your doctor should discuss ahead of time whether you need this procedure.

Hysterectomy is generally very safe, but with any major surgery comes the risk of complications.

Risks associated with abdominal hysterectomy include:

  • Blood clots
  • Infection
  • Excessive bleeding
  • Adverse reaction to anesthesia
  • Damage to your urinary tract, bladder, rectum or other pelvic structures during surgery, which may require further surgical repair
  • Earlier onset of menopause even if the ovaries aren't removed
  • Rarely, death

It's normal to feel anxious about having a hysterectomy. Here's what you can do to prepare:

  • Gather information. Before surgery, get all the information you need to feel confident about your decision to have a hysterectomy. Ask your doctor and surgeon questions. Learn about the procedure, including all the steps involved if it makes you feel more comfortable.
  • Follow your doctor's instructions about medication. Find out whether you should change your usual medication routine in the days leading up to your hysterectomy. Be sure to tell your doctor about any over-the-counter medications, dietary supplements or herbal preparations that you're taking.
  • Discuss what type of anesthesia you'll have. Abdominal hysterectomy requires you to have general anesthesia, which makes you unconscious during surgery.
  • Plan for a hospital stay. How long you'll be in the hospital depends on what type of hysterectomy you have and what your doctor recommends. Generally, abdominal hysterectomy requires a hospital stay of at least one to two days.
  • Arrange for help. Full recovery could take several weeks. Your doctor may recommend restricting your activities during your recovery, such as avoiding driving or lifting heavy objects. Arrange for help at home if you think you'll need it.

After the procedure:

  • The patient is shifted to the recovery room after the surgery wherein the patient is kept under continuous monitoring and observation.
  • The vital signs, such as pulse rate, body temperature, oxygen levels or breathing rate, and heart rate, are monitored continuously.
  • The patient is usually discharged within 2 to 3 days depending upon the complications if any.
  • The doctor may advise taking some painkillers initially and antibiotics to prevent infection.
  • The woman is asked to start moving immediately after the surgery to prevent any blood clots.
  • The patient is usually taking a normal diet and moving out of bed by the time of discharge.
  • There might be some bloody discharge from the vagina for a few days. Hence, the woman is advised to wear a sanitary napkin.
  • The incision on the lower abdomen heals eventually but leaves behind a visible scar.

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