Hysterectomy

Who is a candidate for a hysterectomy?

Your Mercy Health doctor may recommend a hysterectomy in the following cases:

• You have uterine fibroids that are causing severe pain or bleeding which interferes with your daily routine
• You have uterine prolapse - a condition where the uterus slides into the vaginal canal
• You have cervical, ovarian or uterine cancer
• You have severe endometriosis that is impacting your day-to-day life
• You are experiencing chronic abdominal pain or abnormal vaginal bleeding
• You have adenomyosis - thickening of the uterine lining

If you have a non-cancerous condition, a hysterectomy is only used after more conservative treatments have failed.

What are the risks of a hysterectomy?

Although complications are not common, a hysterectomy is a surgical procedure and complications can occur.

Risks associated with a hysterectomy include:

• Blood clots that could lead to a pulmonary embolism, brain aneurysm or heart attack
• Infection
• Excessive bleeding
• Reaction to anesthesia
• Early onset of menopause
• Damage to other pelvic organs such as urinary tract, bladder or rectum
• Increased long-term risk of heart and blood vessel diseases

What to expect during a hysterectomy?

What to expect during a hysterectomy will vary depending on the type of hysterectomy you have.

• Abdominal hysterectomy
  You will be placed under general anesthesia during an abdominal hysterectomy, so you will be asleep for the procedure. The procedure lasts approximately one to two hours. Your doctor will make either a vertical incision, an incision that starts in the middle of your belly and goes all the way to just above the pubic bone, or a horizontal bikini-line incision, an incision approximately an inch above the pubic bone. Your doctor will determine if you are a candidate for a vertical or horizontal bikini-line incision based on the reason you need a hysterectomy, the need to access the upper abdomen as well as the size of your uterus.
• Vaginal hysterectomy
  During a vaginal hysterectomy, you will lie on an exam table with your legs in stirrups. Your doctor will make an incision inside the vagina to access your uterus. Your doctor will close the uterine blood vessels with clamps and remove the uterus from the connective tissue. Your doctor will remove the uterus by cutting it into smaller pieces and removing in sections through the vagina. Any internal bleeding in the pelvis may be stopped with dissolvable stitches.
• Laparoscopic hysterectomy
  During a laparoscopic hysterectomy, a small incision is made at the belly button and a camera is inserted to clearly see the surgical area. Your surgeon will view the images on a nearby TV screen and remove the uterus using specialized instruments and the images on the TV as a visual guide.
• Robotic hysterectomy
  During a robotic hysterectomy, your doctor will make five small incisions in the abdomen and insert surgical instruments through the incisions. Your doctor will view your internal organs on a computer screen and will remove your uterus and potentially ovaries and fallopian tubes, using hand movements on the surgical instruments that translate into precise movements.

Recovery from a hysterectomy

Recovery from a hysterectomy will vary depending on if you have an abdominal hysterectomy or a minimally invasive hysterectomy such as a vaginal hysterectomy, laparoscopic hysterectomy or robotic hysterectomy.

• Abdominal hysterectomy
  If you have an abdominal hysterectomy, you will need to stay in the hospital for at least one night to recover. Recovery time will take as long as six weeks to return to your normal routine. You will not be able to lift anything heavy, participate in sexual activity or participate in strenuous activities until your doctor has given you clearance.
• Vaginal hysterectomy
  If you have a vaginal hysterectomy, you may be able to go home the day of the procedure.You may be able to return to your normal activities within four weeks of the procedure. Even though you may feel better, it is important that you not lift anything heavy or participate in sexual intercourse for six weeks after the procedure.
• Laparoscopic hysterectomy
  If you have a laparoscopic hysterectomy, you can generally go home the day of your surgery. Although you may need over-the-counter or prescription pain medication for a few days after the procedure, you should move around and resume activity soon after surgery. Some women are able to return to work and their day-to-day schedule within a week of their surgery. Talk to your doctor about when you can resume sexual intercourse and lift heavy objects.
• Robotic hysterectomy
  If you have a robotic hysterectomy, you may need to stay in the hospital for one night. You can expect mild to moderate pain where you may need over-the-counter or prescription medication. You may also experience vaginal bleeding for a few days or weeks after the procedure. You will need as long as six weeks to fully recover from a robotic hysterectomy. You should limit your physical activity, avoid lifting anything heavy and get plenty of rest during this period. Most women are given clearance to return to work within four weeks after the procedure. You will be advised to avoid sexual intercourse for nine weeks after a robotic hysterectomy.