Patient education: Hysterectomy (The Basics)

What is a hysterectomy? — A hysterectomy is surgery to remove the uterus (figure 1). The uterus is the part of your body that carries a baby if you are pregnant. After a hysterectomy, you will not be able to get pregnant.

Ask the doctor if they plan to remove your cervix, ovaries, or fallopian tubes along with your uterus. This is important because you might need different medical care depending on which parts are removed (figure 2).

A hysterectomy can be done in 3 ways:

●Open surgery – During an open surgery, the doctor makes a cut, or "incision," in the belly to remove the uterus.

●Minimally invasive surgery – "Minimally invasive" surgery lets the doctor make smaller cuts in the belly. They insert long, thin tools through the cuts. One of the tools has a camera (called a "laparoscope") on the end, which sends pictures to a TV screen. The doctor can look at the screen to see inside the belly. Then, they use the long tools to do the surgery. They can control the tools directly, or with the help of a robot (this is called "robot-assisted" surgery).

●Vaginal surgery – For this type of surgery, the doctor makes a cut in the vagina to remove the uterus.

You might be able to return to normal activities sooner if you had minimally invasive surgery or vaginal surgery.

How do I prepare for a hysterectomy? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They might order tests, such as:

●Lab tests

●Ultrasound

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before surgery. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

●Lowering the risk of infection – In some cases, you might want to trim (not shave) your body hair before your procedure. You might also need to wash the area with a special soap.

●What you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

What happens during a hysterectomy? — When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Types of anesthesia include:

•Regional – This type of anesthesia blocks pain in 1 area of your body, such as an arm, a leg, or the lower half of your body. If you get regional anesthesia, you might be awake. Or you might get medicines to make you relax and feel sleepy, called "sedatives."

•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.

●You might get medicines to help control pain after the procedure.

●The doctor will put a thin, flexible tube called a "catheter" into your bladder. This is to drain urine during the procedure.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will take out your uterus. The doctor might also remove your cervix, ovaries, and fallopian tubes if needed.

●The doctor will close your incisions and cover them with clean bandages.

●The surgery usually takes 2 to 3 hours.

What happens after a hysterectomy? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off. You might have to stay in the hospital for 1 to 3 days. Sometimes, you can go home the same day.

As you recover:

●You might feel groggy or confused for a short time. The doctor or nurse can give you medicine to help with this.

●If you had a catheter in your bladder, it will be removed.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine if needed to help with pain. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

●Some people feel a sense of sadness or loss after a hysterectomy. Talk to your doctor if the feeling lasts for weeks after the procedure.

What are the risks of hysterectomy? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Infection

●Bleeding

●The wound opening up

●Blood clots in your legs or lungs

●Injury to nearby organs

What else should I know? — It is normal to have some light vaginal bleeding or spotting after a hysterectomy. The drainage can be pink to brown or yellow colored and can last for a few weeks.

After a hysterectomy, you will not have a monthly period. It is not possible to get pregnant after your uterus is removed.

If your ovaries were also removed, you will start to go through menopause if you have not already. Symptoms of menopause can include:

●Hot flashes or night sweats

●Low mood

●Vaginal dryness

●Trouble falling or staying asleep

●Trouble concentrating or remembering things

●Weak bones

There are treatments that can help relieve menopause symptoms.

More on this topic

Patient education: Hysterectomy – Discharge instructions (The Basics)
Patient education: Deciding to have a hysterectomy (The Basics)
Patient education: Uterine cancer (The Basics)
Patient education: Uterine fibroids (The Basics)
Patient education: Endometriosis (The Basics)
Patient education: Postpartum hemorrhage (The Basics)
Patient education: Pelvic organ prolapse (The Basics)
Patient education: Oophorectomy (The Basics)
Patient education: What you should know about oophorectomy (The Basics)

Patient education: Vaginal hysterectomy (Beyond the Basics)
Patient education: Abdominal hysterectomy (Beyond the Basics)
Patient education: Care after gynecologic surgery (Beyond the Basics)
Patient education: Endometriosis (Beyond the Basics)
Patient education: Uterine fibroids (Beyond the Basics)
Patient education: Menopausal hormone therapy (Beyond the Basics)