Alyse Mulhare

Many people are confused about what a hysterectomy is. If you’ve been told you need this type of surgery, it is important to understand what it is and what processes are involved.

During a hysterectomy, a woman’s uterus and cervix are removed. It does not automatically include the removal of the ovaries or fallopian tubes. This is important to note because people often believe that a hysterectomy automatically leads to menopause. But since the uterus does not produce hormones, its removal alone will not induce early menopause (removal of the ovaries would do that). However, a hysterectomy does mean a woman can no longer become pregnant, since the baby would need to develop in the uterus. If a woman needed a hysterectomy and still wanted children, it is possible for her to harvest her eggs for fertilization and use a surrogate.

Women who have very heavy bleeding during their period — particularly to the point of becoming anemic or needing blood transfusions — may benefit from a hysterectomy. Other problems leading to a hysterectomy include painful periods, fibroids, polyps, persistent concerns during Pap smears, endometriosis or abnormal cells in the cervix or uterus.

Hysterectomies are more common in women 40 years and older, as they begin to reach the end of their reproductive lives. Half of women are in menopause by age 51. Just like teens who are starting to get their periods, women at the other end of the spectrum can have heavier, more painful and less predictable cycles.

A hysterectomy may involve removing:

Which procedure your doctor recommends depends on the medical reason for your hysterectomy. Because a hysterectomy can involve different organs, ask your doctor what specifically is involved in your proposed surgery.

Hysterectomies are performed in one of three ways:

A traditional abdominal incision hysterectomy involves a large incision through the skin and the muscles r to reach the organ. A vaginal hysterectomy removes the uterus and any other organs through the vagina, eliminating the abdominal incision. A laparoscopic, or robotic, hysterectomy uses small incisions about the size of a dime that are made near the belly button. A tiny camera is inserted in the incision, enabling the surgeon to see inside and, using small instruments, perform the surgery, which removes small pieces of the uterus through the incisions.

A laparoscopic procedure can be enhanced by using robotic surgery. Tiny incisions are made in the abdomen, but the surgeon performs the operation by using a computer to control the surgical instruments. This improves access to small areas, enhances the surgeon’s view, and allows for steady and precise movements.

The vaginal and laparoscopic/robotic procedures are considered minimally invasive because they have no incisions or only small ones. This means the body has less trauma to heal from. Chances of bleeding are reduced as are pain and the risk of infection. Recovery time for an open incision hysterectomy can last six weeks, but for a minimally invasive procedure, recovery time is about two weeks.

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