Hysterectomy

What is hysterectomy and what are the reasons for having one?

Hysterectomy is an operation during which the uterus (womb) is removed. This may be necessary for many reasons, which range from common problems like fibroids (benign tumours of the uterus) or a prolapse ('dropped womb') to rare problems like cancer of the uterus or ovaries.
What happens during a hysterectomy?

The uterus can be removed either through an incision in the stomach (which is called an abdominal hysterectomy), or through the vagina (a vaginal hysterectomy). An abdominal hysterectomy can be carried out using a horizontal cut along the bikini line or a vertical cut starting near the navel. The most common type of operation is an abdominal hysterectomy with a bikini-line scar.
During the procedure, the gynaecologist usually takes away the entire uterus, including the fallopian tubes (tubes from the uterus to the ovary) and the cervix (the neck of the uterus). Whether or not the ovaries are removed depends on the reason for the operation and whether you have passed the menopause. Your gynaecologist will discuss this with you.


What happens before a hysterectomy?

If you smoke, try to stop for at least 48 hours before the operation. Before having your operation, you may be advised to lose weight if you are particularly overweight.
What should I expect at the hospital?

Before surgery, you will have an assessment to make sure you are well enough to undergo the operation. This may be done at a special clinic a few days before the date of your operation or it may be done on the day you are admitted. The doctor asks you questions about your medical history, performs a general examination and may arrange a blood test, an ECG (electrical tracing of the heart) and a chest X-ray. You are asked to sign a consent form to say that you understand the operation and have given your permission for it to be carried out.
You must tell the doctor if you have ever had any allergic reactions to drugs in the past. The doctor also needs to know about any medications you are currently taking.
You are not allowed anything to eat or drink for at least six hours before the operation and you are given a mild laxative to empty the bowel.
A hysterectomy is carried out under a general anaesthetic (you will be asleep). The operation usually takes one to two hours. You wake up in the recovery room and the nurse takes you back to the ward when you are fully awake. There will be a drip in your arm and you will have a catheter tube draining the urine from the bladder and a sanitary towel to collect any bleeding. What are the possible common complications of a hysterectomy?

After having a catheter some women experience a slight bladder infection. It is usual to be mildly constipated.
Infections of the wound or in the abdomen can occur, which need treatment with antibiotics. Occasionally, old blood collects at the top of the vagina (a haematoma) and needs to be released with a minor operation.
Chest infections and thromboses (clots in the veins in the legs) are possible complications of any operation; these are more common if you smoke or are very overweight.