What kinds of hysterectomy are there?
There are different types of hysterectomy operations:
- Total hysterectomy is the operation in which your uterus and cervix are removed. The ovaries are usually left. However, if they are removed this is called a bilateral salpingo-oophorectomy (BSO).
- Subtotal hysterectomy is when your uterus is removed but the cervix is left.
- Radical hysterectomy (also called Wertheim's hysterectomy) is when the whole womb, cervix, fallopian tubes and ovaries, part of the vagina and lymph glands are removed. This operation is done for cancer.
The uterus may be removed either through a cut in the abdomen (usually leaving a scar in the bikini area) or through the vagina, which means you will not have a visible scar. Sometimes the hysterectomy is done by removing the uterus through the vagina and also with using keyhole surgery. Small cuts are made in the abdomen for tools and a telescope to pass through, which help to free the uterus, making it then easier to remove through the vagina. It is worth discussing the way the operation is to be done with your gynaecologist.
Will my ovaries be removed?
Your doctor may remove your ovaries at the same time. The decision to remove your ovaries depends on the reason for doing the hysterectomy. You should discuss the pros and cons of removing the ovaries during a hysterectomy with your gynaecologist. Current recommendations are that removal of healthy ovaries at the time of hysterectomy should not be undertaken.
Removing the ovaries at the time of hysterectomy reduces the risk of ovarian cancer. However, women who have had their ovaries removed have also been found to have an increased risk of developing heart conditions (like angina).
If your ovaries are removed, you may be advised to take hormone replacement treatment (HRT) as once your ovaries are removed you will go through the menopause. If you are under 50 years old and have your ovaries removed then you should discuss with your doctor about taking HRT. All women under the age of 50 years benefit from taking HRT without being exposed to the risks of HRT (any risks of HRT are only relevant for women over the age of 50 years).
If your ovaries are not removed, you still have a 1 in 3 chance of going through the menopause within two years of having the hysterectomy. If you experience symptoms which may be related to the menopause, for example hot flushes, mood swings, etc then you should discuss these symptoms with your doctor.
Will having a hysterectomy affect my sex life?
Removing your uterus should not stop you having a good sex life after the operation. In fact, many women report an improvement in their sexual pleasure after having a hysterectomy. This may be because the reason for having a hysterectomy (pain, prolonged heavy bleeding, etc) is removed. However, some women feel that a hysterectomy impairs their sex life. In particular, some women feel that their orgasm is different after a hysterectomy or even have difficulty reaching orgasm. Having a hysterectomy should not affect your sex drive (libido) unless your ovaries are also removed.
See the paper by Roovers (cited at the end) and the large amount of correspondence that this paper received to get a flavour of the issues and opinions surrounding the topic of sex following a hysterectomy.
You can usually begin to have sex again about 6 weeks after the operation. You obviously will no longer need to use any form of contraception after a hysterectomy.
How will I feel straight after the operation?
You will be given strong painkillers for the first few days, both whilst in hospital and also to take home with you. You will be able to eat and drink within a few hours of having the operation. You are likely to have a catheter (a thin tube going into your bladder which drains urine) in for a couple of days or so. It is very common to have some light bleeding from the vagina, which can last for up to six weeks. If you have any stitches then they are usually removed between 5 and 7 days after your operation.
Average rating:
lisa burke, about 1 year
i am due to have a hystectomy soon but my husband is a bit dubius and thinks i am over exagurating about some things is it true i cannot lift a kettle or anything heavy .
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