Hysterectomy

What is a hysterectomy?

A hysterectomy is an operation in which the uterus is removed. The fallopian tubes and ovaries may also be removed. This depends on the reason for the surgery, the findings during the procedure and the age of the patient.

The gynaecologist can remove the uterus using various surgical methods. An 'abdominal hysterectomy' involves making an incision in the abdomen. A 'vaginal hysterectomy' involves removing the uterus through the vagina. A ‘laparoscopic-assisted hysterectomy' is keyhole surgery through the abdominal wall, after which the uterus can be removed through the vagina.

Reasons for a hysterectomy

fibroid
endometriosis
prolapse
cancer

Before the operation

A number of pre-operative examinations should be done by the GP before the surgery can proceed. The GP will draw blood and conduct a cardiological examination. Depending on your age, a lung X-ray should also be taken. Together with the GP, you will complete a pre-operative file. It is important that you bring this with you on the day you are admitted to hospital.

The day of admission

You need to be fasting on the day of your admission. This means that from midnight, unless otherwise agreed with your gynaecologist, you should not eat or drink anything.
You will report to the Admission Department at the appointed hour. This is where you should state your room choice.
Once in the room, a nurse will join you and go over some questions with you (e.g. any allergies, your medical history and any medications). You need to bring your medication list.
Afterwards, you will be fitted with anti-embolism stockings and given an enema.
Just before being taken to the operating facilities, the surgical area will be shaved.

The operation itself

A hysterectomy is performed under general anaesthesia or 'narcosis'. Usually, a pain pump will also be placed just before anaesthesia via a lumbar puncture. Under general anaesthesia, you will not feel any pain.

You will not wake up until after the operation is over. The operation takes one to two hours, beginning from start to end of the anaesthesia.

Abdominal hysterectomy

The organs are more visible in this case than in a vaginal hysterectomy. When the uterus is very enlarged or there are other problems in the abdominal cavity, abdominal hysterectomy may be preferred. This gives the gynaecologist more room to operate.

An abdominal surgery is usually relatively straightforward, but recovery takes longer because the abdominal muscles are stretched during the procedure.

Vaginal hysterectomy

In a vaginal hysterectomy, the uterus is removed through the vagina. Afterwards, there is only a small scar at the top of the vagina. This surgical technique is well suited for a prolapsed uterus.

The uterus should not be overly enlarged for this approach. With this operation, it is not possible to preserve the cervix.

Laparoscopic-assisted vaginal hysterectomy

With this method, the physician removes the uterus through keyhole surgery.

Sometimes, the uterus is not too large but is insufficiently prolapsed to be removed through the vagina. In this case, laparoscopic uterine removal will be chosen. The gynaecologist makes two to three small incisions of approximately one cm in the abdominal wall. The laparoscope is inserted into the abdomen through one of these incisions. Once the uterus is detached from the surrounding structures, it can be removed through the vagina. Small scars will remain just below the navel, in the groin area and at the top of the vagina. As with vaginal surgery, one of the great advantages of this technique is smoother recovery.

After the operation

In the recovery room, you will be observed for several hours until the anaesthesia wears off. Your IV line and urinary catheter will remain in place for a few days. You will also get a pain pump to prevent pain after your surgery. This will be removed along with the urinary catheter after two days. The first day after surgery, you will remain in bed. From the second day, you will be encouraged to start moving. This is how we try to prevent blood clots from forming. You will remain in hospital for three or four days after surgery. An anatomo-pathological examination is always performed. The gynaecologist will discuss the result of this with you either during your admission or during your check-up afterwards.

Home

The recovery period is highly specific to the individual. On average, you will be fully recovered after a month. Try to rest as much as possible at home because you will be able to cope with less than you think. For the first few weeks, avoid lifting heavy things. If you still have children, family support is not a luxury.

Gradually, you will be able to resume all your activities. The sutures that do not dissolve on their own will be removed after a week. After each operation, an appointment is scheduled for a check-up. The gynaecologist will discuss with you whether further monitoring or treatment is needed.

Leaflet

Centres and specialist areas

General gynaecology

Gynaecological examinations and diseases

Latest publication date: 13/08/2024
Supervising author: Dr Verschueren Eva