Uterine Fibroids and Hysterectomy - Surgery

Highlights	Diagnosis	Resources
Introduction	Treatment	References
Risk Factors	Medications	Resources
Complications	Surgical Alternatives to Hysterectomy	References
Symptoms	Hysterectomy

Hysterectomy

Hysterectomy is the surgical removal of the uterus. The ovaries may also be removed, although this is not necessary for fibroid treatment. Hysterectomy is a permanent solution for fibroids, and is an option if other treatments have not worked or are not appropriate.

A woman cannot become pregnant after having a hysterectomy. If the ovaries are removed along with the uterus, hysterectomy causes immediate menopause.

Types of Hysterectomies

Once a decision for a hysterectomy has been made, the patient should discuss with her doctor what will be removed. The common choices are:

Total hysterectomy (removal of uterus and cervix).
Subototal, also called supracervical hysterectomy (removal of uterus and preservation of the cervix).
Oophorectomy (removal of an ovary). Bilateral oopherectomy is the removal of both ovaries. Bilateral salpingo-oophorectomy is the removal of the fallopian tubes and ovaries). These procedures can be performed with either total or supracervical hysterectomy.

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Types of Hysterectomy Procedures

Hysterectomy procedures include:

Abdominal hysterectomy
Vaginal hysterectomy
Laparoscopically assisted vaginal hysterectomy (LAVH)
Laparoscopic hysterectomy
Robotic hysterectomy

Abdominal Hysterectomy. Abdominal hysterectomy is the standard procedure. It is best suited for women with large fibroids, when the ovaries need to be removed, or when cancer or pelvic disease is present. The surgeon makes a 5-inch to 7-inch incision in the lower part of the belly. The cut may either be vertical, or it may go horizontally across the abdomen, just above the pubic hair (a bikini cut). The bikini cut incision heals faster and is less noticeable than a vertical incision, which is used in more complicated cases. The patient may need to remain in the hospital for 3 - 4 days, and recuperation at home takes about 4 - 6 weeks.

Vaginal Hysterectomy, LAVH, and Laparoscopic Hysterectomy. Vaginal hysterectomy requires only a vaginal incision through which the uterus is removed. The vaginal incision is closed with stitches.