What is hysterectomy?

There are three major types of hysterectomy. Total hysterectomy removes the uterus and cervix. Supracervical (subtotal) hysterectomy removes just the uterus. Radical hysterectomy removes the uterus, cervix, part of the vagina, and some surrounding tissues. Which type you have depends on the reason for the surgery.

Hysterectomy poses some risks of major and minor complications. But most people don't have these problems after the surgery.

Your risk of problems after surgery may be higher or lower than average. This may depend in part on your overall health and how experienced the surgeon is.

Complications after the surgery include:

• Heavy blood loss.
• Bladder or bowel injury.
• Blood clot to the lung.
• Infection.

Possible ongoing problems include:

• Trouble urinating. This is more common after removal of lymph nodes, ovaries, and structures that support the uterus (radical hysterectomy).
• Weakness of the pelvic muscles and ligaments that support the vagina, bladder, and rectum.
• Early menopause if your ovaries are removed.
• Scar tissue (adhesions) in the pelvic area.

A hysterectomy is surgery to take out the uterus. This is the organ in the lower belly where a fetus can grow during pregnancy.

Oophorectomy is surgery to take out one or both ovaries. These are the glands that store and release eggs. They also make sex hormones.

Sometimes the uterus and ovaries are taken out at the same time. And in some cases, one or both of the fallopian tubes are removed too.

Sometimes there is a health reason to have your ovaries removed. Maybe you have a tumor on an ovary. Or maybe you're at high risk for breast or ovarian cancer. You may be able to choose whether to have one, both, or part of your ovaries removed based on what you prefer and your health condition. Talk to your doctor about your options.

Some reasons to have your ovaries removed

• It almost always prevents cancer of the ovaries. This cancer isn't common. But it's something that you may want to think about.
• You won't need surgery later for problems with your ovaries. For instance, sometimes growths happen on the ovaries later in life. This doesn't happen very often. But it won't happen to you if you don't have ovaries.
• If you are having gender-affirming surgery, you may choose to have your ovaries removed.

Some reasons to keep your ovaries

• You want to use your eggs for a future pregnancy. Talk to your doctor about your options if you plan to have both ovaries removed and want to use your eggs for a possible pregnancy in the future.
• You can avoid sudden menopause. This happens if you haven't gone through menopause yet when your ovaries are removed. It can cause symptoms like hot flashes and vaginal dryness. But you can take medicines for these symptoms.
• Your bones may stay strong. Having your ovaries removed may lead to more fragile bones. But you can take medicine to prevent this.
• Having your ovaries removed may raise your risk for some long-term health problems, such as heart disease and stroke. These risks may be higher for people who have their ovaries removed when they are younger. The benefits of keeping your ovaries go down as you age. Talk to your doctor about what's best for you.

You might go home the day of your hysterectomy or stay in the hospital for several days. Recovery can take 4 to 6 weeks. It depends on which type of surgery you have and your overall health. You will have to take it easy for a few weeks and avoid heavy lifting.

There are many different ways to do hysterectomy surgery. The most common procedures are:

Abdominal hysterectomy.

In this procedure, the doctor makes a cut in your belly. The doctor takes out the uterus through this cut.

Vaginal hysterectomy.

The doctor takes out the uterus through your vagina. The doctor makes a small cut in the vagina instead of the belly.

Laparoscopic hysterectomy.

The doctor puts a lighted tube (laparoscope) through small cuts in your belly. The doctor can see your organs with the scope. The doctor can insert surgical tools to remove the uterus through the belly or the vagina.

Most often, a hysterectomy is done to treat problems with the uterus. These problems include pain and heavy bleeding caused by endometriosis or uterine fibroids. The surgery may also be needed if there is cancer in the uterus, cervix, or ovaries. And it may be done as life-saving surgery if there is heavy bleeding during childbirth that can't be stopped.

In most cases, hysterectomy is an elective surgery. You can choose to have it to treat noncancerous female reproductive system conditions that haven't improved with medical treatment. If you don't plan to get pregnant and have tried other treatment options without success, it may be a reasonable treatment choice.

Other reasons for hysterectomy include:

• Heavy menstrual bleeding.
• Pelvic organ prolapse.
• Adenomyosis.
• Chronic pelvic pain. (But surgery is done only when the pain is caused by a diagnosed condition that can be corrected with a hysterectomy.)
• A severe infection of the uterus.
• Gender-affirming surgery.

Sometimes there is a health reason to have your ovaries removed. Maybe you have a tumor on an ovary or are at high risk for breast or ovarian cancer. You may be able to choose whether to have one, both, or part of your ovaries removed based on what you prefer and your condition.