Procedure definition

A hysterectomy is the surgical removal of the uterus (womb). Depending on the condition, it may also include removal of the cervix, fallopian tubes, or ovaries. Once performed, menstruation stops and pregnancy is no longer possible.

There are several approaches:
• Vaginal hysterectomy: The uterus is removed through the vagina without any external incision.
• Laparoscopic or robotic hysterectomy: Small incisions are made in the abdomen to insert a camera and instruments; the uterus is removed in sections.
• Abdominal (open) hysterectomy: A larger incision (4–6 inches) in the lower abdomen is made for removal.

Minimally invasive techniques have become the standard because they reduce pain, hospital stay, and recovery time. Surgery usually lasts 1–3 hours, depending on anatomy and complexity.

Why it’s done

Hysterectomy is performed for non-cancerous gynecologic problems such as:
• Uterine fibroids—benign growths causing pain or heavy bleeding.
• Abnormal uterine bleeding unresponsive to medication.
• Endometriosis or adenomyosis causing chronic pelvic pain.
• Pelvic organ prolapse (uterus dropping into the vagina).
• Chronic pelvic infection or benign ovarian tumors (in some cases).
Less commonly, it may be part of treatment for early uterine or cervical cancer.

Doctors usually try conservative treatments first, such as medication, hormonal therapy, or uterine-sparing procedures (fibroid removal or endometrial ablation). Hysterectomy becomes appropriate when these fail or when the uterus itself is the disease source.

Risks & complications

Overall complication rate: 3–15%, depending on surgical route and patient health.

Typical complications include:
• Bleeding requiring transfusion: 1–2%.
• Infection: 2–5% (lower in laparoscopic/vaginal).
• Injury to urinary tract (bladder/ureter): 0.2–1%.
• VTE (blood clots): 0.2–0.5%.
• Conversion from laparoscopic to open: 1–3%.
• Chronic pelvic pain or dyspareunia: <5%.
• Mortality: <0.1% in elective benign cases.

Long-term effects may include earlier menopause if ovaries are removed, and potential mood or sexual function changes, though many women report improved quality of life when prior symptoms resolve.

Recovery

Hospital stay: 1–2 days for laparoscopic or vaginal; 2–3 days for open abdominal.

Activity: Most patients walk the same day. You can do light household activities in a few days, return to desk work in 2–3 weeks (laparoscopic/vaginal) or 6–8 weeks (open). Avoid lifting >10 lbs and abstain from vaginal intercourse for 6 weeks.

Pain & wound care: Mild soreness and fatigue are common; managed with oral pain medication. Keep incisions clean and dry.

Diet & bowel care: Resume normal diet as tolerated; stool softeners prevent constipation.

Follow-up: A postoperative visit is usually scheduled in 2–3 weeks to check healing. Most women feel fully recovered by 6–8 weeks.

Surgeon types

Performed by Obstetrician-Gynecologists (OB-GYNs). Complex cases—severe endometriosis, multiple prior surgeries, or pelvic organ prolapse—may be handled by minimally invasive gynecologic surgeons (MIGS) or urogynecologists.

Outcomes and recovery are best in experienced hands; vaginal and laparoscopic approaches are preferred whenever feasible.

Sources

1. American College of Obstetricians and Gynecologists (ACOG): “Choosing the Route of Hysterectomy for Benign Disease.”
2. ACOG FAQ: “Hysterectomy—What to Expect.”
3. Cochrane Review (2015): Minimally invasive vs. abdominal hysterectomy—less pain, faster recovery.
4. NIH MedlinePlus: “Hysterectomy.”
5. JAMA Surgery (2018): Complication rates by approach and surgeon volume.