Overview
An abdominal hysterectomy is an operation that removes the uterus through a cut in the lower belly, also called the abdomen. This is known as an open procedure. The uterus, also called the womb, is where a baby grows when someone is pregnant. A partial hysterectomy removes the uterus, leaving the neck of the womb in place. The neck of the womb is the cervix. A total hysterectomy removes the uterus and the cervix.
A hysterectomy also can be done through a cut in the vagina. This is called a vaginal hysterectomy. Or you may have laparoscopic or robotic surgery, which uses long, thin instruments passed through small cuts in the belly.
You may need an abdominal hysterectomy instead of other types of hysterectomy if:
- You have a large uterus.
- Your healthcare provider wants to check other pelvic organs for signs of disease.
- Your surgeon feels it’s in your best interest to do the surgery as an open procedure.
Why it’s done
You may need a hysterectomy to treat:
- Cancer. If you have cancer of the uterus or cervix, a hysterectomy may be the best treatment option. Depending on the specific cancer and how advanced it is, other treatment options might include radiation or chemotherapy.
- Fibroids. A hysterectomy is the only certain, lasting fix for fibroids. Fibroids are tumors that grow in the uterus. They are not cancer. They can cause heavy bleeding, anemia, pelvic pain and bladder pressure.
- Endometriosis. Endometriosis is a condition where tissue that’s similar to tissue lining the inside of the uterus grows outside the uterus. The tissue may grow on the ovaries, fallopian tubes and other nearby organs. For severe endometriosis, a hysterectomy may be needed to remove the uterus along with the ovaries and fallopian tubes.
- Uterine prolapse. When pelvic floor muscles and ligaments stretch and weaken, there may not be enough support to keep the uterus in place. When the uterus moves out of place and slips into the vagina, it’s called uterine prolapse. This condition can lead to urine leakage, pelvic pressure and problems with bowel movements. A hysterectomy is sometimes needed to treat this condition.
- Irregular, heavy vaginal bleeding. If your periods are heavy, don’t come at regular intervals or last many days each cycle, a hysterectomy may bring relief. A hysterectomy is done only when the bleeding can’t be managed by other methods.
- Chronic pelvic pain. Surgery may be needed as a last resort if you have chronic pelvic pain that starts in the uterus. But a hysterectomy doesn’t fix some forms of pelvic pain. Having a hysterectomy that you don’t need may create new problems.
- Gender-confirmation surgery. Some people who wish to better align their bodies with their gender identities choose to have hysterectomies to remove the uterus and cervix. This type of surgery also might include removing the ovaries and fallopian tubes.
After hysterectomy, you can no longer get pregnant. If there’s a chance you might want to become pregnant in the future, ask your health care provider about other treatment options. In the case of cancer, a hysterectomy might be your only option. But for conditions such as fibroids, endometriosis and uterine prolapse, there may be other treatments.
During hysterectomy surgery, you might have a related procedure to remove the ovaries and the fallopian tubes. If you’re still having periods, removal of both ovaries leads to what’s known as surgical menopause.
With surgical menopause, menopause symptoms often begin quickly after having the procedure. Short-term use of hormone therapy can help ease symptoms that really bother you.
