Uterus Removal, Abdominal (Hysterectomy)

What is an abdominal hysterectomy?

An abdominal hysterectomy is a procedure in which the doctor removes the uterus after making a cut in the abdomen. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus.

When is it used?

This operation may be performed because of:

• tumors in the uterus
• consistent bleeding from the uterus
• endometriosis
• endometrial cancer
• chronic pelvic pain
• precancerous or cancerous lesions on the cervix.

Examples of alternatives to this procedure are:

• having a vaginal hysterectomy
• having a vaginal hysterectomy with assisted laparoscopy
• taking medications to control the problem
• choosing not to have treatment, recognizing the risks of your condition.

You should ask your doctor about these choices.

How do I prepare for an abdominal hysterectomy?

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow instructions provided by your doctor. No special preparation is needed for regional anesthesia. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

Your doctor may give you a laxative to take the night before the surgery or an enema the morning before the surgery.

What happens during the procedure?

You will be given a regional or general anesthetic. A regional anesthetic numbs part of your body while you remain awake. It should keep you from feeling pain during the operation. A general anesthetic relaxes your muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain.

An IV will be put in your arm to give you fluids and medications.

The doctor makes a cut in the abdominal wall to expose the ligaments and blood vessels around the uterus. The doctor separates the ligaments and blood vessels from the uterus. The doctor ties off the blood vessels so they will heal and not bleed. Then, the uterus is removed by cutting it off at the top of the vagina. The top of the vagina is repaired so that a hole is not left.

Usually a catheter is inserted to drain your bladder during the night.

What happens after the procedure?

You may stay in the hospital about 3 to 5 days. The IV and catheter are removed 1 or 2 days after the surgery.

Do not do any heavy lifting or otherwise strain the stomach muscles for 4 to 6 weeks. Ask the doctor what other steps you should take and when you should come back for a checkup.

After this operation, you cannot become pregnant. If you have concerns about this, discuss it with your doctor.

What are the benefits of this procedure?

A hysterectomy removes any tumors the doctor finds. It takes care of problems you may have been having with your uterus.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.
• A regional anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Regional anesthesia is considered safer than general anesthesia.
• The sutures may have to be reopened to stop any bleeding.
• Your bladder or the tubes leading to it may be injured and need surgical repair.
• A piece of blood clot may break off, enter your bloodstream, and block an artery in the lung.
• If there is cancer, not all of the tumors may be removed.
• The cancer may recur.
• There is a risk of infection or bleeding.
• The incision may open.
• Your intestine or bowel may be injured during the surgery.

Ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You develop a fever.
• You become dizzy and faint.
• You experience nausea and vomiting.
• You become short of breath.
• You have heavy bleeding from the vagina.
• You have leakage from the incision or the incision opens up.
• You have pain when you urinate.
• You have swelling, redness, or pain in your leg.

Call the doctor during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.