Hysterectomy

Hysterectomy is a surgical procedure to remove the womb (uterus) which is carried out to treat conditions that affect the female reproductive system, including:

• heavy periods (menorrhagia)
• long-term pelvic pain
• non-cancerous tumours (fibroids)
• ovarian cancer, uterine cancer, cervical cancer or cancer of the fallopian tubes.

There are different types of hysterectomy & the type performed will depend on the reason for the surgery and how much of the womb and reproductive system can safely be left in place.

• Total hysterectomy, where the womb and the cervix are removed
• Subtotal hysterectomy, where the womb is removed but the cervix is left in place – this can often be done with keyhole surgery
• Radical hysterectomy, where the cervix and surrounding tissues including the womb and part of the vagina are removed

• Vaginal where the womb is removed through the vagina
• Abdominal where the womb is removed through a cut in the abdomen
• Laparoscopic where a few small incisions are made in the abdomen & the womb is removed through one of these. 

If it possible for a hysterectomy to be performed laparoscopically it has significant advantages over a vaginal or abdominal hysterectomy i.e.

• Less Blood loss
• Less pain after the operation
• Faster recovery time (1-2 weeks instead of 4-6)
• Minimal scarring.

The ovaries are usually left in place because they produce oestrogen. If the ovaries are removed this will induce the menopause.  After a hysterectomy, you will no longer have periods or be able to become pregnant.

• Heavy or irregular bleeding that has not got better with medication
• Bleeding in-between periods
• Bleeding after your menopause
• Irregular bleeding whilst you are taking hormone replacement therapy (HRT)
• Unexplained miscarriages

• fibroids – non-cancerous growths that can develop inside the womb and can sometimes cause symptoms such as pain and heavy periods
• polyps – small growths that develop on the lining of the womb and can cause irregular and heavy periods
• intrauterine adhesions – which are sections of scar tissue that can cause absent periods and infertility

Laparoscopy is a minimally invasive procedure that allows access to the inside of the abdomen and pelvis without having to make large incisions in the skin. It can be used to either diagnose a condition, or to allow treatment. The advantages of this technique over traditional open surgery are that there is a faster recovery time, less pain after the operation and minimal scarring.

• diagnose and treat endometriosis
• diagnose and treat pelvic inflammatory disease
• remove scar tissue (adhesions)
• treat an ectopic pregnancy
• carry out female sterilisation
• remove an ovarian cyst
• remove the womb (hysterectomy) or ovaries (oophorectomy)
• treat fibroids