According to the NHS, there are around 300,000 hysterectomies carried out each year and it’s important to know that it’s a major procedure. After the operation you won’t be able to have children and you will no longer have periods.

 The exact procedure will depend on the type of surgery you have agreed to have following discussions with the specialist; this may be an abdominal hysterectomy, a vaginal hysterectomy, or a laparoscopic hysterectomy.

You would normally need to have a hysterectomy for one of the following reasons and when other treatments have been unsuccessful:

Heavy periods

Heavy periods can often be caused by fibroids. These are non-cancerous tumours that grow in or around the womb

Endometriosis

Endometriosis is a condition where cells that line the womb end up in other areas of the body and reproductive system, such as the ovaries, fallopian tubes, bladder and rectum

Pelvic inflammatory disease (PID)

Pelvic Inflammatory Disease is a bacterial infection of the female reproductive system. If detected early it can be treated with antibiotics. However, if it spreads, it can damage the womb and fallopian tubes, resulting in long-term pain

Adenomyosis

This is a common condition where the tissue that normally lines the inside of the womb starts to grow within its muscular wall

Prolapse of the uterus

When a uterus prolapses, the tissues and ligaments that support the womb have become weak, causing it to drop down from its normal position. Symptoms can include back pain, a feeling that something is coming down out of your vagina, leaking urine (urinary incontinence) and difficulty having sex. It can often occur as a result of childbirth

Ovarian cancer or cancer of the womb or cervix

There are various cancers of the female reproductive system including ovarian cancer, womb cancer or cervical cancer.

The type of hysterectomy and root of it will depend why you’re having this done and this will be discussed with your Consultant.

Subtotal hysterectomy

A subtotal hysterectomy involves removing main body of the womb and leaving the cervix in place. This type of procedure is not performed very often. If the cervix is left in place, there’s still a risk that cervical cancer can develop, so regular cervical screening will still be needed.

Some women will want to keep as much of their reproductive system as possible, including their cervix. If you feel this way, talk to your Consultant about any risks associated with keeping your cervix.

Total hysterectomy with bilateral salpingo-oophorectomy

A total hysterectomy with bilateral salpingo-oophorectomy is a hysterectomy that involves removing:

• The fallopian tubes (salpingectomy)
• The ovaries (oophorectomy)

The National Institute for Health and Care Excellence (NICE) recommends that ovaries should only be removed if there’s a significant risk of further problems, for example, if there’s a family history of ovarian cancer.

Your Consultant can discuss the pros and cons of removing your ovaries with you.

Laparoscopic hysterectomy

Laparoscopic hysterectomy surgery is also known as keyhole surgery. It’s the preferred way to remove organs and surrounding tissues of the reproductive system.

During the procedure, a small tube containing a telescope (laparoscope) and a tiny video camera will be inserted through a small cut (incision) in your tummy. This will allow your surgeon to see your internal organs. Instruments are then inserted through other small incisions in your abdomen or vagina to remove your womb, cervix and any other parts of your reproductive system.

Laparoscopic hysterectomies are usually carried out under general anaesthetic.

Vaginal hysterectomy

During a vaginal hysterectomy, the womb and cervix are removed through an incision that’s made at the top of the vagina. Special surgical instruments are inserted into the vagina to detach the womb from the ligaments that hold it in place. After the womb and cervix have been removed, the incision will be sewn and the operation will normally take about an hour to completed.

A vaginal hysterectomy can be carried out using either:

• General anaesthetic: where you’ll be unconscious during the procedure
• Local anaesthetic: where you’ll be awake, but you may feel some pain, each person is different

A vaginal hysterectomy is usually preferred over an abdominal hysterectomy as it’s less invasive and involves a shorter stay in hospital. The recovery time also tends to be quicker.

Abdominal hysterectomy

During an abdominal hysterectomy, an incision will be made in your tummy (abdomen). It will either be made horizontally along your bikini line or vertically from your belly button to your bikini line.

A vertical incision will usually be used if there are large fibroids (non-cancerous growths) in your womb or for some types of cancer. After your womb has been removed, the incision will be stitched up. The operation will normally take about an hour to perform and a general anaesthetic will be used.

An abdominal hysterectomy may be recommended if your womb is enlarged by fibroids or pelvic tumours and it’s not possible to remove them through your vagina. It may also be recommended that your ovaries need to be removed.

Depending on the reason for your treatment, one of several different types of hysterectomy may be recommended.

After a hysterectomy we’ll help manage any pain or discomfort with painkillers. Depending on the exact nature of your operation, you may need to stay in hospital for up to 48 hours after the operation.

Hysterectomy recovery time will vary, but in all cases you’ll need to rest for a couple of weeks, avoid any heavy lifting and try not to become constipated throughout your recovery. You may not be able to drive for 4-6 weeks. If your ovaries are removed during the operation you may need to start hormone replacement therapy (HRT).

Overall, recovery time is usually shorter if you’ve had a vaginal or laparoscopic hysterectomy. Two to three months is the expected time to fully recover from this surgery, following which you should be able to resume your normal, active and unrestricted lifestyle.