Abdominal hysterectomy

What is an abdominal hysterectomy?

An abdominal hysterectomy is a common surgical procedure to remove the uterus (womb). It is performed through an incision in the lower abdomen and is recommended for various medical conditions. This factsheet provides information on abdominal hysterectomy, including why it’s done, the procedure itself, recovery, and potential risks. It is intended to help you understand the procedure and what to expect.

 

Why is an abdominal hysterectomy performed?

An abdominal hysterectomy is typically recommended when other treatments have been unsuccessful or are not suitable. It may be advised for the following conditions:

  • Uterine fibroids: These are non-cancerous growths in the uterus that can cause heavy periods, pelvic pain, and bloating.
  • Endometriosis: This condition happens when tissue similar to the lining of the uterus, which is normally inside the uterus, starts growing outside of it. This can cause pain and other symptoms.
  • Chronic pelvic pain: Persistent pelvic pain that doesn’t respond to other treatments may lead to the recommendation of a hysterectomy.
  • Heavy menstrual bleeding: If other treatments, such as medication or less invasive procedures, fail to control heavy periods, a hysterectomy may be considered.
  • Uterine prolapse: This is when the uterus slips from its normal position and protrudes into the vaginal canal, often causing discomfort and urinary problems.
  • Cancer: A hysterectomy may be necessary if you have cancer of the uterus, cervix, ovaries, or fallopian tubes.

 

What are the types of abdominal hysterectomy?

There are several different types of abdominal hysterectomy including:

  • Total abdominal hysterectomy (TAH):This is when your uterus and cervix are removed.
  • Subtotal abdominal hysterectomy: This is when your uterus is removed but the cervix is left.
  • TAH and BSO: This is when the above procedure is combined with a bilateral salpingo-oophorectomy (BSO). This is the removal or one or both or your ovaries and fallopian tubes.
  • Radical abdominal hysterectomy: This is when the whole womb, cervix, fallopian tubes and ovaries, part of the vagina and some lymph glands are removed. This operation is done for cancer.

 

The procedure: what happens during an abdominal hysterectomy?

An abdominal hysterectomy is performed under general anaesthesia, meaning you will be asleep during the operation. The gynaecologist will make an incision in your lower abdomen, either horizontally just above the pubic hairline (bikini line incision) or vertically from the belly button down to the pubic bone.

Once the incision is made, the uterus is carefully separated from the surrounding tissues and removed. Depending on the reason for the surgery, the gynaecologist may also remove the cervix, ovaries, and fallopian tubes. This will be discussed with you before the surgery, and the type of hysterectomy performed will be tailored to your specific condition.

The incision is then closed with stitches or staples, and you will be moved to a recovery area to wake up from the anaesthesia. The entire procedure usually takes between one and two hours.

 

Recovery after abdominal hysterectomy

Recovery from an abdominal hysterectomy can take several weeks. The hospital stay is typically 2 to 5 days, depending on how quickly you recover and any complications that may arise. During your hospital stay, you will be monitored closely for signs of infection and other potential issues.

 

At home care:

  • Pain management: It is normal to experience some pain and discomfort after the surgery, especially around the incision site. Pain relief will be prescribed to help manage this.
  • Wound care: You will need to keep the incision area clean and dry. You will be given instructions on how to care for your wound.
  • Rest and activity: It is important to rest and avoid strenuous activities, including heavy lifting, for at least 6 weeks. Gradually increase your activity level as advised by your doctor.
  • Follow-up appointments: Attend all scheduled follow-up appointments to ensure your recovery is on track.

 

Returning to normal activities:

  • Work: Depending on your job and how you feel, you may be able to return to work within 6 to 8 weeks.
  • Driving: You should not drive until you feel comfortable and can perform an emergency stop without pain, typically after 3 to 6 weeks.
  • Exercise: Gentle walking is encouraged but avoid more vigorous activities until you have fully recovered.

 

Potential risks and complications

As with any major surgery, an abdominal hysterectomy carries some risks. It is important to be aware of these and discuss them with your gynaecologist before the procedure.

  • Infection: There is a risk of infection at the incision site, in the urinary tract, or within the pelvis.
  • Bleeding: Heavy bleeding during or after surgery may require a blood transfusion.
  • Blood clots: There is a risk of developing blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism).
  • Injury to surrounding organs: The bladder, bowel, or ureters (the tubes that carry urine from the kidneys to the bladder) may be accidentally damaged during surgery.
  • Adhesions: These are bands of scar tissue that can form inside the abdomen after surgery and may cause pain or complications.
  • Early menopause: If your ovaries are removed during the hysterectomy, you will experience menopause immediately, which can result in symptoms such as hot flushes, mood swings, and vaginal dryness.

 

Benefits of an abdominal hysterectomy

For many women, an abdominal hysterectomy can provide significant relief from symptoms associated with their medical conditions. Benefits may include:

  • Resolution of chronic pain: Many women experience a reduction or complete elimination of chronic pelvic pain.
  • Improved quality of life: Conditions like heavy bleeding and fibroids can greatly affect daily life. A hysterectomy can alleviate these symptoms and improve overall well-being.
  • Reduced risk of cancer: In cases where there is a high risk of uterine or ovarian cancer, removing the uterus and ovaries can significantly reduce this risk.

 

Alternatives to abdominal hysterectomy

Before deciding on an abdominal hysterectomy, your gynaecologist will explore other treatment options. These may include:

  • Medication: Hormonal treatments or other medications may help manage symptoms such as heavy bleeding or pain.
  • Less invasive procedures: Procedures such as endometrial ablation (removal of the lining of the uterus) or myomectomy (removal of fibroids) may be alternatives.
  • Lifestyle changes: In some cases, changes in diet, exercise, and stress management may help alleviate symptoms.

 

Why Choose Birmingham Gynaecology Clinic

At Birmingham Gynaecology Clinic, we provide expert care for abdominal hysterectomy procedures. Our experienced gynaecologists use the latest techniques to ensure a safe and effective surgery, with a focus on minimising recovery time and maximising your comfort. We offer personalized care, guiding you through every step of the process, from pre-surgery consultation to post-operative recovery, ensuring you feel supported and informed throughout your journey.

 

Contact Us

If you are considering an abdominal hysterectomy, contact Birmingham Gynaecology Clinic today to schedule a consultation. Our dedicated team is here to provide you with the highest level of care and support.

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