Medically review by
Paul Chandler, MD
McLeod Women’s Care

Despite hysterectomy ranking as one of the most common surgeries in this country, many myths or misinformation still surround this procedure.

MYTH #1: It’s Not Always Major Surgery

“Surgical and technological advances have transformed many hysterectomies to minimally invasive procedures, with less pain and faster recovery,” says McLeod Gynecologist Paul Chandler, MD. “Even then, I’ll first try medications or more conservative approaches, because without a uterus, you can’t bear children.”

Gynecologists choose the most appropriate surgical approach from a list of options:

• Abdominal hysterectomy represents the traditional approach and includes a longer recovery time. The surgeon can make a vertical incision or the so-called “bikini cut” horizontal incision. Abdominal hysterectomy, considered the most invasive hysterectomy with the largest recovery, is usually reserved for more difficult cases such as large tumors, severe scarring, or cancers. Hospital stay is 2-3 days with return to work in 4-6 weeks.
• Vaginal hysterectomy involves removing the uterus – and possibly ovaries and fallopian tubes – through the vagina. This method avoids visible scars and leads to a quicker recovery. Hospital stay is overnight in most cases with return to work in 3-4 weeks.
• Laparoscopically-assisted hysterectomy incorporates small incisions, a video camera and long narrow instruments. Either a vaginal or abdominal hysterectomy can use the laparoscopic approach with shorter recovery times and smaller scars. Hospital stay is usually overnight with return to work in 2-3 weeks.
• Robotic hysterectomy uses 3 or 4 small incisions to remove the uterus through the vagina. The gynecologist works at a separate console, viewing the internal organs through a 3-D, magnifying monitor and operating with remote hand controls. Recovery is an overnight stay in the hospital with rapid return to work, often within 2-3 weeks.

MYTH #2: A Hysterectomy is a One-Size-Fits-All Procedure

Different types of hysterectomies involve removal of more or fewer organs.

Partial hysterectomy involves removing only the upper part of the uterus (not including the cervix). This is also called a subtotal or supracervical hysterectomy.

Total hysterectomy includes removal of the uterus and cervix.

Radical hysterectomy is normally recommended when cancer is suspected. Surgery removes the uterus, cervix, fallopian tubes, portions of the vagina and any lymph glands that might be affected. In some cases, surgery also removes the ovaries.

MYTH #3: It’s a Painful, Lengthy Recovery

With laparoscopic surgery, patients experience less pain and some go home the next day. Other patients usually go home from the hospital after 1-3 days. Full recovery can take 2-6 weeks, but most women feel dramatically better after a couple of days to weeks.

MYTH #4: Hysterectomy Causes Menopause

You can have your uterus and cervix removed without triggering menopause. The condition occurs when your ovaries and connected fallopian tubes no longer release eggs and hormones into your body. As long as you retain those organs, your body will not automatically give rise to menopause.

MYTH #5: Only Older Women Face a Hysterectomy

Gynecologists always try to use other treatments until a woman no longer wants to bear children. Younger women suffering from fibroids, abnormal bleeding, endometriosis, pelvic inflammatory disease or pelvic organ prolapse may also face a hysterectomy if other treatments are unsuccessful. Gynecological cancer represents a major health danger and will likely require hysterectomy.

Relatively recently, we often will remove the fallopian tubes to reduce, but not eliminate, the risks of ovarian cancer. Some cases of ovarian cancer actually come from the fallopian tubes.

If the cervix is removed, the risks of cervical cancer are almost eliminated. Total hysterectomy also eliminates the risks of uterine cancer. Removal of the ovaries and fallopian tubes during a hysterectomy dramatically reduces, but does not completely eliminate, the risks of ovarian cancer.

ACTION YOU CAN TAKE

Be sure to see your gynecologist for your annual checkup. Problems can be spotted early and hysterectomy avoided. If your physician recommends a hysterectomy, talk with them about your surgical options.

Find a Gynecologist near you.