UNDERSTANDING HYSTERECTOMY
Q: What is hysterectomy?
A: A hysterectomy is the removal of the uterus and the cervix. Sometimes, hysterectomies are done leaving part or all of the cervix. This is called a supracervical hysterectomy.
Q: Will my ovaries and Fallopian tubes be removed also?
A: Having a hysterectomy does not necessarily mean that the ovaries and tubes will also be removed. The term “hysterectomy” refers only to the removal of the uterus and cervix.
Q: Why do I need a hysterectomy?
A: The specific reason for your hysterectomy should be discussed with your physician. There are many reasons for having a hysterectomy, some of which are endometriosis, fibroid tumors, abnormally heavy bleeding unresponsive to medication, precancerous or cancerous cells in the uterus, pelvic adhesions, chronic infection or defects in the support of the uterus.
Q: How will the hysterectomy be done?
A: The uterus and cervix can be removed either through an abdominal or vaginal incision. The specific method of surgery best for you will be determined by your physician and then discussed with you.
Q: Will I have to take hormones after my hysterectomy?
A: The ovaries are the organs that produce hormones, not the uterus and the cervix. Therefore, hormone replacement will only be necessary if the ovaries are removed along with the uterus and cervix, or if you were already on hormones before your hysterectomy. If your uterus and cervix are removed, your ovaries, if left in place, will continue to produce hormones until you reach menopause (which is generally around age 50). At that time, we recommend that you begin taking hormones to protect your bones and tissues.
Q: Will having a hysterectomy cause symptoms of menopause?
A: No. Only if your ovaries are removed or nonfunctional, will you have symptoms of menopause. You will, however, cease to menstruate.
Q: Will having a hysterectomy change my personality or cause weight gain?
A: No to both questions.
Q: Will having a hysterectomy harm my sex life?
A: Some women may notice a change in their sexual response after a hysterectomy. Because the uterus has been removed, uterine contractions that may have been felt during orgasm will no longer occur. Some women have a heightened response, however. In part, this is because they no longer have to worry about getting pregnant and may be relieved of discomfort. Vaginal dryness may be a problem during sex. Use of a lubricant can help to relieve this dryness.
Q: Will I still have periods?
A: No. A “period” occurs when the lining of the uterus is shed because of hormonal changes. Without a uterus, there is no lining to be shed each month.
Q: Will I have excess hair growth because of my hysterectomy?
A: No.
Q: Are there alternatives to a hysterectomy?
A: Alternative treatments are available for some women and may consist of hormonal therapy, treatments to the inside lining of the uterus or simply tolerating troublesome symptoms.
Q: What are the possible surgical complications from having a hysterectomy?
A: Most surgical complications that could be experienced are the same as those from other types of surgery. Reactions to drugs, anesthetics or blood transfusions can occur. Blood clots can occur. Infection can occur after surgery. Injury to adjacent organs, such as the bladder or rectum, can occur. Possible risks are discussed more fully in another handout, which we have given you. A hysterectomy is recommended when the anticipated benefits outweigh the possible risks.
Q: What can I expect after surgery?
A: Immediately after surgery, you can expect an intravenous line (IV) and a urinary catheter in most cases. The IV and catheter are usually removed the first day after surgery. If you are having bladder surgery as well, the catheter will be left in for a longer period of time. Pain medication will be ordered for you. You must ask the nurses for the pain medication. We will want you to get out of bed the first day after surgery and will want you to take good, deep breaths to prevent complications.
If your hysterectomy is done abdominally, you can expect an abdominal incision. Your stitches will be removed about three days after surgery. If your hysterectomy is done vaginally, your stitches are inside your vagina and will gradually be absorbed by the body.
Regardless of which type of hysterectomy you have, you should plan to take it very easy for the first two weeks after surgery. Two to four weeks after surgery, you can gradually build up to almost normal activities and six weeks after surgery, you can resume normal activities, including sexual intercourse. We will see you back in the office at approximately two weeks after surgery and again six weeks after surgery.
This has been a list of some of the most frequently asked questions about hysterectomy. If you have others or are unclear about these, please feel free to call us. We want you to feel comfortable about your decision to have a hysterectomy.