Abdominal Hysterectomy

What Is an Abdominal Hysterectomy?

An abdominal hysterectomy is a surgery to remove a woman’s uterus. The surgeon may remove both the uterus and the cervix as part of a total abdominal hysterectomy or may perform a subtotal hysterectomy and remove the uterus only, and leave the cervix in place, or it may be necessary to perform an abdominal hysterectomy with salpingo-oophorectomy, which removes the ovaries, fallopian tubes, uterus, and the cervix. The determining factor for how much is removed is based on the individual diagnosis. This surgery is performed through an incision in the abdomen and is normally done under general anesthesia.

Why Would an Abdominal Hysterectomy Be Performed?

There are many women’s health issues that may cause doctors to recommend hysterectomy surgery. Abdominal hysterectomy surgery may be used to address:

• Benign fibroid tumors – #1 reason for women to undergo hysterectomy;
• Cancer of the cervix, uterus, ovaries, or endometrium;
• Endometriosis;
• Adenomyosis;
• Prolapsed uterus – the uterus is migrating down into the vaginal area;
• Endometrial hyperplasia.

Gynecological cancer should be the only indication for hysterectomy as the only option, while other conditions may be treated with non-invasive or less invasive alternatives, and hysterectomy should be the last treatment option.

Who Is a Candidate For an Abdominal Hysterectomy?

There are a few different surgical techniques to peform hysterectomy surgery: abdominal, laparoscopic, robotic, and vaginal. Your doctor may recommend an abdominal hysterectomy, if you have a large uterus, or if there is a need to do exploration of other nearby organs while removing the uterus.

For patients with uterine fibroids, doctors often suggest abdominal hysterectomy. Do ask for a second opinion if you are offered any type of hysterectomy for uterine fibroids.

What to Expect From Abdominal Hysterectomy?

Abdominal hysterectomy surgery is most often performed under general anesthesia so the patient is asleep during the procedure. The surgery will be performed through a cut that is normally made above the pubic hairline that is approximately 10 cm in length. There are some cases where the cut will run vertically from the belly button down to the pubic hairline. The surgery traditionally lasts between 1 and 2 hours, then the patient will spend a few hours in the recovery room, and then moved to a regular hospital room. A 2-3 day hospital stay is normal for an abdominal hysterectomy.

Recovery from Abdominal Hysterectomy Surgery

After the surgery, a few hours will be spent in the recovery room while recuperating from the effects of the anesthesia. Some women experience nausea or vomiting after general anesthesia.

You can expect:

• Some pain after the procedure that will be alleviated by IV pain medication while you are in recovery.
• To be moved to a hospital room after you have met a few required milestones in recovery.
• To be encouraged to get up and walk to help prevent blood clots from forming and causing complications.
• To be sent home with a prescription for pain medication, antibiotics, wound care instructions, and aftercare directives from your surgeon.
• Bleeding and discharge from the vagina for several days to a few weeks.
• Instructions on do’s and don’ts during recovery for example: do not lift anything heavy until you are cleared to do so. This may mean your little ones, so acquiring help during the recovery period may be necessary.
• No immersed bathing for the recovery period, showers only.
• To be instructed to refrain from having intercourse for six weeks.

The recovery time for an abdominal hysterectomy is unique to each patient, depending on the circumstances, but is typically between six to eight weeks.

Risks and Side Effects of Abdominal Hysterectomy:

• Adverse reaction to the anesthesia;
• Infection;
• Bleeding;
• Damage to bladder or other nearby organs;
• Potential deep vein thrombosis – blood clots that can form in the legs and migrate to the lungs;
• Can cause early onset of menopause – hot flashes, vaginal dryness;
• May require hormone therapy – can cause other cancers;
• Loss of ability to become pregnant;
• Long recovery process;
• Increased risks of osteoporosis – bone loss;
• Increased cardiovascular risks.

Uterine Fibroid Embolization vs. Abdominal Hysterectomy

Research shows that heavy bleeding caused by uterine fibroids is the most frequently listed reason for a hysterectomy. But what if there was an option that did not include surgery or giving up your uterus, being pushed into early menopause, or sacrificing your fertility completely? If your hysterectomy diagnosis stems from uterine fibroids there is good news!

Uterine Fibroid Embolization (UFE) is a non-surgical procedure that is 90% effective in getting rid of fibroid symptoms, including heavy bleeding. With a very low-risk factor, it shrinks and destroys all the fibroids by blocking the blood flow that is feeding them and making them grow.

Many women have said that UFE gave them their quality of life back and that their only regret was not doing it sooner. UFE has a recovery time of a little over a week compared to the 6-8 week recovery from an abdominal hysterectomy. Many women have become pregnant and had children after UFE which would not have been possible after an abdominal hysterectomy.

If you have been diagnosed with uterine fibroids and have been told you need to have a hysterectomy or robotic hysterectomy, please contact the Atlanta Fibroid Center at 770-214-4600 or make an appointment online to see if you are a candidate for UFE.