The MenopauseRx Hysterectomy Guide

Types of Hysterectomy

The hysterectomy procedure has changed over time. With the advent of newer surgical tools and techniques, the procedure can often be done in a manner that allows much quicker recovery time with less discomfort.

Abdominal Hysterectomy:

The traditional Abdominal Hysterectomy involves making an incision in the lower abdomen. This incision can vary in size and direction. The majority are horizontal in the ‘bikini line’. This type of hysterectomy allows the surgeon full access to the pelvic cavity, and is often done when there is concern of significant pelvic adhesions or when other, more conservative, types of hysterectomy cannot be done. The entire cervix and uterus (total) or uterus alone (supra-cervical) type of hysterectomy can be done with this approach. This type of hysterectomy is often associated with a longer recovery period due to healing time from the incision. The hospital stay is usually 2-3 days. Usually, four to six weeks is needed to heal completely from an abdominal hysterectomy.

Vaginal Hysterectomy:

A Vaginal Hysterectomy is commonly done to remove the uterus entirely from the vagina through an incision at the top of the vagina. Often, this type of hysterectomy is done for pelvic relaxation or prolapsed. The entire cervix and uterus (total) is removed with this type of hysterectomy. The advantage of a vaginal hysterectomy is that an abdominal incision is not necessary. The disadvantage is that the entire pelvic and abdominal cavity cannot be fully visualized. Therefore, it may be more difficult to fully visualize or remove the tubes and/or ovaries. The hospital stay is usually 1-2 days. The recovery time for a vaginal hysterectomy is generally 2-4 weeks.

Minimally Invasive Hysterectomies:

Minimally Invasive Hysterectomies are relatively new techniques. In general, these types of hysterectomies involve the use of a scope (laparoscopy or‘belly button’ surgery) to help guide the surgeon. Women who have a minimally invasive hysterectomy often experience faster recovery, shorter hospital stays, and less pain and scarring than women who have a total abdominal hysterectomy. A Laparoscopic Assisted Vaginal Hysterectomy (LAVH) involves starting the hysterectomy via 2-4 small, 1 centimeter incisions in the abdomen and removing the uterus from the vagina. The procedure is completed from the vagina. A Laparoscopic Supra-cervial Hysterectomy (LSH) involves removing the uterus, while retaining the cervix. The entire procedure is done through the small abdominal incisions.  Finally, a Total Laparoscopic Hysterectomy (TLH) removes the entire uterus and cervix through the small abdominal incisions. All of these minimally invasive hysterectomies allow a much quicker recovery with usually less discomfort. In general, patients are able to leave the hospital the same day or the next day and are able to return to work within 1-2 weeks. There are many reasons why a surgeon would decide to perform one type of minimally invasive hysterectomy versus another. While these types of hysterectomy are associated with quicker recovery times, they require advanced training and surgical skill by the surgeon. It is very important to talk to your doctor about the option of a minimally invasive hysterectomy and his/her experience with these types of hysterectomy. If they do not have the training or expertise, they would be able to refer you to a surgeon who is capable of performing these types of hysterectomy.

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