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The uterus is joined at the cervix to the vagina. The fallopian, or uterine, tubes lead to the ovaries.
A hysterectomy is the removal of the uterus; after hysterectomy, pregnancy is not possible (sterility).
Hysterectomy may be recommended for:
- Uterine fibroids
- Severe, long-term (chronic) infections (pelvic inflammatory disease)
- Severe over growth of the lining of the uterus (endometriosis)
- Tumors in the uterus
- Cancer of the cervix, cancer of the ovary
- Cancer of the endometrium
- Severe, long-term (chronic) vaginal bleeding
Hysterectomy is a very common operation. The uterus may be completely removed, partially removed, or may be removed with the tubes and ovaries. A partial hysterectomy is removal of just the upper portion of the uterus, leaving the cervix and the base of the uterus intact. A total hysterectomy is removal of the entire uterus and the cervix. A radical hysterectomy is the removal of the uterus, both fallopian tubes, both ovaries, and the upper part of the vagina, and nearby lymph nodes.
A hysterectomy may be done through an abdominal incision (abdominal hysterectomy), a laparoscope (laparoscopy hysterectomy) or through a vaginal incision (vaginal hysterectomy).
Most patients recover completely from hysterectomy. Removal of the ovaries causes immediate menopause, and hormone replacement therapy (estrogen) may be recommended, particularly to young women who have sever menopausal symptoms.
The average hospital stay is from 3 - 7 days. Complete recovery may require 2 weeks to 2 months. Recovery from a vaginal or laparoscopic hysterectomy is faster than from a abdominal hysterectomy. If the bladder was involved, a catheter may remain in place for 3 - 4 days to help the bladder pass urine. Moving about as soon as possible helps to avoid blood clots in the legs and other problems. Walking to the bathroom as soon as possible is recommended. Normal diet is encouraged as soon as possible after bowel function returns. Avoid lifting heavy objects for a few weeks following surgery. Sexual activities should be avoided for 6 - 8 weeks after a hysterectomy.
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.
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