A hysterectomy is a procedure that removes the uterus and cervix, but may not necessarily include the removal of the ovaries. What used to be a significant female surgery has become easier to perform and faster to recover from. There are several surgical methods Ogden Clinic’s gynecologists use to perform a hysterectomy, but in most cases, the procedure is done laparoscopically, meaning that tiny incisions are made on the abdomen rather than the large incision method of yesteryears.
The surgery, which removes the uterus and cervix, can be performed laparoscopically, vaginally, or with a robot. If the ovaries must also be removed, this can be done at the same time. Ogden Clinic gynecologists perform the surgery at both McKay-Dee Hospital and Ogden Regional Medical Center.
Long-term satisfaction with a hysterectomy is very high. Most studies show a 90-95% satisfaction rate from women following their hysterectomy surgery. Sexual intercourse for the vast majority of women is unchanged or improved. Women still experience orgasm and their partners are unable to notice a difference during intercourse. Some women may experience difficulty with sexual intercourse causing pain. Some women also experience abdominal pain from scar tissue related to the healing process. This condition occurs in less than 5% of women.
To remove or not remove the ovaries is a commonly asked question by women considering a hysterectomy. The patient will ultimately make her own decision after considering all the factors that are important to her. The age of a patient, her hormones, risk of heart disease and endometriosis, ovarian cysts or a family history of developing ovarian or colon cancer, and scar tissue are key considerations when determining if ovaries should be removed during a hysterectomy.
Laparoscopic-Assisted Vaginal Hysterectomy/Total Laparoscopic Hysterectomy (LAVH/TLH) involves a small camera inserted into the belly button area, allowing the surgeon is view the uterus, ovaries, intestines and other abdominal structures. Two or three total incisions are made in the lower abdominal area so other instruments can be used to assist in the hysterectomy surgery. Endometriosis, abnormally enlarged ovaries, or other abnormalities can be visualized and treated prior to removing the uterus and cervix. If ovaries are removed, they will be removed through a vaginal incision at the same time.
A LAVH/TLH is the most common hysterectomy procedure and requires a 10-23 hour surgery center stay. Many patients are able to drive one week after surgery and most patients return to part-time work in two weeks and full-time work in three weeks following surgery. Sexual intercourse and normal exercise routines can be resumed in six to eight weeks.
Total Abdominal Hysterectomy (TAH) is a surgery performed through an abdominal incision that is similar to a C-section incision, just above the pubic hairline. While the majority of Ogden Clinic hysterectomies are performed laparoscopically through small incisions, some patients may require a larger incision which may be a result of very large fibroids, women with a lot of scar tissue due to prior surgeries, or women that may be concerned with a cancer of the female organs.
A TAH requires a two-day minimum hospital stay and at least six weeks of recovery prior to returning to work. Sexual intercourse and normal exercise can be resumed in six to eight weeks.