Hysterectomy (removal of uterus)

Hysterectomy Surgery Melbourne

What is a hysterectomy?

Hysterectomy is the surgical removal of the womb (uterus).

Which organs are removed at the time of hysterectomy? Are the ovaries removed?

The uterus (womb) and cervix (neck of womb) are removed in total hysterectomy. The cervix is not removed in subtotal hysterectomy.

There is no evidence of any advantage in leaving the cervix behind when a skilled laparoscopic surgeon is performing the hysterectomy. There are some disadvantages of subtotal hysterectomy with potential of ongoing bleeding, continued need for cervical cancer screening tests, and in some cases the need for an additional major surgical procedure to remove the cervix.

Removal of the ovaries (oophorectomy) are not usually recommended in most non-cancerous cases, therefore there will be no change in hormonal function. Conserving the ovaries in women under the age of 65 (even when they are already menopausal) has benefits to the heart, brain and bone health.

More recently there is evidence that removing the fallopian tubes reduces the risk of future ovarian cancer.

The type of hysterectomy and whether the ovaries or fallopian tubes are removed will depend on your personal circumstances. This will be discussed with you by your gynaecologist before your operation.

Will menopause occur after a hysterectomy?

Many women worry that a hysterectomy (removal of the uterus) put them into menopause, with all its associated symptoms and health concerns. This is not the case as it is the ovaries that produce hormones and dictate when a woman go through menopause. If the ovaries are conserved during a hysterectomy (in almost all non-cancerous cases), women will not be menopausal after a hysterectomy. A woman will go through menopause when it is her time – on average 50-51 years old. The obvious change that occurs after a hysterectomy is the lack of menstrual bleeding.

What are the indications for a hysterectomy?

Hysterectomy may be recommended for treating a variety of conditions including:

• heavy or painful periods
• fibroids
• adenomyosis
• endometriosis
• prolapse
• endometrial hyperplasia
• endometrial/uterine cancer

How may a hysterectomy be done?

Hysterectomy may be performed through:

• open incision on the abdomen
• vaginally
• laparoscopically “key-hole” – with or without robot surgical system (robotic hysterectomy is a type of laparoscopic hysterectomy).

What are the advantages of a laparoscopic hysterectomy over the other routes?

A vast majority of hysterectomies can now be safely performed laparoscopically, therefore allowing:

• less pain
• less blood loss during operation
• lower risk of infection
• lower risk of formation of clots in legs (deep vein thrombosis) or lungs (pulmonary embolus) after surgery
• less scar tissue formation
• and quicker recovery – usually 1-2 nights in the hospital, returning to work in 2-3 weeks depending on type of work

If you have been recommended to have an open incision on the abdomen for non-cancerous cases, ask your doctor or gynaecologist for another opinion if this can be done through ‘key-hole’ surgery.

Who should be performing your laparoscopic hysterectomy?

Laparoscopic hysterectomy should be performed by specialist gynaecologists who have completed additional training either in minimally invasive gynaecology surgery, or in surgical gynaecological oncology in order to learn techniques and procedures to complete the most complex surgeries with lower complication rates and quicker recovery period. They also perform higher volume of more complex cases. Kent sees his private patients in Epworth Freemasons in East Melbourne. He also consults in Box Hill and Werribee.

What are the potential risks of a laparoscopic hysterectomy?

There is potential risk of complications with any surgery, this should be discussed with you before the surgery.

These include:

• bleeding
• infection (such as skin wound, vaginal wound, bladder)
• damage to internal organs (bladder, ureters, bowel, major blood vessels)
• blood clots in legs or lungs
• hernia at skin incision site

If you have any specific concerns, please highlight this to your doctor.

Further Information

Link to RANZCOG Patient Information on Hysterectomy.