Abdominal Hysterectomy

Abdominal Hysterectomy: Reasons, Risks & Expects

Abdominal hysterectomy refers to a surgical procedure that entails removing the uterus of a female. In this particular method of removing the uterus, an incision is put on the lower abdomen and through that incision, the uterus is removed. There are two types of abdominal hysterectomy: 

  • Full: In this variant of the surgery, both the cervix and the uterus are removed from the women. 

  • Partial: In this form of hysterectomy, only the uterus is removed and the cervix is kept intact. 

There is also a variant of hysterectomy where only a single ovary is removed from the body. this form is called the Salpingo-oophorectomy

Another way to perform hysterectomy is through the vaginal region. This is called the vaginal hysterectomy where small instruments are used via the small abdominal incisions. That being said, the most appropriate type of procedure is still the abdominal one for the following reasons: 

  • If your uterus size is too big, then this form of procedure can help you deal with the discomfort. 

  • If your doctor wants to check other problematic regions on the pelvic area. 

The reasons for abdominal hysterectomy

The reasons to perform abdominal hysterectomy are as follows: 

  • To treat gynecological cancer: If you have any sort of gynecological cancer where the regions are either the cervix, the ovaries or the uterus, then this is one of the treatment measures taken in order prevent cancer to prevent from going metastatic. 

  • To treat Fibroids: In the case of benign tumors of the uterus, the only option that you have to deal with them is the abdominal hysterectomy. These tumors might be benign, however; at times they cause symptoms like persistent bleeding, bladder pressure or pelvic pain. While nonsurgical means to deal with are possible, the maximum amount of discomfort removal is done through this method.

  • To treat endometriosis: This is a condition where the tissue that s supposed to lining inside the uterus, tends to grow outside the ovaries, fallopian tubes or other pelvic organs. In cases where the medications and other treatments are improving this condition, the only way out is through surgery. 

  • To treat Uterine ProlapseThis is a condition where the uterus descends into the vagina if the supporting ligaments and other issues tend to become weak. This can cause incontinence of urinary nature and cause issues with the bowel movement. To that end, one of the ways to deal with this is the hysterectomy. 

  • To treat abnormal vaginal bleeding: If there is bleeding in the vagina of an abnormal nature either during the periods or a prolonged cycle, abdominal hysterectomy provides you with a way to deal with the discomfort associated with it. However, this option should only be chosen if all the other options are exhausted.  

  • To treat chronic pain in the pelvic region: Surgery tends to be necessary last resort for women if the pain in the pelvic region turns out to be chronic. As this pain most often arises due to the uterus, sometimes it is best that you get it removed. 

What are the risks associated with this procedure?

If there is one thing that you should remember prior to opting for this form of surgery, it is this: you won’t be able to conceive a child anymore. To that end, you need to consult with your doctor for other options before you pick this one. Furthermore, there are risks associated with this form of surgery that you should look into:

  • There might be blood clots

  • There might be an infection due to bleeding

  • There can be an adverse reaction to the anesthesia

  • There can be damage to the urinary tracts, rectum bladder or other pelvic structures during the surgery process. 

  • There also have been cases of early chances of menopause if the ovaries are removed. 

  • There are also long terms risks like heart and cardiovascular diseases

Preparing for hysterectomy

Preparation before the procedure entails the following: 

  • Gathering the appropriate amount of information: You can ever be too much informed about anything. The same goes for this process. Therefore, only opt for this procedure if you are fully committed to it. To that end, make sure that you know all you need to know about this procedure. 

  • Medications needed to be dealt with as well: You should be completely honest about your medications to your doctor. This way, they are able to ascertain which of the medications that you should stop taking prior to the surgery process. 

  • Anesthesia decision: As we have already mentioned that one of the risks of this procedure is that the anesthesia can have an adverse effect. To that end, you need to make sure to discuss the matter of anesthesia with your doctor. This way, you can be provided with a proper one when the time comes. 

  • Make sure that you plan your stay in the hospital: planning your hospital stay is extremely important before the surgery. 

  • You will need help after the surgery: After the surgery is over with, you will need a lot of assistance as much of your activities will be restricted for a particular recovery period. To that end, make sure that you have all the support that you might need. 

What to expect from an abdominal hysterectomy?

While this procedure is going on, the surgeon is going to detach your uterus from the ovaries, the fallopian tubes and the vagina and the blood vessels or any other connective tissue. Now, as there can be full or particle hysterectomy, the surgeon might leave the cervix (partial) or remove it completely (total) along with the uterus. 

Tests before the procedure

Before the procedure is going on, there are certain tests that the surgeon took in order to make sure that proper preventive measures can be taken if there are any sort of complications. These tests include the following: 

  • Cervical Cytology: this is the test where the abnormal cervical cells are detected

  • Endometrial Biopsy: this is the test to detect any abnormalities with the uterus lining or signs of endometrial cancer.

  • Pelvic Ultrasound: this test shows the size of the ovarian cysts, fibroids, or the endometrial polyps.

During the procedure: 

The entire surgical process is done when the patient is under general anesthesia. The process lasts about two hours and the following takes place during this time: 

1. A urinary catheter is placed in the urethra to empty any sort of residual waste in the bladder. This catheter remains there for a short time.

2. Now, the procedure begins and two cuts are made on the lower abdomen. There can be two approaches to this: 

  • A vertical incision: It starts out from the abdominal middle to the bottom of the navel

  • A horizontal incision: it is about one inch above the pubic bone

After the procedure

After this procedure is complete, you will be placed in a recovery room and the following will take place: 

  • Your vital signs are monitored.

  • You will be given medicine in order to prevent any sort of infection. 

  • You will be encouraged to get up and walk around. 


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Dr. Madhu Goel

Senior Gynecologist and a Senior Consultant

Dr. Madhu Goel is a well renowned senior gynaecologist and a senior consultant at Fortis La femme, New Delhi. She runs a private consultation in Goel’s surgery and Gynea centre and prior to being associated with Fortis; she was a consultant a Rockland Hospital.