Abdominal Hysterectomy

An abdominal hysterectomy is a surgical procedure where the uterus is removed through an incision in the abdomen. This type of surgery is also known as an open hysterectomy.

Reasons for Abdominal Hysterectomy

• Uterine cancer or precancerous changes
• Uterine fibroids that cause bleeding, pain, or other symptoms
• Endometriosis that causes severe pain and bleeding
• Uterine prolapse, where the uterus slips out of its normal position
• Chronic pelvic pain that has not responded to other treatments

Types of Abdominal Hysterectomy

• Total abdominal hysterectomy (TAH): removal of the entire uterus, including the cervix
• Subtotal abdominal hysterectomy: removal of the upper part of the uterus, leaving the cervix in place
• Radical abdominal hysterectomy: removal of the uterus, cervix, and part of the vagina, as well as surrounding tissues and lymph nodes (usually performed for cancer)

Surgical Procedure

The surgery typically involves:

• A horizontal incision in the lower abdomen, usually about 4-6 inches long
• Separation of the abdominal muscles and tissues to access the uterus
• Ligation (tying off) of the blood vessels that supply the uterus
• Removal of the uterus, cervix, and other necessary tissues
• Closure of the incision with sutures or staples

Risks and Complications

• Bleeding or hemorrhage during or after surgery
• Infection of the surgical site or uterus
• Damage to surrounding organs, such as the bladder or bowel
• Adhesions or scar tissue formation
• Vaginal vault prolapse (where the top of the vagina collapses)

Recovery and Aftercare

After an abdominal hysterectomy, patients typically:

• Spend 1-3 days in the hospital for recovery
• Experience pain, discomfort, and fatigue for several weeks
• Need to rest and avoid heavy lifting or strenuous activities for 4-6 weeks
• May experience changes in bowel or urinary habits
• Will need follow-up appointments with their doctor to monitor healing and remove sutures or staples

Hormonal Changes and Menopause

An abdominal hysterectomy may cause:

• Premature menopause, if the ovaries are removed during surgery
• Changes in hormone levels, which can affect mood, libido, and other symptoms
• A decrease in estrogen production, which can increase the risk of osteoporosis and heart disease

Alternatives to Abdominal Hysterectomy

• Vaginal hysterectomy: removal of the uterus through the vagina
• Laparoscopic hysterectomy: minimally invasive surgery using a laparoscope and small incisions
• Robotic-assisted hysterectomy: minimally invasive surgery using a robotic system