A hysterectomy is a procedure in which the uterus is surgically removed. In addition to the uterus, the fallopian tubes and ovaries might also be removed. There are several types of hysterectomy. Radical hysterectomy is the most invasive type of hysterectomy and is most often performed as a treatment for cervical cancer.
Hysterectomy is a relatively common surgical procedure, one that women can elect to undergo for personal reasons as well as medical ones. When hysterectomy is carried out for medical reasons, it is sometimes as a treatment for cervical cancer or uterine cancer but more often is a treatment for women with non-malignant uterine diseases such as endometriosis or pelvic inflammatory disease. Hysterectomy for these diseases generally is partial, meaning that only the uterus and cervix are removed.
A radical hysterectomy generally is reserved for treating cervical cancer, because the highly invasive nature of this type of cancer requires removal of additional reproductive tissues. In a radical hysterectomy, the entire uterus is removed, along with the cervix, the upper part of the vagina and certain other pelvic soft tissues. This procedure can be performed in one of three ways.
An abdominal radical hysterectomy is the most common method for performing this operation. In the abdominal method, the surgeon makes an incision of approximately 6 inches (15 cm) across the lower abdomen, through which the uterus and other reproductive tissues are removed. In a vaginal hysterectomy, the procedure is performed through the vagina, with the tissues being removed via this route. This procedure is preferred by many women because it leaves no external scars and tends to have a shorter recovery time, but it is not always suitable for a radical procedure.
The third method is a laparoscopically assisted vaginal hysterectomy. In this procedure, vaginal-access surgery is combined with laparoscopic surgical techniques. Laparoscopic surgery involves the use of several very small incisions in the abdomen, through which a surgeon can manipulate tools, a light source and a tiny video camera that transmits images to an external monitor. This surgical method has the same advantages as vaginal hysterectomy, with the additional benefit of allowing the surgeon to visualize the interior of the pelvis more accurately.
Women who undergo a radical hysterectomy should expect a hospital stay of two to five days, followed by a recovery period of four to six weeks. The length of the hospital stay and recovery depend on the type of surgical method used and the general health of the individual. The emotional response to hysterectomy is difficult to gauge, because it is a highly personal response that depends on the woman undergoing the surgery and her reasons for doing so.