Hysterectomy

Dr. Panagiotis Polyzos MD PhD MSc

Obstetrician Gynaecologist
Doctor of Medicine, University of Athens Medical School

Panagiotis Polyzos, Gynaecologist Obstetrician, is active at the Institute of Life - IVF Unit of Iaso Maternity Hospital.

Contents

Υστερεκτομή – χειρουργική αφαίρεση μήτρας

Hysterectomy

What is a hysterectomy?

A hysterectomy is the surgical removal of the uterus. It is a procedure used to treat various gynecological conditions, including gynecologic cancers.

What symptoms or conditions lead to this surgery?

  • Uterine fibroids in women who do not wish to preserve fertility
  • Adenomyosis
  • Endometriosis in women who do not wish to preserve fertility
  • Uterine prolapse
  • Abnormal uterine bleeding that does not respond to conservative treatment
  • Chronic pelvic inflammatory disease unresponsive to medical therapy
  • Endometrial cancer
  • Cervical cancer
  • Ovarian and fallopian tube cancer

Types of Hysterectomy

Total hysterectomy

Removal of the entire uterus, including the cervix.

Total Hysterectomy with Bilateral Salpingo-Oophorectomy

Removal of the entire uterus, including the cervix, as well as the ovaries and fallopian tubes.

Radical Hysterectomy

Removal of the uterus, cervix, ovaries, fallopian tubes, parametrium, and the upper third of the vagina.

Subtotal (Partial/Supracervical) Hysterectomy

Removal of the uterus while preserving the cervix.

This technique is suitable only for benign conditions. It has the advantages of being shorter in duration, less invasive, and lower risk to the urinary tract. It does not shorten the vagina or affect pelvic support and sexual function. However, Pap testing remains necessary.

What surgical techniques are available?

Abdominal Hysterectomy

Performed through a low transverse incision just above the pubic bone or a vertical midline incision. This approach is mainly used when ovarian or uterine tumors are present. A major drawback of abdominal hysterectomy is the more painful postoperative recovery.

Vaginal Hysterectomy

Performed through a small incision in the vagina. This method leaves no external scar and is typically used for benign conditions. It is especially preferred for patients with uterine prolapse. Advantages include quicker and easier recovery.

Laparoscopic Hysterectomy

Performed with 3–4 small (1–2 cm) incisions on the abdominal wall. This method is chosen when potential barriers exist that prevent a vaginal hysterectomy.

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Recovery after Hysterectomy

Recovery usually lasts between 4 and 6 weeks.

The exact time to return to normal daily activities depends on the surgical approach:

  • Recovery from abdominal hysterectomy: 4–6 weeks
  • Recovery from vaginal hysterectomy: 3–4 weeks, and often even shorter for laparoscopic hysterectomy, with minimal postoperative pain.

After surgery, a period of rest is necessary. Sexual intercourse should be avoided during recovery, as the vaginal incision needs time to heal and intercourse may cause pain, discomfort, or minor bleeding.

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