- ATHENS OFFICE MED4WOMAN ATHENS
- VOLOS OFFICE MED4WOMAN VOLOS
Obstetrician-Gynecologist
PhD, University of Athens Medical School
Obstetrician-gynecologist Panagiotis Polyzos practices at the Institute of Life, the IVF Unit of IASO Maternity Hospital.
A hysterectomy is the surgical removal of the uterus. It is a procedure used to treat various gynecological conditions, including gynecologic cancers.
Removal of the entire uterus, including the cervix.
Removal of the entire uterus, including the cervix, as well as the ovaries and fallopian tubes.
Removal of the uterus, cervix, ovaries, fallopian tubes, parametrium, and the upper third of the vagina.
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.
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.
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.
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.
Recovery usually lasts between 4 and 6 weeks.
The exact time to return to normal daily activities depends on the surgical approach:
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.
The robotic hysterectomy is an evolution of laparoscopic surgery. It is performed through the same small incisions, with a three-dimensional view and instruments that move more freely than the human wrist. It has an advantage with large uteri, multiple fibroids, extensive endometriosis and in women with a higher body weight.
In total hysterectomy the body of the uterus and the cervix are removed. It is the most common choice, because it leaves no cervix that needs monitoring. In a subtotal hysterectomy the cervix remains, so Pap test screening continues, and a few women have light cyclical bleeding. The decision on whether to remove the ovaries as well (hysterectomy with salpingo-oophorectomy) depends on age, the condition and family history. Before menopause healthy ovaries are usually preserved, while the fallopian tubes are often removed as a preventive measure.
Contact your doctor if you develop fever, bleeding heavier than a period, severe pain, foul-smelling discharge, or pain and swelling in the calf.
The cost of a hysterectomy depends on the technique (laparoscopic, robotic, vaginal or abdominal), the clinic and the number of days in the hospital, the histological examination, and whether you have private insurance or coverage from EOPYY (the Greek national health insurer). A laparoscopic hysterectomy usually has higher material costs, but a shorter hospital stay and a faster return to work. You will receive an exact quote after your examination, once the right technique for you has been decided. Schedule an appointment for an assessment.
A hysterectomy is a permanent solution, but for most benign conditions it is not the only one. Before deciding, it is worth knowing the alternatives:
A hysterectomy becomes the best choice when the alternatives have not worked, when a woman does not want another pregnancy and wants a permanent solution, or when there is cancer or a precancerous change.
The weeks before surgery are a chance to get into better physical shape, which speeds up recovery.
The decision about the ovaries is separate from the decision about the uterus and has long-term consequences.
If the ovaries are removed before menopause, hormone replacement therapy is usually recommended until about the age of natural menopause, unless there is a contraindication. You will find more about the symptoms on the page about menopause.
A hysterectomy is a common and safe procedure, but it is still major surgery. Possible complications include:
The risk is affected by the technique, the size of the uterus, previous surgeries and your general health. Minimally invasive techniques, such as laparoscopy, are associated with fewer wound infections and faster mobilization.
Pelvic floor strengthening exercises, started gently a few weeks after surgery, help support the vagina and control urination. A pelvic floor physical therapist can guide you properly.
In the first weeks, some women feel a more frequent need to urinate or a burning sensation. If frequent urination persists or comes with fever, you need to be checked for a urinary tract infection.
Relief from symptoms is usually the main feeling. Still, it is not unusual to also feel a sense of loss, especially in younger women. Talk about it with your doctor or a mental health professional if it weighs on you.
A hysterectomy is best planned when you take an active part in the decisions. Take your time, ask for explanations about anything that is unclear and, if you need to, discuss it again at a second appointment.
After a laparoscopic or vaginal hysterectomy, you return to daily activities in two to four weeks. After an abdominal hysterectomy, full recovery takes six to eight weeks.
Walking starts on the first day and helps prevent blood clots. Driving is usually allowed after two to four weeks. Avoid lifting for about six weeks.
A hysterectomy on its own does not cause weight gain. If the ovaries are also removed before menopause, hormonal changes can affect metabolism. Reduced activity during recovery also plays a role.
Only if both ovaries are removed. If they are preserved, your periods stop, but hormones continue to be produced until natural menopause.
On the technique (laparoscopic, vaginal, abdominal), the hospital, the number of days in the hospital and your insurance coverage. For exact information, contact the office.
In a total hysterectomy, the whole uterus is removed together with the cervix. In a subtotal hysterectomy, the cervix remains, so Pap test screening continues.
No. After a total hysterectomy, periods stop permanently. After a subtotal one, some women have very light cyclical bleeding from the cervix.
For most women it does not, and it often improves, because the pain and bleeding caused by the condition go away. Intercourse usually resumes after six weeks.
If the hysterectomy was done for a benign condition and there was no history of precancerous changes of the cervix, screening usually stops. If there was such a history, vaginal screening continues according to your doctor's instructions.
Usually one to three hours, depending on the technique, the size of the uterus, any adhesions and whether the ovaries and tubes will also be removed.
Yes. In a vaginal hysterectomy, the uterus is removed through the vagina and no visible scar is left. It is mainly suitable for uteri of normal or small size and for prolapse.
Only if the ovaries are removed before menopause or if you have severe menopause symptoms. Without a uterus, treatment is usually estrogen only, without a progestogen.
Yes. Previous cesarean sections may have left adhesions between the uterus and the bladder, which makes the procedure more demanding. The surgeon takes this into account when choosing the technique, and a laparoscopic approach usually remains possible.
