FAQs about hysterectomies

Written by: Mr Ajay Swaminathan
Published:
Edited by: Robert Smith

Approximately, 55,000 hysterectomies are performed each year in the UK. About 1 in 5 women will have a hysterectomy at some point.

We spoke to a highly established obstetrician and gynaecologist, Mr Ajay Swaminathan, to discuss everything patients should know about hysterectomies before having the procedure.

 

What is a hysterectomy?

Hysterectomy is an operation to remove the uterus (womb) (taken directly from St Marys). It is a major operation.

 

What are the different kinds of hysterectomies?

The majority of hysterectomies I perform tend to be laparoscopic (keyhole hysterectomy). Small cuts (usually between half a centimetre to one centimetre) are made in the abdomen, and the uterus (womb) is removed through the vagina. The other common ways of performing a hysterectomy include abdominal hysterectomy (which involves a bigger cut either through a bikini line cut or an up and down cut. Vaginal hysterectomy is when the womb is removed through the vagina with no cut or scar on the tummy. A total hysterectomy is when both the body of the uterus and the neck of the uterus (cervix) is removed. A subtotal hysterectomy involved leaving behind the cervix and removing only the body of the uterus.

 

What are the common reasons for hysterectomy and what are the benefits?

The usual reasons include:

  • heavy, painful or abnormal periods (Which have not improved with medical or less invasive treatments.
  • Fibroids of the uterus (which can cause painful heavy periods as well as pressure symptoms). endometriosis (Where cells of the womb lining are found in the pelvis) and
  • adenomyosis (cells of the womb lining are found in the muscle of the womb)
  • Cancer and precancer changes as well as prevention of cancer
  • PMS as part of treatment for PMS
     

How long do I need to stay in hospital after a hysterectomy?

You will be admitted to the hospital on the day of the operation and usually go home after an overnight stay for laparoscopic hysterectomy (key) (enhanced recovery programme). For abdominal hysterectomies, the stay will be longer. You will usually have a catheter draining urine from the bladder during the operation. This is usually removed at the end of the operation or removed after the overnight stay.

 

How long is the recovery time after hysterectomy?

During the hospital stay, you would be encouraged to stand and have a short walk. While recovering at home, rest and avoid heavy lifting. Gradually increase your activity while recuperating.

 

What are the complications of a hysterectomy?

The majority of hysterectomies are straight forward. A detailed discussion of the complications is usually done at the time of consenting and listing for the operation. Serious complications include (but not limited to) complications from anaesthesia, bleeding, damage to the bowel, bladder, blood vessels, ureters, infection, blood clots, vaginal problems including the breakdown of stitches, early menopause and ovarian failure.

What is surgical menopause?

If during hysterectomy the ovaries are removed you will go through menopause immediately (This is surgical menopause). Even if the ovaries have been left behind (‘conserved’), menopausal symptoms may be experienced earlier. Most of these symptoms can be eased off with HRT (Hormone replacement therapy).

 

If you require a hysterectomy or would like more information on the treatments mentioned in this article, we recommend booking an appointment with a leading obstetrician and gynaecologist such as Mr Ajay Swaminathan. Click here to visit his profile today.

By Mr Ajay Swaminathan
Obstetrics & gynaecology

Mr Ajay Swaminathan is a leading consultant obstetrician and gynaecologist in Cheshire. As a specialist in gynaecology, reproductive medicine and sexual and reproductive healthcare, he assists patients with a wide range of conditions.

His private practice is based at Spire Regency Hospital in Macclesfield along with an online and ‘virtual practice’. His NHS practice is based at Mid Cheshire (Leighton) Hospital and at the Hewitt Fertility Centre (Liverpool Women’s Hospital NHS Trust). Within the field of gynaecology, he specialises in subfertility and laparoscopic surgery.

During his training in the UK, he was in the Mersey rotation. He also attended the Kiel School of Gynaecological Endoscopy in Germany and is a British Fertility Society (BFS) accredited specialist in pelvic ultrasound, as well as a BFS accredited trainer in pelvic ultrasound.

Ajay has received extensive training in transport IVF and has vast experience in laparoscopic procedures (key-hole surgeries) as well as day case procedures including surgeries for ectopic pregnancy, endometriosis, adhesiolysis, ovarian cyst removal, tubal surgery and laparoscopic hysterectomy. He is also the deputy lead for gynaecology oncology at Leighton Hospital and a member of the South Manchester Cancer Network MDT.
 
In his clinics, in addition to patients with general gynaecological problems, he consults patients with heavy periods, pelvic masses and fibroids, subfertility, pelvic pain, endometriosis, polycystic ovarian syndrome, recurrent miscarriages and menopausal symptoms. At Leighton hospital, he implemented the enhanced recovery programme for gynaecological surgery.
 
Ajay was awarded the Diploma in Management in 2012 (University of London – London School of Economics and Political Sciences). He is involved in training candidates for the MRCOG examinations and was an RCOG moderator for the Enhanced Revision Programme. Ajay is the departmental lead for undergraduate medical education with the Manchester Medical School and is also a trained mentor for newly appointed consultants.

He was the principal investigator at Leighton Hospital for the GaPP2 trial which is a multi-centre randomised controlled trial looking at Gabapentin for pelvic pain. Ajay has presented research papers in various conferences including the European Society of Gynaecological Endoscopy Conference. He is a member of the Royal College of Obstetricians and Gynaecologists and specialist societies including the British Fertility Society and British Menopause Society.
 

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