Total abdominal hysterectomy: What is it?

An abdominal hysterectomy is a form of surgery that extracts your uterus through an abdominal incision. While a partial hysterectomy leaves the cervix intact and removes only the uterus, a Total Abdominal Hysterectomy involves the removal of both.

Total abdominal hysterectomy: Who needs it?

Since a total abdominal hysterectomy removes your uterus and cervix, it prevents you from being able to conceive in the future. The treatment option is therefore typically used as a last resort – except in cancerous cases. Dr G adopts abdominal hysterectomy only when laparoscopic or vaginal hysterectomy is contraindicated or not feasible. Apart from cancer, a total abdominal hysterectomy may be used to treat:

  • Uterine fibroids – an extremely large uterus with restricted mobility.
  • Severe Endometriosis – the abnormal growth of endometrial tissue.
  • Vaginal bleeding – if persistent, prolonged, and untreatable by other means.

Total abdominal hysterectomy: How is it done?

Before Dr G performs the total abdominal hysterectomy, an anaesthetist from his team of specialists will give you general anaesthesia.

During the surgery, Dr G will make a vertical or horizontal incision in your lower abdomen. Your uterus will then be detached from surrounding organs and tissue. These include the ovaries, fallopian tubes, supporting connective tissue, upper vagina, and blood vessels. Dr G will then remove your uterus through the abdominal slit, close the incision with stitches, and dress the area.

Some cases call for the simultaneous removal of either or both of the ovaries and fallopian tubes. This additional procedure is called salpingo-oophorectomy.

Total abdominal hysterectomy: Risks

While a total abdominal hysterectomy is generally considered safe, complications have been known to arise. They include infection, haemorrhaging (blood loss), formation of blood clots, adverse reactions to anaesthesia, and accidental damage to pelvic and/or abdominal organs. These risks aren’t common, however, so talk to Dr G if you have any concerns about your likelihood of developing them.

Total abdominal hysterectomy: Recovery

Recovering from a total abdominal hysterectomy can take longer than recovering from a vaginal hysterectomy or laparoscopic hysterectomy. That is why Dr G recommends open hysterectomy only as a last resort when laparoscopic or vaginal hysterectomy is not suitable. Depending upon your case, you may be required to stay at the hospital for between one to four days after the procedure. Total abdominal hysterectomy recovery time is usually between six to eight weeks.

Note:

  1. Minimal Vaginal bleeding after a hysterectomy surgery is normal, and should last for a few weeks. To absorb this blood, Dr G recommends using sanitary napkins since tampons can increase your risk of developing an infection. He will also prescribe you medicines to reduce any pain you may have and to lower your chances of contracting an infection.
  2. Do not lift heavy objects for the first six weeks following the surgery or until your vagina has healed completely. You should abstain from vaginal intercourse during this period, as well.

If your ovaries were removed during the hysterectomy procedure, you will soon enter menopause. For more information on what to expect after a hysterectomy, please visit our page on Life After a Hysterectomy.

Important

If you experience any of the conditions mentioned below in the days post hysterectomy surgery, you may require immediate medical attention.

  • Fever
  • Severe pain
  • Abnormally heavy vaginal bleeding
  • Offensive vaginal discharge
  • Acute nausea or vomiting
  • Problems emptying your bowel or bladder

For information on surgical alternatives to a Total Abdominal Hysterectomy, please visit our pages on Laparoscopic Hysterectomy and Vaginal Hysterectomy.