Hysterectomy: what it is, when to do it and recovery

Hysterectomy is a type of gynecological surgery that involves the removal of the uterus and, depending on the severity of the disease, associated structures, such as the tubes and ovaries.

Typically, this type of surgery is used when other clinical treatments have been unsuccessful to cure serious problems in the pelvic region, such as advanced cervical cancer, cancer of the ovaries or myometrium, serious infections in the pelvic region, uterine fibroids, bleeding frequent endometriosis or uterine prolapse, for example.

Depending on the type of surgery performed and the severity of the disease, the recovery time from this surgery can vary from 3 to 8 weeks.

Types of Hysterectomy

There are 3 types of hysterectomy, which are chosen according to the purpose of the surgery and the need to remove the affected organs after the doctor's evaluation:

• Total hysterectomy, which consists of the removal of the uterus and cervix; Subtotal hysterectomy, in which the body is removed from the uterus, keeping the cervix; Radical hysterectomy, in which the uterus, the cervix, the upper region of the vagina and part of the tissues around these organs are removed, being more used in cases of advanced cancer.

In some cases, such as severe endometriosis or advanced cancer, it may also be necessary to remove the tubes and ovaries. Also learn how to identify changes in the uterus.

Types of surgery

Hysterectomy can be performed through 4 surgical procedures, described in the following table:

Type of surgery	Cut location	Hospitalization Time	Recovery time
Total abdominal hysterectomy	A cut is made in the abdomen similar to that of cesarean section	4 days	6 weeks
Vaginal hysterectomy	Cutting is performed in the vagina	1-2 days	2-3 weeks
Laparoscopic hysterectomy	Small cuts are made in the navel or vagina	1-2 days	2-3 weeks
Robotic hysterectomy	Small cuts are made in the navel or vagina using special machines	1-2 days	2-3 weeks

The most used surgery is total abdominal hysterectomy, as it allows the surgeon to better visualize the area, facilitating the identification of the affected tissues and organs.

Care after surgery

After surgery, vaginal bleeding is common during the first few days, and the gynecologist will recommend painkillers, anti-inflammatory drugs and antibiotics to relieve pain and prevent infections at the site.

In addition, some important precautions are:

• Rest, avoiding weights, physical activities or sudden movements for at least 3 months; Avoid intimate contact for about 6 weeks or according to medical advice; Take short walks at home throughout the day, avoiding staying in bed all the time to improve circulation and prevent thrombosis.

It is important to remember that the main risks of this surgery are hemorrhage, problems with anesthesia and complications in neighboring organs, such as intestine and bladder.

Signs of complications after surgery

Some signs that indicate complications after surgery are:

• Persistent fever above 38ºC; Frequent vomiting; Severe pain in the abdomen, which persists even with pain medication indicated by the doctor; Redness, bleeding or presence of pus or smelly secretion at the procedure site; Presence of major bleeding than normal menstruation.

In the presence of any of these signs, an emergency room should be sought to assess possible complications of the surgery.

How is the body after surgery

After surgery to remove the uterus, the woman will no longer menstruate and will no longer be able to conceive. However, sexual appetite and intimate contact will remain, allowing for a normal sex life.

In cases where the surgery includes the removal of the ovaries, menopause symptoms start, with the presence of constant heat, decreased libido, vaginal dryness, insomnia and irritability. When both ovaries are removed, you will also need to start hormone replacement therapy, which will reduce the characteristic symptoms of menopause. See more details at: what happens after the uterus is removed.