The uterus is an organ surrounding the pelvic bone (pelvis), consisting of smooth muscles, in which the baby develops during pregnancy. It delivers the baby by contracting during labor. If no pregnancy occurs for a while, the layer covering the inside of the uterus (endometrium) is excreted every month in the form of menstrual bleeding. Hysterectomy is the operation of removing the uterus. It is the surgical removal of the uterus. It is one of the most frequently performed surgeries in female to male gender reassignment operations and gynecological diseases. Some of the indications of hysterectomy are female to male transition, myomas (high-density tumors that develop from the flat muscle of the uterus), endometriosis, abnormal bleeding, long-lasting womb-induced pain that does not respond to treatments, uterine prolapse, and cancer. Uterus removal surgery does not involve removing the ovaries and tubes. The type of hysterectomy varies depending on the examination findings of the patient, the condition necessitating the surgery, and the doctor’s preference.

Abdominal Hysterectomy (removal of the womb from the abdomen)

An incision is made on the skin in the lower abdomen to reach the uterus. Depending on the size of the uterus and the reason for the operation, the incision may be horizontal or vertical. The approach to the uterus through the abdomen requires longer recovery times than other types of hysterectomy. Nevertheless, it also has some advantages. In this type of hysterectomy, the doctor can see and examine the uterus and some other intra-abdominal organs better. It is a good way to examine suspected cancer cases, especially in cases of large growths.

Vaginal Hysterectomy (removal of the uterus through the vagina)

In this method, there is no incision in the abdomen. Since the incision is in the vagina, the recovery time is shorter than that in abdominal hysterectomy.

Laparoscopic Hysterectomy

The operation is performed partially or completely by means of a device called a laparoscope. A laparoscope is a thin instrument consisting of an illumination and lens system. It is inserted into the abdomen through a small incision (usually around the navel). The doctor sees the patient’s abdominal organs in an enlarged view with the help of the laparoscope. A few more small incisions are made to insert surgical instruments. The operation time is longer than the abdominal and vaginal hysterectomy procedures, but the recovery period of the patient is shorter.

Hysterectomy Procedure

Before a hysterectomy, some tests (such as blood, urine, lung imaging, heart tests – ECG) will be requested from the patient to prepare them for surgery. Again, during the preparation phase, parts can be taken from the uterus. Enema can be performed the night before and/or the morning of the operation. Antibiotics are used to prevent infection.

A plastic needle is attached to a vein on the hand or arm to provide the necessary fluids during and after the surgery. For the patient’s comfort during the operation, general (full-body) or local (waist-down) anesthesia is induced depending on the patient’s situation. A thin tube (urinary catheter) is placed into the patient’s bladder so that the surgeon can monitor the condition of the patient and adjust the amount of fluid to be provided. In general, this procedure involves risks that can be seen in any major surgical procedure including clot development in the veins or the arteries of the lungs (venous thrombosis, thromboembolism), infection, bleeding during or after surgery, injury to organs adjacent to the surgical site (e.g., bladder, urinary tract, intestines), lazy bowel syndrome after the surgery (ileus, subileus), and anesthetic-related problems.

Hysterectomy patients stay in the hospital for a few days. The length of hospital stay varies depending on the type of surgery, as well as whether a problem develops during or after surgery. The patient should walk as early as possible after the surgery. Walking will help regulate blood circulation and prevent clot development in the veins. Resting speeds up the patient’s recovery. As the patient gets better, they can gradually increase the intensity of their activities such as light physical activities, sports, and driving. If you’re the ovaries remain, they continue to secrete hormones, but the patient can no longer conceive because they have no uterus. Effects related to the removal of hormones (menopausal signs) are seen. The mental effects of the removal of the uterus include depressive symptoms related to the loss of the ability to bear children, whereas some women may feel relieved due to the disappearance of their complaints after the surgery. Some women state that their sexual lives have changed after hysterectomy. It should be kept in mind that hysterectomy is a major surgical intervention. Patients can ask our doctors for help in making this decision.