Total Hysterectomy for Gynecological Cancers and Other Conditions

A total hysterectomy involves the surgical removal of the uterus, cervix and some surrounding tissues. This procedure may be considered for treating gynecological cancer, such as ovarian cancer, or a noncancerous gynecologic condition, such as endometriosis, fibroids, uterine prolapse, abnormal vaginal bleeding or chronic pelvic pain.

When is a total hysterectomy considered for treating gynecological cancer?

After diagnosing gynecological cancer, a physician will determine whether a total hysterectomy is appropriate by evaluating several factors, including the type, size, location, grade and stage of the tumor as well as the patient’s age, overall health and preferences.

In many cases, a total hysterectomy is performed along with other cancer treatments, such as chemotherapy, radiation therapy and hormone therapy, to help prevent tumor growth, spread or recurrence. If a total hysterectomy is considered for treating ovarian cancer, the surgeon may also suggest a bilateral salpingo-oophorectomy. This separate but related procedure involves surgically removing both ovaries and fallopian tubes and can be performed during the same surgical session.

What are the types of total hysterectomy surgery?

The two main types of total hysterectomy are:

• Simple or total abdominal hysterectomy – The uterus is removed through an incision in the abdomen.
• Vaginal hysterectomy – The uterus is removed through an incision in the vagina.

When performing a total hysterectomy, the surgeon may use minimally invasive techniques (laparoscopy) with robotic assistance. After making a few small incisions, the surgeon will insert a thin, lighted tube with a miniature camera attached to the end (laparoscope). Using the laparoscope, the physician will create detailed images of the uterus, ovaries and surrounding tissues, which will be displayed on a nearby monitor in real-time. Guided by the images, the surgeon will use specialized surgical instruments to remove the uterus. Laparoscopic hysterectomy is often preferred over traditional open surgery because it typically results in less pain, faster recovery and minimal scarring.

5 things to expect after a hysterectomy

After undergoing a total hysterectomy, the patient can generally expect:

1. Bleeding – During the first 24 hours, the patient will likely experience vaginal bleeding that slowly tapers off. If the bleeding seems to be getting heavier rather than lighter, the patient should contact her treatment team right away.
2. Fatigue – Because a total hysterectomy is a major surgery, the patient will likely feel tired afterward, and the fatigue may linger for up to several weeks. In the meantime, she should try to be as active as possible and take frequent breaks as needed.
3. Discharge – For several weeks after a hysterectomy, the patient may have vaginal discharge that appears bloody at first and gradually becomes thinner and lighter over time.
4. Menopause symptoms – If both ovaries are removed during a hysterectomy, the patient may experience menopause symptoms, such as hot flashes, night sweats and vaginal dryness. If appropriate, the treatment team may suggest hormone replacement therapy or another medication to help alleviate the discomfort.
5. Emotional changes – After a hysterectomy, the patient may experience a sense of loss that causes her to feel depressed, decreases her appetite, impairs her concentration or disrupts her sleep. These feelings and reactions are normal and should diminish with time. If they persist or interfere with daily living, the patient should talk with her physician or a supportive care provider, such as a psychologist.

What to watch for as you recover from a hysterectomy

While recovering from a hysterectomy, the patient should seek immediate medical attention for:

• Fever or other signs of infection
• Heavy vaginal bleeding (soaking through a pad in less than one hour)
• Severe pain that does not respond to prescribed medications
• Nausea or vomiting
• Diarrhea or constipation
• Difficulty urinating
• A foul vaginal odor

Benefit from world-class care at Moffitt Cancer Center

If you would like to learn more about total hysterectomy and other types of ovarian cancer surgery, you can request an appointment with a specialist in our gynecological clinic by calling 1-888-663-3488  or submitting a new patient registration form online. We do not require referrals.

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