By the time an American woman is in her sixties the odds are high that she will have had a hysterectomy. Indeed, more than half a million women a year have a hysterectomy; only cesarean sections are performed more often. Given these numbers it is likely that most women will face some sort of decision about hysterectomy in their lives. Thus, having information on hysterectomy and the various methods used to perform it is imperative for the majority of women.

There are three main methods by which a hysterectomy is accomplished: Abdominal hysterectomy; vaginal hysterectomy; laparoscopic hysterectomy. Some of the methods are not appropriate for all reproductive problems requiring a hysterectomy. As with any surgical procedure, there are advantages and disadvantages to all three types of hysterectomy.

An abdominal hysterectomy is the procedure of choice when there is the possibility that a large growth such as a fibroid tumor may have to be removed. This method also allows the physician an optimal view of the pelvic area. Abdominal hysterectomies are performed under general anesthesia. While they may require less time in actual surgery than a laparoscopic hysterectomy, they require significantly more recovery time sometimes up to two months. The recovery period may also be more painful that other hysterectomy surgery. A hysterectomy of this type also leaves a larger scar than a similar operation performed with a laparoscope. If an abdominal hysterectomy is absolutely necessary, it may be possible to make a less noticeable bikini line incision. Aesthetic considerations and recovery time aside, an abdominal hysterectomy is an excellent tool for making sure that all risks have been determined and eliminated.

A vaginal hysterectomy is called for when the uterus has not been massively enlarged by disease. Many women prefer this method because it leaves no abdominal scars and require a shorter hospital stay than even a laparoscopic hysterectomy. Although recovery may not be as painful as that of an abdominal procedure, stitches made inside the vagina may be quite uncomfortable. Hysterectomies performed vaginally do not give the doctor a clear view of other problems which may exist. Also, if in the operating room the uterus proves to be too large for a vaginal hysterectomy an abdominal hysterectomy must be done instead.

Laparoscopic hysterectomies are increasingly popular with both doctors and their patients. Using a laparoscope – a slender flexible optical tube – a doctor can closely examine the pelvic area but is not committed to surgery as invasive as an abdominal hysterectomy. The scars created by the laparoscope and instruments for removing the uterus and possibly other reproductive organs are much smaller than those made by complete abdominal surgery. A hospital stay of only one or two days is required and recovery may be as little as two weeks with minimal associated pain.

Any type of hysterectomy is major surgery performed under general anesthesia. All hysterectomies also have lasting side effects which may include surgically induced menopause. No matter what type of hysterectomy a woman is considering, she should thoroughly discuss all of the options open to her including alternative treatments. Further, while recovery time and scarring are important items to be weighed, the most important factor when deciding whether or not to have a hysterectomy should always be confronting and eliminating the medical problem.

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