Introduction: What is a Hysterectomy?

A hysterectomy is a major surgical intervention in which the uterus is removed. It is one of the most frequently performed gynecological surgeries in the world. The decision to perform a hysterectomy is always made on an individual basis, following a thorough assessment of the patient's health status and the failure of conservative treatment methods. The goal of the surgery is to eliminate serious conditions that threaten a woman's health and quality of life.

Depending on the volume of tissue removed, there are several types of hysterectomy:

Subtotal hysterectomy (supracervical hysterectomy): only the body of the uterus is removed, while the cervix remains.
Total hysterectomy: both the body and the cervix of the uterus are removed.
Hysterectomy with adnexa: in addition to the uterus, the ovaries and fallopian tubes are removed (unilateral or bilateral salpingo-oophorectomy).
Radical hysterectomy: the uterus, cervix, upper part of the vagina, surrounding tissues, and lymph nodes are removed. This type of surgery is most often used for oncological diseases.

Primary Indications for Hysterectomy

A hysterectomy is performed when there are serious medical indications and other treatment methods have proven ineffective or impossible. Such indications include:

Uterine fibroids (leiomyoma): benign tumors that can cause heavy bleeding, pain, and pressure on adjacent organs.
Endometriosis: the growth of tissue similar to the endometrium outside the uterus, causing chronic pain and bleeding.
Adenomyosis: a form of endometriosis where endometrial tissue grows into the muscular layer of the uterus.
Uterine prolapse: a condition in which the uterus descends into the vagina or protrudes outside it.
Chronic pelvic pain: if its cause is related to uterine diseases and does not respond to other treatments.
Heavy uterine bleeding: that does not respond to conservative therapy.
Oncological diseases: uterine (endometrial) cancer, cervical cancer, as well as certain types of ovarian cancer. For example, in the case of a rare highly differentiated follicular carcinoma of ovarian origin with extensive abdominal metastasis, as described in one clinical case, the patient underwent a total hysterectomy, bilateral adnexectomy (removal of ovaries and fallopian tubes), removal of part of the greater omentum, and pelvic lymph nodes [5].

Preparation for Surgery and Surgical Methods

Before a hysterectomy, the patient undergoes a comprehensive examination, including blood and urine tests, ECG, pelvic ultrasound, and consultations with an anesthesiologist and other specialists. It is important to discuss all risks and benefits of the surgery with your doctor, as well as possible alternatives.

A hysterectomy can be performed using various methods:

Abdominal (open) hysterectomy: performed through an incision in the abdomen. This is a traditional method often used for large uterine sizes or the presence of extensive adhesions.
Vaginal hysterectomy: the uterus is removed through the vagina without external incisions. This method is usually associated with faster recovery.
Laparoscopic hysterectomy: the surgery is performed through several small incisions in the abdomen using a laparoscope and special instruments. It can be robot-assisted (robot-assisted laparoscopic hysterectomy). This method is less invasive, which helps reduce pain and accelerate rehabilitation.

The choice of method depends on the indications, the size of the uterus, the presence of comorbidities, and the surgeon's experience.

Recovery After Hysterectomy: Important Aspects

The recovery period after a hysterectomy depends on the type of surgery and individual body characteristics. In general, it can take from several weeks to several months.

Early Postoperative Period

Pain: controlled with pain medication.
Activity: early mobilization and light activity help prevent thromboembolic complications and improve bowel motility.
Nutrition: a gradual return to a normal diet, with a preference for light food.
Hygiene: maintaining the cleanliness of the surgical wound, and using antiseptics if necessary.

It is important to carefully monitor any changes in your well-being and report them to your doctor. Although the presented scientific papers concern other types of surgical interventions, they emphasize the importance of monitoring various indicators to assess postoperative recovery, such as time to adequate oral intake, need for analgesics and antiemetics, and time to normalization of body temperature and blood counts [6]. Studies also show that inflammatory processes can affect recovery after surgery, and active resolution of inflammation, mediated by specialized pro-resolving mediators (SPMs), plays a key role in restoring tissue homeostasis [1].

Long-term Recovery and Restrictions

For several weeks after discharge, it is recommended to avoid:

Lifting heavy objects.
Intense physical exertion.
Sexual intercourse.
Taking baths (showers are permitted).

Complete healing of internal tissues can take up to 6-8 weeks. Regular follow-up visits with a gynecologist are necessary to assess the healing process and discuss any questions that may arise.

Life After Hysterectomy: Long-term Consequences

The removal of the uterus entails a number of changes that can affect a woman's life.

Absence of menstruation and inability to become pregnant: these are obvious consequences of a hysterectomy.
Menopause: if the ovaries were removed along with the uterus (oophorectomy), surgical menopause occurs, accompanied by hot flashes, vaginal dryness, mood swings, and other symptoms associated with estrogen deficiency. Estrogen deficiency can increase oxidative stress and reduce nitric oxide bioavailability, which contributes to cardiac fibrosis, as shown in studies on ovariectomized rats [8]. In such cases, hormone replacement therapy (HRT) may be considered.
Psycho-emotional state: some women may experience emotional difficulties related to the loss of reproductive function or changes in body image. Psychological support and, if necessary, consultation with a specialist are important.
Impact on sexual function: for most women, sexual life does not worsen, and sometimes even improves due to the disappearance of pain or bleeding. However, some may notice changes in sensations.
Risk of osteoporosis and cardiovascular diseases: when ovaries are removed, the risk of these conditions may increase due to estrogen deficiency. Studies show that estrogen deficiency contributes to the development of cardiac fibrosis after myocardial infarction, and that antioxidants, such as ellagic acid, can mitigate these effects, improving cardiovascular function [8].

It is important to actively discuss all these aspects with your attending physician to develop an individual plan for maintaining health and quality of life after surgery.

Conclusion

A hysterectomy is a serious decision that can significantly improve the quality of life for a woman suffering from severe gynecological diseases. Understanding the indications, the recovery process, and potential long-term consequences helps patients and their loved ones prepare for changes and successfully navigate this stage. Modern medicine offers various surgical methods and effective strategies to minimize risks and optimize recovery, allowing women to return to a full life.

Sources

[1] Sex-specific associations of perioperative Resolvin D1 and D2 dynamics with postoperative atrial fibrillation in cardiac surgery: a secondary analysis of a prospective observational study. (European Heart Journal: Open, 2026) https://pubmed.ncbi.nlm.nih.gov/42404140/
[2] High-density mapping guided the modified box and driver ablation for non-paroxysmal atrial fibrillation: a retrospective single-center study. (BMC Cardiovascular Disorders, 2026) https://pubmed.ncbi.nlm.nih.gov/42108442/
[3] Analysis of Essence Human Acellular Dermal Matrix Compared With Other Products in Prepectoral Direct-to-implant Reconstruction. (Plastic and Reconstructive Surgery. Global Open, 2026) https://pubmed.ncbi.nlm.nih.gov/42713483/
[4] Repetitive transcranial magnetic stimulation for vestibular migraine in women of reproductive age: a retrospective propensity score-matched study. (Frontiers in Neurology, 2025) https://pubmed.ncbi.nlm.nih.gov/41561339/
[5] Bilateral highly differentiated follicular carcinoma of ovarian origin with extensive abdominal metastasis: A case report. (Medicine, 2026) https://pubmed.ncbi.nlm.nih.gov/42470065/
[6] Comparison of postoperative recovery indicators between stereoelectroencephalography and subdural grid electrode implantation for drug-resistant epilepsy. (Seizure, 2026) https://pubmed.ncbi.nlm.nih.gov/42107918/
[7] Association of Myocardial Degeneration With Delayed Recovery of Left Ventricular Function in Atrial Fibrillation-Induced Cardiomyopathy. (Circulation Reports, 2026) https://pubmed.ncbi.nlm.nih.gov/42428634/
[8] Ellagic Acid Attenuates Oxidative Stress and Improves Cardiovascular Function Following Myocardial Infarction in Ovariectomized Rats. (Journal of Cellular and Molecular Medicine, 2026) https://pubmed.ncbi.nlm.nih.gov/42363416/

Disclaimer

The information provided in this article is for reference purposes only and is not a guide to self-treatment. Before making any decisions regarding your health, be sure to consult with a qualified medical professional.

Uterine Removal (Hysterectomy): Indications, Recovery, and Life After