Procedures
Abdominal hysterectomy

Overview

An abdominal hysterectomy is a surgical procedure which involves the removal of the uterus through an incision in the lower abdomen. A partial hysterectomy involves the removal of a portion of the uterus, leaving the cervix intact. A total hysterectomy is the removal of both the uterus and the cervix.

In some cases, a hysterectomy may include the removal of one or both ovaries and the fallopian tubes through a procedure called a total hysterectomy with salpingo-oophorectomy.

When is an abdominal hysterectomy?

An abdominal hysterectomy may be recommended if your uterus is large or if the gynaecologist wants to check other pelvic organs for signs of disease. A hysterectomy may be done to treat the following conditions:

• Gynecologic cancer – These are cancers that occur in the uterus or the cervix. Depending on the type of cancer you may have, your other treatment option may include radiation or chemotherapy.
• Fibroids – These are benign tumours that occur in the uterine, which may cause persistent bleeding, anaemia, pelvic pain or bladder pressure.
• Endometriosis – This occurs when the tissue lining the inside of the uterus, called the endometrium, grows outside the uterus on the ovaries, fallopian tubes, or on other pelvic or abdominal organs.
• Uterine prolapse – This is when the supporting tissue and ligaments of your pelvis weaken, which leads the uterus to sag into the vagina. It may result in urinary incontinence, pelvic pressure or difficulties with bowel movements.
• Abnormal bleeding – This is a condition where your periods may be heavy, irregular or prolonged each cycle. A hysterectomy may provide relief when the bleeding can’t be controlled by other treatment options.
• Chronic pelvic pain – This is when you are experiencing pelvic pain that may be caused by a uterine condition.

What does abdominal hysterectomy entail?

During the procedure, Dr Hlabisa will pass a urinary catheter through your urethra in order to empty your bladder. Your abdomen and vagina will be cleaned with a sterile solution before surgery. The gynaecologist will make an incision in your lower abdomen with the use of either a vertical incision (in the middle of the abdomen above the pubic bone) or a horizontal bikini-line incision (above the pubic bone). Dr Hlabisa will then detach your uterus from the ovaries, fallopian tubes and the upper vagina. The lower portion of the uterus, called the cervix, may also be removed. Other pelvic organs and tissue such as your ovaries or fallopian tubes may be removed.