Types of Hysterectomy

There are three types of hysterectomy procedures. But, before choosing which type is right for you, it is important to educate yourself on all of your hysterectomy options

What is a Hysterectomy?

A hysterectomy is a surgery to remove the uterus. It is a very common type of surgery for women in the United States.¹  There are many reasons you may need a hysterectomy.  You may have a benign (non-cancer) diagnosis (such as uterine fibroids, endometriosis, pelvic organ prolapse, abnormal bleeding, or chronic pelvic pain), or cancer diagnosis of the uterus or cervix.  The most common reasons for hysterectomy are for benign conditions, specifically, to treat uterine fibroids, endometriosis, and uterine prolapse.¹

There are several surgical and non-surgical treatment options for each condition.  If your surgeon recommends surgery, it is important to choose which hysterectomy option is best for you.

Normally, a woman has a vagina, cervix, uterus, two fallopian tubes, and two ovaries. These anatomies make up the reproductive system.

In a hysterectomy procedure, your surgeon will remove your uterus, and may also remove your cervix, fallopian tubes, and ovaries at the same time.

There are three types of hysterectomy procedures

Total Hysterectomy

The uterus and the cervix are removed.  A Total Hysterectomy is necessary when the cervix needs to be removed, for example, if you have cervical cancer.

Partial Hysterectomy

In a Partial Hysterectomy (also known as Supracervical or subtotal hysterectomy), the uterus is removed, but the cervix is not.

Radical Hysterectomy

The uterus, the cervix, both fallopian tubes, and both ovaries are removed all at the same time. A Radical Hysterectomy is typically recommended if you have a cancer diagnosis.

Other Types

  • When the ovaries are removed, this procedure is called an ooprectomy.
  • When the fallopian tubes are removed, this procedure is called a salpingectomy.
  • When the ovaries and the fallopian tubes are removed, this procedure is called a salpingo-oophrectomy.

Women with hereditary cancer risks

Women who have a hereditary risk for breast and ovarian cancer (a BRCA 1 or BRCA 2 genetic mutation) have a higher risk of getting breast and ovarian cancer than the normal population. As a result, these women will have risk-reducing mastectomy (removal of breast tissue) and salpingo-oophrectomy procedures to remove their risk of developing cancer in the future. These procedures will be done to reduce their risk of getting ovarian or breast cancer. Many women will also opt to remove their uterus as well, and therefore, will have a risk-reducing radical hysterectomy as well.

Choosing which type of hysterectomy to have depends on your diagnosis. Talk with your doctor to determine which type of hysterectomy is right for you.

Surgical Procedures for Hysterectomy

There are five surgical approaches for hysterectomy.  The procedure your surgeon recommends will be based on the size and shape of your uterus and vagina, your diagnosis, the need for additional surgical procedures, the level of training your surgeon has, the technology your surgeon and hospital have, and patient preference.

Hidden Scar Hysterectomy

Hidden Scar Hysterectomy is a natural approach. In a Hidden Scar hysterectomy, your surgeon will perform a total or radical hysterectomy through the vagina, the body’s natural opening. The Hidden Scar approach is the least invasive approach, is safe, has low rates of complications and is cheaper for patients.1,2,3 And, a woman will have the added benefit of no visible scar. These are the reasons why the Hidden Scar approach is preferred by health insurance companies and is highly recommended by medical societies like American College of Obstetricians and Gynecologists and the Society of Gynecologic Surgeons.4 Ask your surgeon if you’re a candidate for Hidden Scar Surgery or find a Hidden Scar trained surgeon here.

Abdominal Hysterectomy

In an abdominal hysterectomy, your surgeon will perform any type of hysterectomy through the abdomen by making a vertical or horizontal incision in the abdomen. This is the most invasive approach, and should only be recommended when other approaches are not possible.³ In addition, a woman is left with a very visible scar.

Laparoscopic Hysterectomy and Robotic Hysterectomy

In a Laparoscopic Hysterectomy, a scope, camera, and other surgical instruments are inserted through several incisions around the abdomen. A Robotic Hysterectomy is similar to the laparoscopic hysterectomy, but the surgeon will use a robot to manipulate the instruments. Your surgeon will perform any type of hysterectomy (total, partial or radical hysterectomy) using these approaches. Although Laparoscopic and Robotic approaches are often called minimally invasive, they result in visible scars and patients often experience higher postoperative pain as compared to a vaginal approach.³ Additionally, a woman is left with several scars on her stomach.

Laparoscopic Assisted Vaginal Hysterectomy (LAVH)

In an LAVH procedure, your surgeon will perform a total or radical hysterectomy) using a combined laparoscopic and vaginal approach.  The laparoscope will be used for most of the procedure, and the uterus will be removed through the vagina. A woman is left with several scars on her stomach.

Learn more about what to expect during recovery after each type of hysterectomy.  

References

  1. ACOG Committee Opinion.  Choosing the Route of Hysterectomy for Benign Disease.  Nov 2009.  Reaffirmed 2011.
  2. Wright K, et al.  Costs and Outcomes of Abdominal, Vaginal, Laparoscopic and Robotic Hysterectomies.  JSLS (2012) 16:519-524
  3. Safety in gynecologic surgery:  A Roundtable Discussion. OBG Management Supplement. 2015.
  4. Chen et al.  Comparison of vaginal and abdominal hysterectomy:  A prospective non-randomized trial. Pak J Med Sci 2014. Vol. 30. No. 4
  5. United Healthcare Network Bulletin. Jan 2015.

Find a Surgeon or Hospital