Different Types of Hysterectomies

Extent of Organ Removal and Surgical Procedures

Surgeons performing surgery in operating room
Getty Images/Morsa Images

A hysterectomy is the surgical removal of all or part of a woman’s uterus. Hysterectomies are typically performed to treat cancer, chronic pain, or heavy bleeding that has not been controlled by less invasive methods.

Because you cannot get pregnant after having a hysterectomy, other medications or procedures are sometimes tried beforehand. Some women wait to have a hysterectomy until after they have completed their families. Just keep in mind that if you choose another option besides a hysterectomy, you may need additional treatment later.

As for what happens during a hysterectomy, there are three different types of hysterectomies that can be done, and which one your surgeon opts to perform depends on why you need to get one in the first place.

Complete or Total Hysterectomy 

This type of hysterectomy involves the removal of both the uterus and the cervix. The majority of women undergoing hysterectomies have a complete or total hysterectomy.

Partial or Subtotal Hysterectomy (Supracervical Hysterectomy)

This type of hysterectomy involves the removal of the upper two-thirds of the uterus and leaves the lower third of the uterus, which is called the cervix, intact. Women who have never had an abnormal Pap smear result may be candidates for this type of hysterectomy. Some believe a partial or subtotal hysterectomy helps to reduce sex-related consequences. It can be performed laparoscopically or abdominally.

Radical Hysterectomy

During a radical hysterectomy, the uterus, the cervix, the upper part of the vagina, and supporting tissues are removed. A radical hysterectomy may be necessary in certain cases of cancer.

When both the ovaries and the fallopian tubes are removed during a hysterectomy, it is referred to as a hysterectomy with bilateral salpingo-oophorectomy. The bilateral salpingo-oophorectomy is routinely performed in the United States. Removal of the ovaries before a woman reaches natural menopause often causes induced or surgical menopause.

Types of Hysterectomy Procedures

Besides the extent of removal of organs and tissues, there are different types of surgical procedures used in performing a hysterectomy.

  • Abdominal Hysterectomy:  This surgery gives the surgeon the best view of what is going on in your pelvis. It is done with an incision in the abdomen that can be vertical or horizontal and will leave a scar. It may be done when there are adhesions or if the uterus is very large. The drawbacks are that there is a greater risk of complications compared with less-invasive procedures. These risks include infection, bleeding, clots, and damage to nerves and tissues. You will also probably need a longer stay in the hospital.
  • Laparoscopic Hysterectomy: This is a minimally-invasive procedure using a laparoscopic. The surgical instruments are inserted either through the vagina or through small incisions in the abdomen. The uterus is removed in pieces, either through the incisions or through the vagina. The advantages compared with an abdominal hysterectomy are that there is often less pain, less risk of infection, and less time spent in the hospital. But there is still a risk of injury to the urinary tract and other organs.
  • Vaginal Hysterectomy: This hysterectomy is performed entirely through the vagina, avoiding any abdominal incision or scars. It is usually the first choice unless there are reasons for using the more invasive procedures, such as adhesions or a large uterus. You should have a shorter healing time and return to your usual activities than with the other types of hysterectomy.

A Word From Verywell

Be sure to ask your surgeon questions before your hysterectomy so you understand the procedure, risks  side effects, and expected recovery time. It's important to understand the surgical procedure itself, the conditions that make a hysterectomy medically necessary, and the details of any alternative procedures that may be more appropriate for you.

View Article Sources
  • Hysterectomy. The American College of Obstetricians and Gynecologists. https://www.acog.org/Patients/FAQs/Hysterectomy.