Gynaecology

Hysterectomy

at Cadogan Clinic, London’s Leading Cosmetic Surgery Specialists. 

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What is a Hysterectomy?

A hysterectomy is a surgical procedure to remove the uterus (womb). Once the uterus has been removed, your periods will stop and you will no longer be able to get pregnant.

A hysterectomy is carried out to treat a range of health conditions that affect the female reproductive system. This may include fibroids, prolapse of the uterus, pelvic pain, gynaecological cancers and heavy, painful periods that are impacting on a woman’s quality of life.

Depending on the reasons for surgery, you may also have your cervix, ovaries and/or fallopian tubes removed as part of this procedure.

Although many women have a hysterectomy for various reasons, it is a major operation and comes with a long recovery time attached. It can take six to eight weeks to make a full recovery from a hysterectomy.

If your ovaries are removed as part of your hysterectomy, you will go through menopause immediately after the operation, regardless of your age. This is known as a surgical menopause.

A hysterectomy is usually only considered if all other treatment options have not worked, for example surgery to cut away endometrial tissue in the case of endometriosis.

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What are the different types of Hysterectomy?

There are four different types of hysterectomy. Your surgeon will help decide which one is right for you depending on the nature of your condition.

This surgery involves the complete removal of the uterus (womb) and the cervix, which is the neck of the womb. This is the most commonly performed type of hysterectomy. By removing the cervix as part of this procedure, this means that there is no risk of cervical cancer developing in the future.

In this procedure, the main body of the uterus is removed, but the cervix is left in place. This means that there is still a risk of cervical cancer and cervical screening tests (smear tests) will still need to be carried out.

Some women prefer a subtotal hysterectomy over a total hysterectomy as they want to be able to maintain their reproductive system as much as possible. Subtotal hysterectomy is a procedure that is not performed very often as surgeons tend to favour a total hysterectomy.

Bilateral salpingo-oophorectomy refers to the removal of both (bilateral) fallopian tubes (salpingo) and ovaries (oophorectomy). The uterus and cervix are also removed. Because the ovaries are removed, this will trigger menopause.

The National Institute for Health and Care Excellence (NICE) only recommends this particular type of hysterectomy if the ovaries are likely to cause problems if left in situ. A surgeon may recommend this type of hysterectomy if you have a family history of ovarian cancer, for example.

This involves the removal of the uterus and all surrounding tissues, including the ovaries, fallopian tubes, part of the vagina, lymph glands and fatty tissue. Because the ovaries are removed as part of this procedure, this will trigger a surgical menopause.

This is a much more extensive type of hysterectomy and is usually carried out to remove and treat cancer. A radical hysterectomy is recommended if other cancer treatments, such as chemotherapy or radiotherapy, have not worked.

There are three surgical methods which may be used when performing a hysterectomy. This includes a laparoscopic hysterectomy (keyhole surgery), a vaginal hysterectomy (uterus and cervix removed via the vagina) and an abdominal hysterectomy, where a horizontal cut is made along the bikini line to remove the uterus and any additional tissues via the abdomen.

The surgeon will decide on the best surgical method according to the type of hysterectomy which is being performed and your medical history.

When is a hysterectomy appropriate?

A hysterectomy can bring relief from a number of gynaecological conditions. These include:

Fibroids are benign (noncancerous) growths made up of muscle and fibrous tissue that develop in or around the uterus. They range from the size of a pea up to the size of a melon. Some women may not even be aware that they have fibroids, but around one in three will experience fibroids symptoms such as heavy or painful periods, abdominal or lower back pain and pain during sex.

In endometriosis, tissue similar to that found in the uterus starts growing where it shouldn’t be, for example on the ovaries or fallopian tubes. This can be incredibly painful and lead to heavy and irregular periods. A hysterectomy will usually only be considered as a treatment if other less-invasive treatments have not worked.

After childbirth, the tissues and ligaments supporting the uterus may become weak, causing it to drop down from its normal position and bulge into the vagina. Women with a prolapsed uterus, who are post-menopausal or who do not plan on having any more children, may be suitable for a hysterectomy. This can help to relieve the pressure on the vaginal walls, cutting the chance of a prolapse recurring. 

A hysterectomy is carried as a cancer treatment only when all other treatments, such as chemotherapy and radiotherapy, have not worked. A hysterectomy may be carried out to treat cervical cancer, ovarian cancer, cancer of the uterus or cancer of the fallopian tubes.

Pelvic inflammatory disease (PID) is a bacterial infection that affects the female reproductive system. It can be successfully treated with antibiotics if caught early, but as it progresses it can damage the uterus and fallopian tubes, resulting in long-term pain.

Sometimes heavy periods are caused by fibroids, but in many cases it isn’t clear why a woman suffers from heavy periods. As well as losing lots of blood, a woman experiencing regular heavy periods may suffer from stomach cramps and pain, affecting her quality of life.

In this condition, tissue that normally lines the uterus starts to grow within the muscular wall of the uterus, causing a great deal of pelvic pain and period pain.


The cost of a Hysterectomy

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Included in this treatment

Up to two 60 minute consultations with a leading specialist plastic surgeon at our award-winning premises in Chelsea

Your procedure carried out at London’s leading specialist cosmetic surgery centre of excellence

24/7 on call nurse assistance 

Dedicated Patient Co-ordinator, as a personal point of contact through your journey with Cadogan 

A pre-operative medical assessment to ensure you are fit for surgery 

Comprehensive post-operative aftercare courtesy of our specialist cosmetic nurses


What does the procedure involve?

There are three different ways that a hysterectomy can be performed.

Laparoscopic (keyhole) surgery is by far the preferred method to carry out a hysterectomy. Laparoscopy is a minimally-invasive surgical procedure which allows the surgeon to see inside the abdomen and pelvis without having to make large cuts through the skin. Instead only a small incision is needed, just big enough to allow a small tube with a light and camera (a laparoscope) into the body. Surgical instruments will be inserted through other small incisions made in the abdomen or vagina to remove your uterus, cervix and any other parts of the reproductive system. A laparoscopy is usually carried out under a general anaesthetic. It is the least invasive of the three hysterectomy procedures.

A vaginal hysterectomy, where the uterus and cervix are removed through a cut made at the top of the vagina, can be carried out under a general, local or spinal anaesthetic.

Once the incision has been made special surgical instruments are put into the vagina to gently detach the uterus from the ligaments that hold it in place. After the uterus and cervix have been removed, dissolvable stitches are used to close the incision.

A vaginal hysterectomy is a less invasive procedure than an abdominal hysterectomy and the recovery time is usually quicker.

An abdominal hysterectomy is usually recommended if your uterus has been enlarged by fibroids of pelvic tumours, making it physically impossible to remove the uterus through the vagina.

The surgeon will make a horizontal incision along the bikini line to remove the uterus. If there are particularly large fibroids present, then a vertical incision, stretching from the belly button to the bikini line, may be used instead.

An abdominal hysterectomy takes around one hour to perform under a general anaesthetic. It is the most invasive surgical option.

How should I prepare for a Hysterectomy?

You should aim to exercise, eat healthily and lose weight if you are overweight as good health before surgery will help speed up recovery and reduce the risk of complications.

Will also be expected to do the following ahead of your surgery:

  • Stop smoking. Smoking can slow the healing process. If you smoke, your doctor will recommend that you stop smoking six weeks before surgery and during the recovery period. You should avoid smoking for at least 48 hours before your surgery.
  • Avoid taking certain medications. You should avoid taking aspirin, anti-inflammatory drugs and herbal supplements in the week ahead of your surgery. Taking these can increase the risk of bleeding.
  • Avoid alcohol. You should not drink any alcohol for 48 hours ahead of your surgery.
  • Avoid food and drink: You should not eat or drink in the six hours prior to surgery, other than small sips of clear fluid which will be allowed up to two hours before you are admitted to the clinic.

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Frequently Asked Questions

There are some side effects that you might experience following your hysterectomy. You may experience some, all, or none of the following:

Vaginal discharge: It is common to experience some vaginal discharge and bleeding during your hysterectomy recovery. This may last for up to six weeks.

If the discharge has a strong smell, or if you start to bleed more heavily or pass clots, you should see your doctor.

Urinary tract infections: You may find that you develop urinary tract infection (UTIs) after surgery.

Constipation: It is common for women to experience constipation following a hysterectomy. Upping your fibre intake will help to combat this, but you may need laxatives at first to help you avoid straining.

Menopausal symptoms: If you have had your ovaries removed during the procedure, you will be in surgical menopause. This means you may experience typical menopausal symptoms, such as hot flushes and feeling weepy and anxious. Hormone replacement therapy (HRT) can be prescribed to ease these symptoms.

Emotional difficulties: A hysterectomy is a major operation and you may find it triggers emotional difficulties. It is common to experience grief and a sense of loss, particularly if there was no other alternative to a hysterectomy (in cancer treatment, for example). You may find it helps to seek out a support group or counselling if needed. If you are experiencing feelings of depression which won’t go away, speak to your doctor.

The hysterectomy itself will be carried out under an anaesthetic, meaning you will not be able to feel any pain while the surgery is taking place. The type of anaesthetics which may be used are a general anaesthetic (you will be asleep during the procedure), local anaesthetic (you will be awake but the treatment area will be numb) or a spinal anaesthetic (be numb from the waist down). The type of anaesthetic used depends on which type of hysterectomy you are having and your own personal circumstances.

You may experience some pain once the anaesthetic has worn off, but you will be given painkillers to help with this. Once you have been discharged, over-the-counter painkillers will help with any pain or discomfort.

Hysterectomy recovery time depends on the type of surgery that you have had. It is quicker to recover from a vaginal or laparoscopy hysterectomy than an abdominal hysterectomy. It generally takes between six and eight weeks to fully recover from a hysterectomy. You should be driving again by two weeks and be able to resume your exercise routine in four to six weeks, depending on how your body feels. You should expect to take between three and six weeks off work to recovery, depending on what kind of work you do.

You should avoid all heavy lifting during your recovery.

Yes it is possible to get a hysterectomy on the NHS. However the NHS has been, and continues to be, hit hard by the Covid-19 pandemic. High levels of staff sickness have had an impact on waiting times across the board. These waiting times vary from hospital to hospital, but you may be waiting for up to a year if your case isn’t urgent. Any new waves of Covid-19 infections may result in this wait getting even longer. Because of this, many people choose to go to a private clinic for their hysterectomy. At the Cadogan Clinic, there is no waiting list, so you can have the procedure promptly.

A private hysterectomy in the UK costs in the region of £6,000. This varies from clinic to clinic and depends on what is included in the treatment package.

If you choose the Cadogan Clinic for your hysterectomy in London, you will get:

  • Up to two 60 minute consultations with a leading specialist plastic surgeon at our award-winning premises in Chelsea
  • Your hysterectomy at London’s leading specialist cosmetic surgery centre of excellence
  • 24/7 on-call nurse assistance
  • A Dedicated Patient Coordinator, as a personal point of contact through your journey with Cadogan
  • A preoperative medical assessment
  • Comprehensive aftercare courtesy of our specialist team of nurses

As with any other type of surgery, there is a small risk of complications attached to having a hysterectomy. These include: bleeding, infection, damage to the bladder, ureter or bowel, infection, blood clots and ovary failure. If you have had your ovaries removed during surgery then you will go into menopause after surgery.

Just like any other type of surgery, there is also a risk of complications caused by the general anaesthetic. Your surgeon will discuss the risks and complications with you ahead of your hysterectomy.

Yes, a hysterectomy is serious surgery. It can take several weeks to recover from. You should make sure you rest and avoid heavy lifting during your recovery.

A hysterectomy means that you will not be able to get pregnant and if your ovaries are removed as part of the surgery, you will go into menopause immediately afterwards. Having a hysterectomy can also have a huge emotional impact too. But on the plus side, a hysterectomy can relieve you of pain and heavy periods and improve your quality of life.

You may notice a change in your body shape after your hysterectomy. When the ligaments holding the uterus in place are cut, this can cause skeletal changes which may result in a shortened, thickened midsection, protruding belly, and loss of the curve in the lower back. Some women may find they suddenly have rolls of fat, even without gaining weight. However everyone is different and a hysterectomy can affect different women in different ways.

You should avoid having sex until your scars have healed and you have stopped producing vaginal discharge. This should take between four and six weeks. You should not have sex unless you feel comfortable and ready to do so. You should also avoid using internal sex toys during this period.

If you find sex uncomfortable, stop and try again later. If the discomfort continues, speak to your doctor. If you have entered menopause after having your ovaries removed, then you may experience some vaginal dryness. You can try some lubricant or your GP may prescribe you some HRT to help with this.

Hysterectomy scarring depends on which procedure you have had. Abdominal hysterectomy results in a visible scar, but this is usually along the bikini line, so it is easily covered by clothing.

A vaginal hysterectomy leaves no visible scarring. A minimally-invasive laparoscopic hysterectomy involves a small incision in the belly button and two or three other small incisions in the abdomen. These incisions will leave a few small scars around the size of a penny. These will soon fade and you will barely notice they are there.


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What are the risks?

Complications are rare although, as with all surgery, possible. Your surgeon will discuss each of these risks comprehensively at your consultation. Read our FAQ section for more information.


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