vaginal hysterectomy is a surgical procedure to remove the uterus through the vagina.
During a vaginal hysterectomy, the surgeon frees the uterus from the ovaries, fallopian tubes and upper vagina, as well as from the blood vessels and connective tissue that support it. Then the surgeon removes the uterus.
This approach, which takes the uterus through the vagina, involves a shorter time in the hospital, lower cost and faster recovery than taking the uterus through a cut, called an incision, in the lower belly. But vaginal hysterectomy is not always possible. It depends on the size and shape of the uterus or the reason for the surgery.
Your healthcare professional will talk with you about other types of surgery. These might include hysterectomy using robotic or laparoscopic surgery through small cuts on the belly or a hysterectomy through a longer cut on the belly, called abdominal hysterectomy. Robotic and laparoscopic surgeries most often involve the uterus being removed through the vagina.
Hysterectomy often includes removal of the cervix. This is called a total vaginal hysterectomy. When the surgeon also removes one or both ovaries and fallopian tubes, it's called a total hysterectomy with salpingo-oophorectomy (sal-ping-go-o-of-uh-REK-tuh-me). All these organs are in the pelvis as part of the reproductive system.
Why it’s done
Vaginal hysterectomy treats conditions that affect the female reproductive system, including:
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Fibroids. Fibroids are tumors in the uterus that aren't cancer. Fibroids can cause bleeding, anemia, pelvic pain, pain during intercourse and bladder pressure.
Large fibroids might need a different type of hysterectomy surgery. The surgery removes the uterus through a cut, called an incision, in the lower belly. This is called an abdominal hysterectomy.
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Endometriosis. This condition happens when tissue that is similar to the inner lining of the uterus grows outside the uterus. The tissue may grow on the ovaries, fallopian tubes or other organs. Most people with endometriosis have a laparoscopic hysterectomy. For this type of surgery, a surgeon uses a lighted scope with a camera put through a cut in the belly.
Other people with endometriosis might have surgery using robotic controls, called a robotic hysterectomy, or an abdominal hysterectomy. But sometimes a vaginal hysterectomy for endometriosis is possible.
- Adenomyosis. This happens when the tissue that lines the uterus grows into the uterine wall. Adenomyosis makes the uterus get bigger and causes painful, heavy periods. Adenomyosis often goes away after menopause. Or treatment might involve a hysterectomy.
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Gynecologic cancer. Treatment might involve a hysterectomy for cancer of the uterus, cervix, endometrium or ovaries, or for changes that come before cancer, called precancerous changes. For endometrial cancer, surgeons most often use robotic or laparoscopic hysterectomy.
Treatment for ovarian or cervical cancer most often involves an abdominal hysterectomy. But sometimes a vaginal hysterectomy can treat endometrial or cervical cancer.
- Uterine prolapse. When tissues and ligaments that support the pelvis weaken or stretch out, the uterus can sag into the vagina. This can cause urine leakage, pelvic pressure or trouble passing stool. Removing the uterus and repairing supportive tissues might relieve those symptoms.
- Irregular, heavy or very long periods. A hysterectomy may be needed if medicine or a less invasive surgical procedure doesn't control the bleeding.
- Ongoing, also called chronic, pelvic pain. If a condition of the uterus is the clear cause of pelvic pain, a hysterectomy might help if no other treatment has worked. Chronic pelvic pain can have several causes. So before having a hysterectomy, you need a correct diagnosis of the cause.
For most of these conditions except cancer, hysterectomy may be just one treatment option. Medicines or less invasive gynecological procedures might ease your symptoms.
You cannot become pregnant after a hysterectomy. If you think you might still want to get pregnant, find out about other treatments.