The uterus and cervix are two of the most dominant organs in the female reproductive system. They serve important purposes for the woman throughout her life, such as those regarding pregnancy and childbirth, menstruation, hormone production and more. However, there are instances when these organs do not function properly or when they become diseased. While there are various treatments available for different types of conditions that may save the organs, there are instances when a total abdominal hysterectomy is needed. If you have been told that you need this procedure done, you may be interested in learning more about it.

What Is a Total Abdominal Hysterectomy?

A hysterectomy is medical terminology regarding the surgical removal of the uterus from the body. A total abdominal hysterectomy means that both the uterus and the cervix are removed. In some cases, the ovaries and fallopian tubes are also removed, but this depends on the surgeon and the patient.

The surgery usually is completed by making an incision in the abdomen. The incision may be a bikini cut, meaning that that it is concealed by the lower half of a bikini, or a vertical cut. This is considered to be a major abdominal surgery.

Lab work and fasting must be completed before the procedure. Anesthesia is required, and the patient typically will need to remain in the hospital for at least a couple of days after the procedure to recover and to ensure that there are no serious complications.

Who May Need a Total Abdominal Hysterectomy?

A total abdominal hysterectomy is a very serious surgery in terms of its significance on the body, and it has long-term impacts on the patient’s life. For example, it can affect her ability to have children in the future as well as to produce hormones naturally. With this in mind, the decision to get a total abdominal hysterectomy is not a matter to take lightly.  Some of the conditions that may result in the recommendation for this surgery or in the medical necessity for it include fibroids, endometriosis, an overgrowth of the uterine lining, pelvic pain, abnormal vaginal bleeding, an infection in these organs and more.

It is important for you to know that abdominal hysterectomies rarely should be performed any longer.  This is because most doctors are trained to perform newer surgical techniques and will perform laparoscopic, robotic, or vaginal hysterectomies since they are better for the patient.

If your doctor recommends this significant level of surgery, you should ask questions so that you have a full understanding of the need for it. You may also obtain a second opinion unless you need emergency surgery that cannot wait.

Risks Involving a Total Abdominal Hysterectomy

As with all surgeries, there are risks associated with having a total abdominal hysterectomy performed, and there are also long-term consequences associated with it. During the surgery, the patient may experience significant or heavy bleeding that could result in the need for a transfusion. In rare cases, the patient experiences severe damage to surrounding organs, and these include the bladder, kidneys, ureters or bowels. Death is very rare from a hysterectomy.

After the surgery has been completed, the patient may experience symptoms or side effects. These include bowel obstruction or severe gas pains, an incision that re-opens or that will not heal, a hernia, a blood clot in the lungs or in the legs, an infection at the incision site, redness, pain, swelling and the developing of thick scar tissue that causes the appearance of lumps in the abdomen.


Because a total abdominal hysterectomy is a serious surgery, the recovery time is rather significant. Most patients are able and even encouraged to get up and move around within 24 hours after the surgery. Mobility encourages more rapid recovery time, but it can be painful after this type of surgery. Pain medications are usually provided to the patient, and the patient may take the drugs for one to two weeks or longer in some cases to manage the pain.

When the patient is mobile and signs of serious complications have not developed, the patient may return home from the hospital. This is usually within two to three days after the surgery. Bed rest alternating with light walking can promote healing in the days following the surgery.

Only patients who also have their ovaries removed should be aware that they can take hormone supplements to minimize menopause symptoms. In addition, pregnancy is not possible after this procedure. If eggs were protected, however, a surrogate pregnancy is one option that couples can consider. Menstruation will also no longer occur after this procedure has been performed.

Alternatives to a Total Abdominal Hysterectomy

Because a total abdominal hysterectomy has serious consequences, patients may consider alternatives to this surgery if possible. Depending on the symptoms or diagnosis, the doctor may also recommend a uterine ablation to scrape the inside of the uterine walls, oral medications to manage pain or fight infection and more. In some cases, a supracervical hysterectomy may be completed.  It is almost always better for a patient to have a vaginal, laparoscopic, or robotic laparoscopic hysterectomy and one of these procedures should be recommended before the abdominal hysterectomy.

It is important for patients to speak openly with their doctor about all possible alternatives to this surgery and to seek a second opinion as desired, especially if your doctor won’t discuss any other options with you.  The impact of this surgery is irreversible, such as the impact on fertility, and all patients should be comfortable with this outcome. Keep in mind that some patients are not given an option, and this procedure may be completed urgently in an effort to save the patient’s life in some cases.

Summing Up

If you have been told that you need a total abdominal hysterectomy, you may understandably be feeling stressed and concerned. Many patients have a fear of being on an operating room table or staying in a hospital, and this is understandable. Others are concerned about the long-term effects of this procedure on their lives.

The decision to proceed with this surgery is not a matter to take lightly, but bear in mind that the surgery can improve your life in many ways. For example, it can alleviate pain and other unpleasant symptoms you may be experiencing that are interfering with your life currently. If you have any personal experience with this surgery, do share your experience.


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