Hysterectomy

Introduction
General Information
Terms
Types of Surgery
Companion Surgeries
External Links: Additional Resources

Introduction

Hysterectomies are performed as treatment for various ailments such as uterine fibroids, pelvic support problems, chronic pelvic pain, gynecologic cancer, abnormal uterine bleeding, and abnormal uterine bleeding. This page will focus on the role that hysterectomies play for transgender men who have gender dysphoria regarding the possibility of getting pregnant.

This surgery to remove the uterus has a multitude of reasons to be performed. The reason for the surgery's inclusion here, is in regards to it being a gender-affirming surgery for certain transgender men. Why is it gender-affirming? For some trangender men, the idea of having a uterus causes gender dysphoria. Being able to menstruate and conceive isn't appealing to a majority of transgender men. This surgery helps provide gender euphoria and the comfort of knowing that the organ for creating a child (something heavily associated with being a woman) is gone.

General Information

A hysterectomy is the surgical removal of the uterus. This is a surgery that is performed by a gynocological surgeon while the patient is under general anesthesia. Though less common, some patients will be given regional anesthesia for a hysterectomy.

Hysterectomies are safe, but come with the same risks as any other surgical procedure done under general anesthesia such as; heavy bleeding during or after surgery, blood clots in the leg that can travel to the lungs, fever and infection, injury to the urinary tract or nearby organs, and breathing or heart problems related to anesthesia.

After having a hysterectomy, the patient will no longer be able to get pregnant or menustrate, making this surger appealing to many transgender men who experience gender dysphoria regarding pregnancy and menustration.

Hysterectomies typically take 2-3 hours to perform. Pain medications are typically perscribed after a hysterectomy.

The most common side effects after a hysterectomy are; difficulty peeing or pooping in the days following surgery, fatigue and tiredness from surgery, soreness or irritation at the incision sites, and vaginal bleeding and drainage (can last up to six weeks).

If your ovaries are removed, you may experience symptoms of menopause such as loss of libido, insomnia, vaginal dryness, and hot flashes.

Terms

Oophorectomy - Removal of the ovaries.
Radical Hysterectomy - The uerus and cervix are removed along with the structures that surround the uterus, such as the lymph nodes and surrounding tissues.
Salphingectomy - The removal of the fallopian tubes. On its own, this is also a common form of sterilization.
Salpingo-Oophorectomy - The removal of the fallopian tubes and the overies.
Supracervical Hysterectomy - The upper part of the uterus is removed. The cervix is not removed.
Total Hysterectomy - The uterus and the cervix are removed.

Types of Surgery

Abdominal Hysterectomy

The uterus is removed through a 6 to 8 inch long incision made in the lower abdomen - from belly button to your pubic bone or across the top of the pubic hairline. Stitches or staples are used to close the incision. Abdominal hysterectomies can be performed even if the uterus is large, or if there are adhesions present from a previous surgery. Abdominal hysterectomies are typically inpatient procedures. Typically the patient will stay in the hospital for 2-3 days after the procedure.

Abdominal hysterectomies are associated with a greater risk of the following potential complications (as opposed to other types of hysterectomies); such as wound infection, bleeding, blood clots, and nerve and tissue damage.

Laparoscopic Hysterectomy

A Laparscope is a thin tube with a video camera on the end of it. During a robot-assited laparoscopic hysterectomy, the surgeon controls a robotic machine that performs the surgery. Not all laparoscopic hysterectomies are robot-assisted. Robot-assisted hysterectomies take longer to perform than non-robot-assisted hyterectomies.

Laparoscopic hysterectomies typically result in a lower risk of infection, less pain, and a shorter hospital stay than abdominal hysterectomies. Laparoscopic hysterectomies are typically outpatient procedures.

Abdominal Laparoscopic Hysterectomy

Similar to an abdominal hysterectomy, a few small incisions are made in the abdomen. A laparoscope is inserted through one of the incisions near the bellybutton to allow the gynocological surgeon to see the pelvic organs. The uterus is then removed in small pieces, through the small incisions, or through a larger incision made in the abdomen.

Vaginal Laparoscopic Hysterectomy

A laparascope is inserted into the abdomen through a vaginally made incision to allow improved visualization of the pelvic structures. The uterus is removed through the vagina.

Recovery is typcially shorter and less painful than with an abdominal laparoscopic hysterectomy.

Vaginal Hysterectomy

During a vaginal hysterectomy, a small incision is made at the top of the vagina. Through this incision, the uterus is removed. Dissolvable stitches are used to stitch up the incision made. No abdomninal incisions are made.

Vaginal hysterectomies typically have fewer complications and shorter healing times than other types of hysterectomies. Recovery for a vaginal hysterectomy is typically around 4 weeks. If you are looking to get a hysterectomy, a vaginal one is recommended before other types. Someone with adhesions from a previous surgery, or has a large uterus may not be able to have a vaginal hysterectomy. Vaginal hysterectomies are typically outpatient procedures.

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