An abdominal hysterectomy is removal of the uterus and cervix with or without the ovaries through an incision approximately five inches wide in the abdomen. There are three types of hysterectomies that can be performed:

• Complete or total hysterectomy - the most common type of hysterectomy where the uterus and cervix are removed.
• Partial or subtotal hysterectomy - the cervix remains in place while the uterus is removed.
• Radical hysterectomy - usually performed when cancer is present. The uterus, cervix, and upper part of the vagina and tissue are removed.

An abdominal hysterectomy may be advised for any of the following:

• Uterine fibroids - non-cancerous tumors of the uterus that can cause heavy bleeding, discomfort and pain.
• Cancer of the uterus or organs and structures nearby.
• Chronic pelvic pain
• Endometriosis - a condition where tissue that typically lines the uterus grows elsewhere such as on the ovaries or behind the uterus. Endometriosis can cause scarring and infertility.
• Uterine prolapse - occurs when women age and vaginal supports begin to sag downward. The bladder and rectum may be pulled downward with the uterus.

Alternatives to hysterectomy depend on the condition it may be advised for. If cancer is present, a total hysterectomy may be the best course of treatment. When fibroids or endometriosis are present, other treatments are available. In the case of fibroids, surgery to remove the fibroids is an option. In addition, certain medications can help endometriosis.

Prior to any surgery, your doctor will give you a complete medical examination and evaluate your overall health and your health history. You may be required to get additional tests such as X-rays and lab tests. Your doctor will also review with you the potential risks and benefits of the operation and will ask you to sign a consent form. It is important that you ask questions and be sure you understand the reason for the surgery as well as the risks.

It is important that you inform your doctor if you have allergies to any medications, what medications you are taking, and if you have bleeding problems. It is also important to inform your doctor if you are pregnant.

Your doctor will also give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.

Depending on the circumstances of your surgery, you may be instructed to do the following:

• Completely empty your colon and cleanse your intestines prior to surgery. You may be requested to drink clear liquids only for one or several days prior to surgery.
• Stop eating or drinking after midnight the night before the operation except medications that your doctor has told you are permissible to take with a sip of water the morning of surgery.
• Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties.
• Stop smoking at least six to eight weeks prior to surgery as smoking delays wound healing. Smokers are also more likely to have breathing problems during surgery.

Depending on the type of hysterectomy you have, the length of your hospital stay may vary, usually one to two or two to four days. Complete recovery from abdominal hysterectomy is usually four to six weeks. Plan for significant recovery time which includes time off work and assistance from family members or friends.

Follow these recommendations for a smoother recovery:

• Avoid all lifting after surgery and for four to six weeks.
• Use pain reliever prescribed by your doctor to minimize discomfort.
• Use sanitary pads for discharge that may occur for several days after surgery.
• Use a heating pad over or under your abdomen.

If you experience any of the following symptoms occur after surgery, contact your doctor:

• High fever
• Heavy vaginal bleeding
• Leakage from your incision
• Shortness of breath
• Dizziness, fainting, nausea or vomiting
• Swelling, redness or pain in your leg

After abdominal hysterectomy is performed, you will experience major hormonal changes that can cause any of the following:

• Decreased sex drive
• Low energy
• Depression
• Vaginal dryness
• Hot flashes and night sweats

You should talk to your doctor about hormonal changes and side effects to determine strategies to help you with these changes. Medications and natural alternatives to hormone replacement are available.

A variety of factors may influence the cost of the surgery. They include:

• Insurance coverage
• Pre-existing health
• Insurance co-pay
• Location of the facility

These factors vary depending on you and your situation.

The cost of each procedure can vary dramatically based upon age, location, gender, and insurance coverage. HealthGrades provides detailed cost estimates which include the costs of the procedure, drugs, hospital stay, and more. Each cost estimate is easy to understand and provides medical terms you need to know.

The detailed cost estimate for Total Hysterectomy, includes costs for:

• Repair of bladder fistula with hysterectomy
• Open surgery to remove uterus only
• Open surgery to remove uterus and cervix
• Open surgery to remove uterus and cervix and repair pelvic floor
• Open surgery to remove uterus and cervix with pelvic lymph node sampling
• Open surgery to remove uterus, cervix, upper part of vagina, and supporting tissues for treatment of cancer
• Open surgery to remove all parts in pelvis to treat cancer
• Open surgery to remove tumor with hysterectomy and partial removal of lymph nodes
• Total hysterectomy with removal of ectopic pregnancy
• and Total hysterectomy following a c-section.