Hysterectomy Fact Sheet
Hysterectomy is a major surgery. Hence, it is important to exhaust all conservative non-surgical therapies before resorting to this operative solution. Only after failure of all other treatments should a hysterectomy be considered.

In preparation for a hysterectomy, every effort should be made to shorten the recovery period, including hospital stay and time required to return to a normal life style. Reduction in postoperative pain and possible long tern effects are significant goals as well. Therefore, it is very important to choose the proper form of hysterectomy.

Types of Hysterectomy
• Total Abdominal Hysterectomy (TAH): TAH is the most conventional type of hysterectomy. It requires a several inch length abdominal and vaginal incisions. Patients spend at least 3 – 4 days in the hospital and need about 6 – 8 weeks of recovery before returning to a normal lifestyle. More than 60% of hysterectomies in the United States are preformed as TAH.

• Total Vaginal Hysterectomy (TVH): TVH is almost always preferred as compared to TAH. This type of hysterectomy requires only a vaginal incision. Postoperatively, 1 – 2 days of a hospital stay and about 4 weeks of recuperation before returning to normal activities is needed. A higher level of surgical expertise is required to perform a TVH as compared to TAH. There are virtually no cases when the TVH procedure could not be utilized instead of the TAH; however, only about 30% of hysterectomies in the United States are done vaginally.

• Total Laparoscopic Hysterectomy (TLH) and Laparoscopically Assisted Vaginal Hysterectomy (LAVH): TLH and LAVH have similar lengths of hospital stay and time to recover at home as compared to TVH. Contrary to TVH, three laparoscopic (abdominal) incisions are needed in addition to the basic vaginal incision. Surgeons who are less comfortable performing vaginal surgery prefer TLH/LAVH. A high degree of experience in laparoscopic surgery is required to perform TLH.

• Laparoscopic Supracervical Hysterectomy (LSH): LSH is preferred over TVH, TAH, TLH and LAVH for selected patients. LSH requires only three laparoscopic incisions – a tiny (half an inch) umbilical-naval incision and two tiny (fifth of an inch) abdominal incisions. LSH leaves the uterine cervix and its pelvic attachments intact and therefore there is no vaginal incision. This may possibly contribute to less pelvic floor dysfunction as compared to other types of hysterectomy. LSH is an outpatient surgery and the patient returns to her normal lifestyle in only two weeks. LSH is suitable only for compliant patients whose PAP smears were performed regularly and were all normal for several years. A high level of knowledge in laparoscopic surgery is required to perform a LSH. LSH results in fewer complications as compared to other types of hysterectomy.