Abdominal hysterectomy is a surgical procedure that involves the removal of the uterus through an incision made in the lower abdomen. Depending on the medical condition, the procedure may also involve removal of the cervix, fallopian tubes, and/or ovaries. It is one of the most commonly performed gynaecological surgeries and may be recommended for a variety of benign or malignant conditions affecting the uterus.

The suitability of abdominal hysterectomy depends on several individual factors, including the underlying medical condition, the size and position of the uterus, previous abdominal or pelvic surgeries, overall health, and the specific goals of treatment.

When is Abdominal Hysterectomy Considered?

Abdominal hysterectomy may be considered for women with conditions such as:

• Large uterine fibroids
• Abnormal or heavy uterine bleeding not responding to other treatments
• Endometriosis or adenomyosis
• Uterine prolapse
• Chronic pelvic pain related to uterine conditions
• Gynaecological cancers, including cancer of the uterus, cervix, or ovaries
• Cases where a large or complex uterus makes a minimally invasive approach less suitable

Before recommending the procedure, the doctor may evaluate:

• The nature and severity of the underlying condition.
• The size and mobility of the uterus.
• Previous abdominal or pelvic surgical history.
• Overall health and fitness for surgery.
• Whether the ovaries and/or cervix should also be removed.
• Alternative treatment options, where applicable.

A detailed evaluation helps determine whether abdominal hysterectomy is the most appropriate approach compared to other surgical techniques.

What Happens During Abdominal Hysterectomy?

Before the procedure, the doctor reviews the patient’s medical and surgical history and conducts relevant investigations to assess the uterus and surrounding structures. The procedure is performed under general or regional anaesthesia.

During surgery, an incision is made in the lower abdomen, either horizontally or vertically, depending on the size of the uterus and the reason for surgery. The uterus is carefully separated from surrounding tissues, blood vessels, and ligaments, and then removed. Depending on the clinical need, the fallopian tubes and ovaries may or may not be removed at the same time.

The exact surgical approach and extent of removal depend on the underlying condition and the surgeon’s clinical judgement.

Recovery After Abdominal Hysterectomy

Recovery after abdominal hysterectomy typically takes longer than minimally invasive approaches, as it involves a larger incision. Patients are generally advised to follow their doctor’s postoperative instructions carefully.

Important aspects of recovery may include:

• Keeping the surgical area clean and following wound-care instructions.
• Taking prescribed medications for pain relief and infection prevention.
• Gradually resuming daily activities while avoiding heavy lifting or strenuous exertion.
• Allowing adequate time for the abdominal incision to heal.
• Attending scheduled follow-up appointments.
• Discussing when it is appropriate to resume normal activities, including work and exercise.

Your doctor will provide personalised guidance based on your recovery and overall health.

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