Removal of the uterus (hysterectomy)

Hysterectomy or removal of the uterus is a surgical procedure that involves removing all or part of the uterus

Female genitalia

Removal of the uterus (hysterectomy) | Dr Velemir, chirurgien gynécologue obstétricien à Nice

Extraperitoneal caesarean section

Removal of the uterus (hysterectomy) | Dr Velemir, chirurgien gynécologue obstétricien à Nice

Dr. Velemir is one of the ten gynecologists-obstetricians to practice extraperitoneal caesarean section in France. The technique of extraperitoneal cesarean section is still unknown, almost confidential, it has great benefits for moms and their babies. With extraperitoneal caesarean section, the sequelae and the risk of complications are reduced.
Learn more about extraperitoneal caesarean section.

What is a hysterectomy ?

A hysterectomy is a surgical procedure that involves removing all or part of the uterus.

We talk about :

total hysterectomy if the removal includes the body and the cervix.
subtotal hysterectomy if only the upper part of the uterus is removed and the cervix is left intact.
inter-adnexal hysterectomy if the ovaries and fallopian tubes are left intact.

Why should this operation be performed?

The main reasons behind such an intervention are:

Genital bleeding due to a uterine disease (fibroids, endometrial hyperplasia, adenomyosis, etc.) and a poor response to medical treatment or surgical alternatives that would preserve the uterus;
Genital prolapse (pelvic organ descent) with descent of the uterus;
Ovarian or uterine cancer;
Certain precancerous lesions of the uterus;
In exceptional cases, pain caused by uterine refractory response to medical treatment (endometriosis).

What happens during the operation

The procedure can be performed, depending on the case, under general or loco-regional (spinal) anaesthesia.

The procedure can be performed in three ways:

1. Laparoscopic hysterectomy

This is a precise and minimally invasive method with a simple and usually fast post-operative course. The patient can walk and urinate normally on the following day. The patient is generally discharged on the second day after the operation. Dr. Velemir uses this approach when performing a subtotal hysterectomy or in the case of uterus cancer.

2. Vaginal Hysterectomy (or by vaginal route)

This procedure is performed vaginally. The post-operative course is usually simple and fast. The patient can walk and urinate normally the next day. The patient is generally discharged on the second after the operation. Dr. Velemir uses the vaginal route in patients who have already given birth vaginally or who have had a prolapse.

3. Abdominal hysterectomy (or by laparotomy)

In this case, the operation is performed by opening the abdomen, generally horizontally (as in a caesarean section) and sometimes vertically, between the pubis and the navel. Powerful analgesics (derived from morphine) are often necessary during the first 24 hours. A catheter can be left in place in the bladder for 24–48 hours. It is generally possible to discharge the patient as of the fifth post-operative day. Dr. Velemir reserves this approach for very large uteruses or for advanced gynaecological cancers.

What happens after a hysterectomy ?

You are prescribed a work break for a period of 2 to 4 weeks. After you leave the clinic, you will be able to gradually resume your normal daily activities.
Sex and baths should be avoided for a period of four weeks, which is necessary for proper internal healing.

A post-operative visit is carried out within 2 to 4 weeks after surgery.

If you are not a post-menopausal woman before the surgery:

The main sign after a hysterectomy will be the absence of menstrual flow and the inability to become pregnant, which does not mean that you will be post-menopausal.
If the ovaries are left intact, they will continue to function until natural menopause. You will neither have hot flashes nor other menopausal signs after surgery.
If the ovaries are removed, the surgery leads to menopause and it is possible you will experience symptoms such as hot flashes. You can discuss the possibility of an alternative medical treatment with your doctor.

If you are post-menopausal before the surgical intervention:

There will be no notable change later.

A hysterectomy does not modify the possibility or quality of sexual intercourse in any case. There is no reason why you should experience side effects such as weight gain or depression, symptoms sometimes wrongly attributed to a hysterectomy.

Are there risks or inconveniences?

Hysterectomy is a common and efficient surgery, and consists of a procedure that is simple in most cases.

During the surgery, the route can first be changed according to the observations made. Opening the abdomen may be necessary if the surgery was scheduled due to natural means or by laparoscopy. Lesions of neighbouring organs may occur in exceptional cases i.e. injuries to the intestines, urinary tract or blood vessels, which require a specific surgical treatment. A blood transfusion may be necessary in the event of severe bleeding,

Ablation of the uterus (hysterectomy) in Nice

Because each patient is unique, with its own background and different experiences, trust the expert hands of Dr. Luka Velemir.