Intimate Wellness Institute

What is a hysterectomy?

A hysterectomy is a surgery to remove the uterus, and sometimes, the cervix (bottom of the uterus. Depending on the reason for the surgery and your desires, a hysterectomy may also  involve removing the fallopian tubes and ovaries as well. (uterus diagram)

What are the different kinds of hysterectomy?

Dr. Guerette will discuss which options for a hysterectomy are available depending on your condition. This will determine if your cervix, fallopian tubes and/or ovaries need to be removed or should remain in place.

  • Total hysterectomy: This involves removing your uterus and cervix, but leaving your ovaries.
  • Supracervical hysterectomy: This is surgery to remove just the upper part of your uterus while leaving your cervix.  This is often done with a prolapse repair.
  • Total hysterectomy with bilateral salpingo-oophorectomy: Removal of your uterus, cervix, fallopian tubes (salpingectomy) and ovaries (oophorectomy).  (Diagram of types)

Ovaries are the organs that produce your hormones, not the uterus.  Leaving your ovaries WILL NOT put you in menopause if your ovaries are still functioning.

Why is a hysterectomy performed?

  • Abnormal or heavy vaginal bleeding that is severe or hasn’t improved with other treatments. 
  • Severe pain that isn’t improved by other treatment methods
  • Leiomyomas or uterine fibroids (noncancerous tumors).
  • Uterine prolapse – a “dropped uterus” that is causing symptoms.  This often occurs with other prolapse and incontinence.
    • Dr. Guerette also specializes in UTERINE PRESERVATION PROCEDURES for prolapse so a hysterectomy is not always necessary.
  • Cervical or uterine cancer or abnormalities that may lead to cancer for cancer prevention.  You will be referred to one of our oncology partners for cancer treatment.
  • Precancerous conditions of the uterus or endometrial lining of the uterus (what causes your period).
  • Endometriosis or Adenomyosis (endometriosis in the uterine muscle).

How common is it to get a hysterectomy?

Very common.  About 300,000 women get hysterectomies in the United States each year. 

Hysterectomy Approaches:

There are several different surgical approaches to perform a hysterectomy.  Dr. Guerette specializes in minimally invasive surgical approaches and a big abdominal incision is almost never needed.

Vaginal hysterectomy

  • Your uterus is removed through an incision at the top of your vagina. There is no visible incision.
  • Dissolvable stitches close the top of the vagina.
  • This is most often an outpatient procedure.

Laparoscopic hysterectomy

  • A small camera is  placed in your lower abdomen through a small incision in your belly button.
  • Additional small incisions are made for the other instruments.
  • Your uterus is removed through the one of the small incisions or through your vagina.
  • This is most often an outpatient procedure.

Abdominal hysterectomy

  • With Dr. Guerette’s expertise this is almost never required.
  • Your uterus is removed through an open incision in your abdomen.
  • This usually requires a longer hospital stay (two or three days), a longer recovery time and is more painful.

Robotic-assisted laparoscopic hysterectomy (diagram)

  • Dr. Guerette performs the procedure using a robot.
  • Small, thin surgical tools are inserted through three to five incisions around your belly button. Robotic arms and instruments are controlled by Dr. Guerette.
  • Patient  have less pain and recover faster with this technique.  
  • More complex procedures can be done in a minimally invasive fashion
  • Dr. Guerette is among the most experienced robotic gynecologic surgeons and is pioneer in robotic pelvic surgery.  He has been doing robotic gynecologic and reconstructive surgery since 2006 and has the longest experience of any surgeon in the region.  He has done extensive research in the field and has developed many advances in technique.
  • See IWI Robotic Program

Recovery from a hysterectomy:

Robotic, Vaginal and laparoscopic recovery take about two to four weeks. 

How does a hysterectomy affect sex?

Sex is often better after hysterectomy because the issue causing pain, bleeding, prolapse, etc is corrected.  Your sexual function isn’t usually negatively affected by a hysterectomy. Removing your ovaries will start symptoms of menopause if you were not already in menopause. Symptoms such as low sex drive and vaginal dryness may occur. Talk to the IWI team about hormone optimization.

Can you still have an orgasm after a hysterectomy?

Yes, you can still have an orgasm and ejaculate after a hysterectomy. A hysterectomy does not affect the nerves in the clitoris and vagina that give sexual sensation and orgasm. 

Does sex feel different to my partner after a hysterectomy?

Studies have consistently shown your partner’s sexual satisfaction is not affected by a hysterectomy.  Menopause from the ovaries being removed or naturally can cause dryness and discomfort.  IWI has excellent treatments to reverse these issues.

What are the benefits of advanced robotic surgery?

The incisions made during a robotic surgery cause minimal trauma (8mm) compared to those made to accommodate open surgery. As a result, laparoscopy offers:

  • Less postoperative pain
  • Lower risk of complications
  • Quicker recovery
  • Faster return to normal activities
  • Minimal scarring

Many minimally invasive procedures, whether robotic or traditional laparoscopy, can be done as an outpatient, so you go home the same day. If your procedure requires hospitalization, your stay is shorter than it would be for open surgery.

To learn more about robotic surgery, call IWI or book an appointment.