Types and Procedures of Hysterectomies

By Kim Vopni, The Vagina Coach — Certified Pelvic Floor Fitness Specialist · Published April 18, 2022

Direct Answer

A hysterectomy is surgery to remove the uterus, and sometimes the cervix, ovaries, or surrounding tissue, most often performed to treat cancer, chronic pain, or heavy bleeding that hasn't responded to less invasive treatment. The main types are total, partial (subtotal), and radical hysterectomy, and the procedure can be done vaginally, abdominally, or laparoscopically depending on your situation.

Key Takeaways

• A hysterectomy removes the uterus and, depending on type, the cervix, ovaries, or other reproductive structures.
• Common types include total (uterus + cervix), partial/subtotal (uterus only), and radical (uterus, cervix, upper vagina, and supporting tissue) hysterectomy.
• The procedure can be performed vaginally, abdominally, or laparoscopically, each with different recovery times and risks.
• Vaginal and laparoscopic approaches are generally less invasive, with less pain and faster recovery than abdominal surgery.
• Preparing your pelvic floor before and after surgery can support a smoother, more confident recovery.

 Photo by Thirdman on Pexels

Hysterectomies are typically performed to treat cancer, chronic pain, or heavy bleeding that has not been controlled with less invasive methods.

Depending on your condition, your surgeon will remove some or all of your uterus and possibly additional parts of your reproductive system. After a thorough assessment of your situation, your doctor will determine the procedure that is best for you.

Types of Hysterectomies

Complete Hysterectomy 

This type of hysterectomy involves the removal of both the uterus and the cervix. The majority of women undergoing hysterectomies have a complete or total hysterectomy.

Total Hysterectomy
Total hysterectomy is the most common type of hysterectomy. The uterus and your cervix are removed, but not your ovaries.

Total Hysterectomy with Bilateral Salpingo-Oophorectomy

This is when both the ovaries and the fallopian tubes are removed during a hysterectomy. The hysterectomy and bilateral salpingo-oophorectomy are both done during one procedure and will remove the uterus, cervix, ovaries, and fallopian tubes.

Partial (Subtotal) Hysterectomy

This type of hysterectomy involves the removal of the upper two-thirds of the uterus and leaves the lower third of the uterus, the cervix, intact. Women who have never had an abnormal Pap smear result may be candidates for this type of hysterectomy. Some believe a partial or subtotal hysterectomy helps to reduce sex-related concerns. It can be performed laparoscopically or abdominally.

Radical Hysterectomy

During a radical hysterectomy, the uterus, the cervix, the top portion of the vagina, and the supporting tissues are removed, and sometimes the pelvic lymph nodes. A radical hysterectomy may be an option in certain cases of cancer.

Hysterectomy Procedures

A hysterectomy can be done through the vagina, the abdomen or with laparoscopy.

Vaginal Procedure - the uterus is removed through a small incision inside the vagina, with no abdominal incisions. This minimally invasive technique generally causes fewer complications, less pain, and faster recovery than open procedures. It is usually the first choice unless there are reasons for using the more invasive procedures, such as adhesions or a large uterus. You should have a shorter healing time and return to your usual activities than with the other types of hysterectomy.

Abdominal Procedure - also referred to as open surgery - the uterus is removed through a large abdominal incision. Sometimes this incision is along the hairline, similar to a C-section incision. Other times, it runs up and down on the abdomen. This surgery gives the surgeon the best view of what is going on in your pelvis. The drawbacks are there is a greater risk of complications compared with less-invasive procedures. These risks include infection, bleeding, clots, damage to nerves and tissues and longer recovery time.

Laparoscopic Procedure - is minimally invasive using a laparoscope. Several thin instruments and a tiny video camera attached to a telescope are inserted through multiple small incisions in the abdomen. The advantages are that there is often less pain, less risk of infection, and less recovery time. But there is still a risk of injury to the urinary tract and other organs.

Hysterectomies are generally safe, but problems can occur as is the case in any necessary surgery.

Surgery may be the best option for you and I want you to be informed so you can make the best decision for your body and be calm and confident before, during and after the procedure.

That is why I created the Pelvic Surgery Success Program.

Pelvic Surgery Success is a one-of-a-kind program that will take you from feeling depressed, anxious, and consumed by fear of surgery to informed, confident and calm so you can put your nagging symptoms behind you and get back to living life with spontaneity and joy!

Frequently Asked Questions

What is the difference between a total and partial hysterectomy? A total hysterectomy removes the uterus and cervix, while a partial (subtotal) hysterectomy removes only the uterus and leaves the cervix in place.

What is a radical hysterectomy? A radical hysterectomy removes the uterus, cervix, the top portion of the vagina, and supporting tissue, and sometimes the pelvic lymph nodes, most often for certain cancers.

Which hysterectomy procedure has the shortest recovery time? The vaginal approach is usually the first choice when possible, since it's minimally invasive and generally causes less pain and a faster recovery than abdominal surgery.

Is laparoscopic hysterectomy safe? Laparoscopic hysterectomy is generally safe and minimally invasive, with less pain and quicker recovery than open surgery, though there is still some risk of injury to the urinary tract or other organs.

Will I need my ovaries removed during a hysterectomy? Not necessarily. Whether your ovaries are removed depends on the type of hysterectomy and your specific condition, so this is an important question to discuss directly with your surgeon.

How can I prepare my pelvic floor for hysterectomy surgery? Guided pelvic floor education and training before and after surgery can help you feel more informed, comfortable, and confident throughout your recovery.

If you're preparing for or recovering from a hysterectomy, guided pelvic floor training can help you feel supported and confident every step of the way. Join the Buff Muff membership for programs built to help you rebuild pelvic floor strength safely, before and after surgery.

Another Resource:

Why you may need a Hysterectomy and Alternatives

Vaginal Hysterectomy and Pelvic Floor Repair Surgery

Recovery Time after Rectocele Surgery

Menopause & Pelvic Organ Prolapse

If you enjoyed this article, you might also like our episode:
Optimizing Pelvic Floor Recovery Post-Op - Hysterectomy and More With Dr Rebeca Segraves

Listen to the episode