Hysterectomy is the surgery to remove uterus (womb). The commonest indication to perform hysterectomy is to remove fibroid uterus. It is the only definitive cure for abnormal uterine bleeding. It remains the most common major gynaecological procedure performed worldwide.

Dr Sem is an expert in total laparoscopic hysterectomy. He has performed hundreds of this procedure, and it is well recognized that high volume surgeons will have less intra-operative and post-operative complications in comparison to low volume surgeon.


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any concerns you have.

Types of Hysterectomy

Hysterectomy can be divided into which approach used to achieve removal of uterus. 

When it is performed through a large incision on abdominal wall, it is called abdominal hysterectomy. It can also be performed vaginally, hence the name vaginal hysterectomy. When it is performed exclusively through small incisions on abdominal wall (between 5 – 12 mm), then it is a laparoscopic hysterectomy.

Dr Sem will recommend the most appropriate approach for your clinical condition.

Hysterectomy is also classified based on the extent of the surgery.

  • Total hysterectomy – where both uterus (womb) and cervix (neck of the womb) are removed.
  • Sub-total or supra cervical hysterectomy – only the uterus is removed and cervix is kept.
  • Radical hysterectomy – usually reserved for treatment of gynaecological cancer, for example cancer of the cervix. In this surgery, the uterus and cervix, as well as connective tissue next to uterus (parametrium) and vaginal cuff are also removed to achieve clear surgical margin.

A common misconception is about removal of the ovaries at the time of hysterectomy. In pre-menopausal women, unless the ovaries were abnormal, generally there would be no indication to remove them. Of course, this may not apply to women with higher than average risk of ovarian cancer. Please check Dr Sem’s article on risk reduction surgery.

For recently post-menopausal woman (less than 5 years from last menstrual period), there might still be some additional health benefits in keeping the ovaries.

Dr Sem recommends removal of Fallopian tubes at the time of hysterectomy, to provide protection to some types of ovarian cancer and Fallopian tube cancer.

Indication for Hysterectomy

The commonest indication to perform hysterectomy is to remove fibroid uterus.

It is the only definitive cure for abnormal uterine bleeding/ heavy menstrual bleeding.

When the uterus (womb) has prolapsed down the vaginal canal, hysterectomy is performed in conjunction with pelvic reconstructive surgery.

It is also offered to women who have higher than average risk to develop uterine (womb) cancer. 

Alternatives to Hysterectomy

This will depend on the condition that you have. 

For example, to treat abnormal uterine bleeding caused by abnormality in the endometrium (lining of the womb), there are different options available.

It can be treated with hormones, anti-inflammatories medication, tranexamic acid, use of Mirena intrauterine system. 

Ablation (burning) of the endometrium can also achieve significant reduction in your menstrual blood loss.

Dr Sem will go through the different options with you, and will be able to recommend the best treatment to suit your clinical condition.