A hysterectomy is a surgical procedure that involves the removal of the uterus, also known as the womb. This operation is performed for various medical reasons. This article explains the internal anatomical changes that occur after a hysterectomy.
Understanding What is Removed
Hysterectomy procedures vary based on the specific organs or parts of organs removed. A supracervical or partial hysterectomy involves the removal of only the upper part of the uterus, leaving the cervix intact. In contrast, a total hysterectomy removes the entire uterus and the cervix.
A more extensive procedure, known as a radical hysterectomy, is performed in cases of cancer. This surgery involves removing the whole uterus, the cervix, and the upper portion of the vagina, along with tissue on the sides of the uterus. Depending on the patient’s condition and the reason for the surgery, the ovaries (oophorectomy) and fallopian tubes (salpingectomy) may also be removed during any type of hysterectomy.
Immediate Internal Appearance After Surgery
Immediately after a hysterectomy, the internal surgical site shows signs of the procedure. The areas where the uterus and possibly other organs were detached will have raw edges. These edges are closed with sutures, or stitches, to hold tissues together for healing.
Some swelling and bruising may be present in the pelvic cavity. A small amount of fluid or blood may also be present. Internal stitches dissolve on their own within a few weeks.
Long-Term Internal Anatomy and Organ Repositioning
In the long term, the internal appearance of the pelvic cavity changes significantly after a hysterectomy. The empty space where the uterus once resided becomes less pronounced as surrounding organs naturally shift. The small and large intestines are the primary organs that settle into this newly vacant area.
This repositioning is a natural adjustment of the body to the altered anatomy. While some women may experience a slight shift in the position of organs like the bladder or bowels, the pelvic floor muscles remain in place, providing continued support. Over time, the internal appearance becomes much smoother and less inflamed as tissues heal and settle.
The Vaginal Cuff and Internal Scar Tissue
Following a total or radical hysterectomy, a structure known as the vaginal cuff is created. This cuff is the closed-off top end of the vagina, formed by stitching the vaginal edges together. It appears as a healed, often flattened or dome-shaped area of scar tissue.
Beyond the vaginal cuff, other internal scar tissue, referred to as adhesions, can form in the pelvic cavity. These adhesions appear as fibrous bands of tissue that can connect organs that are not normally joined. While adhesions are a natural part of the healing process, they are not visible externally and are an internal consequence of the body’s repair mechanisms.