Hysterectomy & Bilateral Salpingo-Oophorectomy

Hysterectomy and bilateral salpingo-oophorectomy are two gender-affirming, lower body surgeries.
Hysterectomy removes all or part of the internal reproductive organ (uterus) and sometimes the gonads (ovaries), internal reproductive organ (fallopian) and internal organ (cervix). Oophorectomy removes one or both of the gonads (ovaries).

The goal is to prevent monthly bleeding, eliminate the need for regular Pap tests, allow you to lower your dose of testosterone, reducing its unwanted side effects and risks, and eliminate the risk of ovarian, uterine and cervical cancer. This surgery is done by an obstetrician or gynecologist in BC.


Referral & consult

1Complete surgical readiness assessment

To get started, you will need to complete one or two surgical readiness assessment(s) by one or two qualified assessors and and meet the eligibility and criteria required for this surgery. After you have completed your assessment, your primary care provider will direct your referral to the surgeon of choice. Additional assessments may be required at the discretion of the surgeon.

2Review referral options

Your primary care provider will direct your referral to an available obstetrician and gynecologist. Visit surgery referral for steps required in the referral options for hysterectomy and bilateral salpingo-oophorectomy. 

3Speak to your surgeon

You may want to speak to your surgeon about:

  • The different surgical techniques available
  • The advantages and disadvantages of each technique
  • The limitations of a procedure to achieve "ideal" results
  • Whether they have before-and-after photographs of their own patients, including those of both successful and unsuccessful outcomes
  • The risks and possible complications of the various techniques
  • The surgeon's own complication rates for each procedure
Surgery

The procedure

  1. About 3 to 5 tiny incisions are made on your abdomen.
  2. Gas is put into your abdomen to inflate it.
  3. A very small telescope is inserted into one of the incisions so the surgeon can see inside.
  4. Long, narrow instruments are inserted through the incisions to detach the internal reproductive organ (uterus and fallopian tubes), gonads (ovaries) and internal organ (cervix).
  5. The internal reproductive organ (uterus and fallopian tubes), gonads (ovaries) and internal organ (cervix) are removed through the internal genitals (vagina).
  6. The top of the internal genitals (vagina) is closed with stitches that will dissolve over time.
  7. The gas is released.

Preparing for surgery

While you wait for your referral to be processed, you should keep your personal information updated with all of your health care providers, including any change of name or contact information. This will ensure your health care professionals can reach you to schedule consultation and surgery appointments.

You may also want to visit the Preparing for Surgery page to help you create a plan for success after surgery.

Complications

All surgical procedures involve some risks. Risks include negative reactions to anesthesia, blood loss, blood clots and artery blockages. It's important to discuss these risks in detail with your surgeon. Your surgical care team will take a wide variety of steps to prevent these problems, detect them if they arise and respond to them appropriately. They will also inform you about what you can do to minimize your risks.

After surgery

Post-operative care

You will likely be discharged home 1 to 2 days after your surgery.

You will likely receive painkillers and antibiotics to reduce the chance of infection.

During the healing process, you can expect:

  • Discomfort in your belly
  • Pain in your upper chest and shoulder area, due to the gas used to inflate your abdomen.
  • Pink, brown or yellowish-brown discharge from your internal genitals (vagina) for 4 to 6 weeks
  • Possibility of passing some stitches (this is normal)
  • Incisions that may be red with some bruising (this will slowly go away)
  • Incisions that will be closed with Steri-strips, sutures or staples. Your surgeon will let you know whether and how these will be removed

Check-ups

The number of check-ups needed varies from person to person. You will likely be asked to visit your surgeon 4 to 6 weeks after your surgery to ensure you are healing as expected. You can also see your primary care provider about any concerns in the post-operative period.

When you visit your surgeon or primary care provider, they should check your surgical sites to make sure there are no infections or wound healing problems. They will ask questions about pain, bleeding, discharge, urination, bowel movements, fever and how you are feeling physically and emotionally.

Recovery time

Recovery time varies from person to person, so always follow the advice of your surgeon. You'll need to get plenty of rest in the first 2 weeks. Most people are back to their usual activities within 4 to 6 weeks. Some activities, such as driving, heavy lifting, exercise, sex and soaking in hot tubs, may be restricted in the post-operative period. Your surgeon will give you advice about when it is okay to resume these activities.

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