FTM (Female to Male) Hysterectomy – a surgical procedure to remove all parts of the uterus and sometimes the ovaries and/or fallopian tubes. It is a gender-affirming, masculinizing lower surgery. Oophorectomy is a surgery to remove the ovaries and is a gender-affirming, masculinizing lower surgery.
The three surgical approaches to a hysterectomy are:
- Abdominal laparotomy, which involves an incision in the lower abdomen
- Transvaginal, which involves removing the uterus through the vagina or front hole
- Abdominal laparoscopy, which involves a small incision near the belly button
Preparation prior to surgery:
Assessment of the medical history (any allergies, serious medical condition and all
medications taken both prescribed and non-prescribed), physical examination, and laboratory tests will be performed during consultation.
Smoking must be avoided for about 3-4 weeks prior to surgery, as nicotine interferes with circulation and will greatly affect healing process.
You will likely to be asked to stop drinking alcohol, a week before the surgery and throughout your recovery period.
Avoid taking any medications such as hormones, anticoagulants, anabolic steroids and supplements at least 4-6 weeks to prevent complicating medical factors prior to surgery. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.
Types of anesthesia use:
Admission stays in our affiliated hospital 2-3 nights
Surgery takes 1-3 hours
During the procedure:
You’ll lie on your back, in a position similar to the one you’re in for a Pap test. You might have a urinary catheter inserted to empty your bladder. A member of your surgical team will clean the surgical area with a sterile solution before surgery.
To perform the hysterectomy:
- Your surgeon makes an incision inside your vagina to get to the uterus
- Using long instruments, your surgeon clamps the uterine blood vessels and separates your uterus from the connective tissue, ovaries and fallopian tubes
- Your uterus is removed through the vaginal opening, and absorbable stitches are used to control any bleeding inside the pelvis
Laparoscopic or robotic hysterectomy
You might be a candidate for a laparoscopically assisted vaginal hysterectomy (LAVH) or robotic hysterectomy. Both procedures allow your surgeon to remove the uterus vaginally while being able to see your pelvic organs through a slender viewing instrument called a laparoscope.
The surgeon performs most of the procedure through small abdominal incisions aided by long, thin surgical instruments inserted through the incisions. Your surgeon then removes the uterus through an incision made in your vagina.
Your surgeon might recommend LAVH or robotic hysterectomy if you have scar tissue on your pelvic organs from prior surgeries or from endometriosis.
A hysterectomy is a major operation. You can be in hospital for up to 3 days after surgery, and it takes about 6 to 8 weeks to fully recover.
Recovery times can also vary depending on the type of hysterectomy.
Rest as much as possible during this time and do not lift anything heavy, such as bags of shopping. You need time for your abdominal muscles and tissues to heal.
Risks and Complications:
- The possible risks involved in a hysterectomy are as follows:
- Hemorrhage – if the bleeding is excessive, the patient might require a blood transfusion or a return to the operating room where the doctor can detect the root of the problem and stop the bleeding.
- Urinary retention
- Blood clots
- Early menopause
- Injury to other organs – these injuries can be spotted and corrected during the surgery. If something is detected after the hysterectomy, another operation might be needed.