There are several different methods used in performing a hysterectomy. The procedures vary depending on the medical reason for the hysterectomy, the size and position of the uterus and any other individual health concerns of the patient. The different types of procedures include:

• Abdominal hysterectomy. This type of hysterectomy, which was once the only type available, is performed through an incision in the abdomen. The advantage of the abdominal incision is that it offers the gynecologist the greatest access to the pelvic organs. This type of procedure is used to treat severe endometriosis, extensive scar tissue, when cancer is suspected or for abnormally large uterine fibroids. Depending on the reason for the hysterectomy, the incision may be horizontal or vertical. This type of procedure is most often used for:
  
  
• The removal of an abnormally large uterus
  
  
• The removal of a uterus with fibroids exceeding 8 inches (20 centimeters) across or near blood vessels
  
  
• Suspicion of a reproductive cancer, such as ovarian, uterine or cervical cancer
  
  
• A suspect ovarian growth that eludes diagnoses through ultrasound
  
  
• Severe scarring from endometriosis in the pelvic region
  
  
• Vaginal hysterectomy. This option is used only when the uterus can be easily removed through the vaginal opening and when the detection of a possible cancer is not a concern. Although the recovery time is much shorter, this type of hysterectomy often leads to a shortening and/or tightening of the vagina that can lead to discomfort during intercourse. This type of procedure is most often used for:
  
  
• The removal of small uterine fibroids
  
  
• A hysterectomy performed on a woman with a normal or slightly enlarged uterus
  
  
• In the absence of endometriosis lesions
  
  
• Laparoscopic assisted vaginal hysterectomy (LAVH). This type of procedure is performed by removing the uterus through the vagina with the aid of one or more minute incisions in the abdomen into which a laparoscope (lighted viewing instrument) is inserted to guide the procedure. The recovery time for LAVH is also much shorter than for an abdominal hysterectomy. This type of procedure is most often used for:
  
  
• The removal of small to moderate sized uterine fibroids
  
  
• The removal of a uterus that is only slightly larger than normal
  
  
• Women who have never given birth to a child
  
  
• The removal of endometriosis lesions limited to the uterus, fallopian tubes and/or ovaries
  
  
• For assessment or removal of ovaries at the same time as a vaginal hysterectomy
  
  
• Laparoscopic supracervical hysterectomy (LSH). Tiny incisions in the abdomen are used to insert a laparoscope and surgical instruments. The uterus is taken one small piece at a time and the cervix is left intact. In addition to a shorter recovery time, the LSH offers the advantage of having the cervix remain to support other internal organs that otherwise might shift down into the pelvis, which in turn could cause sexual and/or urinary problems. This type of procedure can be used for the removal of fibroids of any size or any size uterus.
  

There are also three major types of hysterectomy, which are:

• Total hysterectomy, which is the complete removal of the uterus and the cervix. This may or may not include a salpingo-oophorectomy. 
  
  
• Subtotal hysterectomy, which is the removal of the uterus alone, leaving the cervix intact. This type of procedure is sometimes referred to as a partial hysterectomy.
  
  
• Radical hysterectomy, which includes the removal of the uterus, cervix, ovaries and surrounding support structures. In some cases, the lymph nodes are also removed. This type of hysterectomy is sometimes used in cases of severe endometriosis or for cancers of the uterus or cervix.