Hysterectomy can be performed through an abdominal incision. This procedure is often called total abdominal hysterectomy, and may be combined with removal of the tubes and ovaries.

Alternatively, the uterus may be removed through the vagina. This procedure is called vaginal hysterectomy. Occasionally the uterus is prepared for vaginal removal by using the laparoscope to cut some of its connections to the pelvis. This procedure is called laparoscope assisted vaginal hysterectomy.

Hysterectomy is usually performed using general anesthesia with routine monitoring and endotracheal intubation. While hysterectomy can be performed with spinal or epidural anesthesia, this is an unusual choice. A urinary catheter is inserted after anesthesia has begun. Most hysterectomies are completed without blood transfusion.

Patients will need pain medicine after hysterectomy. Pain medicine will be administered by the direct injection or as patient controlled analgesia. Because they have an abdominal incision, patients undergoing abdominal hysterectomy usually experience more discomfort than those undergoing vaginal hysterectomy.