Hysterectomy in New Zealand: Types, procedure, recovery, and cost

What is a hysterectomy?

A hysterectomy is a surgical procedure which removes the uterus and, depending on the underlying condition, may also remove other reproductive structures, such as the cervix, fallopian tubes, or ovaries.

A hysterectomy may be an emotional decision for the patient because removing the uterus will mean they can no longer bear children. Receiving professional and family support is vital during this time.

Types of hysterectomy

There are three main hysterectomy procedures:

• Total hysterectomy: involves removing the entire uterus, including the cervix.
• Partial (subtotal) hysterectomy: removes the main body of the uterus but leaves the cervix intact.
• Radical (extended) hysterectomy: removes the uterus, cervix, part of the vagina, and surrounding tissue.

What does a hysterectomy treat?

A hysterectomy can treat or relieve a variety of medical conditions affecting the uterus. The most common include:

• Uterine fibroids: Benign tumours growing inside or on the uterus, which can cause heavy menstrual bleeding, pelvic pain or pelvic pressure, and sometimes affect fertility.
• Endometriosis: Occurs when tissue similar to the lining of the uterus grows outside of it, often on the ovaries, fallopian tubes, bowel, or pelvic lining. This condition can lead to chronic pelvic pain, tiredness, bowel problems, and fertility issues.
• Chronic pelvic pain: Caused by pelvic inflammatory disease (PID) and conditions affecting the uterus, like fibroids or adenomyosis.
• Adenomyosis: A painful condition where the uterine lining grows into the muscular wall of the uterus, causing severe cramping, heavy periods, and an enlarged uterus.
• Cancer: A hysterectomy may be considered for lowering the risk of or treating cancers affecting the uterus, cervix, ovaries, endometrium, or fallopian tubes.
• Heavy or abnormal uterine bleeding: For women who experience prolonged or excessive menstrual bleeding caused by hormonal imbalances, uterine fibroids, polyps, or other underlying conditions that do not respond to other treatments.
• Uterine prolapse: When the uterus slips into or out of the vaginal canal, often due to weakened pelvic muscles from vaginal childbirth, age, or other factors. Symptoms of prolapse can include pelvic pressure, urinary incontinence, and difficult bowel movements.

RECOMMENDED READINGS

Cervical cancer: causes, signs & treatment

Cervical screening and HPV primary screening in New Zealand

Ovarian cancer, causes, symptoms & treatment

Bilateral salpingo-oophorectomy in New Zealand

The hysterectomy procedure

Understanding the hysterectomy procedure can help alleviate your concerns and set realistic expectations in terms of recovery.

Pre-surgery preparation

Before undergoing a hysterectomy, you’ll meet with your gynaecologist or specialist to discuss how to prepare. You may need to adjust certain medications, fast for several hours, and possibly take laxatives to clear your bowels.

The surgery

Depending on whether partial, total, or radical, your hysterectomy will be performed via one of the following surgeries:

• Abdominal hysterectomy: This is commonly performed in cases of large uterine fibroids or cancer, and involves an incision across the lower abdomen to access the uterus. It generally has a longer recovery period compared to other methods.
• Vaginal hysterectomy: The uterus is removed through an incision made at the top of the vagina. It typically results in a quicker recovery as there are no external incisions. However, a vaginal hysterectomy may not be suitable for women with larger fibroids or other complicating factors.
• Laparoscopic hysterectomy: A laparoscopic hysterectomy is performed via keyhole incisions through which a camera and surgical instruments are inserted. This method offers the benefits of less scarring, less pain, and a shorter recovery period.

Post-surgery recovery

After your hysterectomy, you will be moved to a recovery area where healthcare professionals will monitor you as you wake up from the anaesthesia. Once in your ward or private room, you will likely stay in hospital for one or two days, depending on the type of hysterectomy performed.

Hysterectomy recovery and healing time

Your expected recovery and healing time after a hysterectomy will depend on the type of surgery and other factors, like your health and age. Complete recovery from an abdominal hysterectomy can take 6-8 weeks. A vaginal hysterectomy requires a 6-week recovery period, while healing from a laparoscopic hysterectomy can take 2-4 weeks.

To recover well, follow your doctor’s advice on what activities are OK and which ones should be avoided. You will be encouraged to do light exercises, such as walking, and to refrain from heavy lifting and unnecessary physical exertion. 

Potential complications and side effects

While a hysterectomy is generally a safe procedure, as with any major surgery, it carries certain risks and potential side effects. Understanding these can help you make informed decisions and be prepared for a positive recovery.

Surgical complications

During or shortly after surgery, complications can arise, depending on the type of hysterectomy and your overall health:

Fever
Inform your healthcare provider if you have a fever (38°C or higher) as this could indicate infection.

Infection
Infections developed at the incision site or within the pelvic region can generally be managed with proper wound care and medications. Signs of infection include fever, increased pain, redness, swelling, foul-smelling vaginal discharge, or discharge from the wound.

Excessive bleeding
Some bleeding is normal after surgery, but in rare cases, excessive bleeding occurs during or after the procedure, potentially requiring a blood transfusion.

Blood clots
There is a risk of developing blood clots in the legs (which can travel to the lungs) after surgery. Leg pain, swelling, or redness in your calf could indicate a blood clot and require immediate medical attention. Patients are encouraged to move around soon after surgery and may be given blood-thinning medication.

Damage to surrounding organs
During the procedure, surrounding organs, such as the bladder, ureters, or bowel, may be accidentally damaged. This is rare, but immediate repairs can be made if the damage is identified at the time of surgery.

Side effects of hysterectomy

After a hysterectomy, you may experience a range of side effects that are generally temporary but can sometimes persist longer, or even permanently.

Cessation of menstrual periods and symptoms of menopause
Removing the uterus will result in the cessation of your menstrual periods. You may also experience temporary menopausal symptoms.

Pre-menopausal individuals whose procedure included removing both ovaries (bilateral oophorectomy) or both ovaries and fallopian tubes (bilateral salpingo-oophorectomy) will experience immediate menopause, possibly alongside symptoms such as hot flushes, skin dryness, insomnia, vaginal dryness, and hair loss.

Vaginal discharge and bleeding
Light vaginal bleeding or discharge is normal after a hysterectomy and can last for several weeks. However, if you experience heavy bleeding or pass large clots, you should contact your healthcare provider.

Fatigue and emotional changes
Fatigue is common after surgery and can continue for several weeks. Some women may experience emotional changes, including depression or a sense of loss. It’s important to seek support from family, friends, or healthcare professionals to help you through these changes.

Pelvic pain
It’s normal to have some level of pelvic pain or discomfort as the body heals, especially in the early weeks following surgery. Pain usually diminishes over time, but in rare cases, chronic pelvic pain can develop.

How to get a hysterectomy in New Zealand

If you’re considering a hysterectomy, you have three pathways: New Zealand’s public health system; paying out-of-pocket for private treatment; or using your comprehensive health insurance to cover the procedure.

Can I have a hysterectomy when I want one?

Under New Zealand’s public health system, hysterectomies are generally considered elective (i.e., for those who aren’t in urgent need of treatment) unless for cancer or emergencies, like uncontrollable bleeding. Your doctor can help you weigh up your options and the consequences of each to determine whether a hysterectomy is the best treatment for you.

Public health system

The New Zealand public health system provides hysterectomies at no direct cost to the patient, funded through taxation. However, the public system has some challenges, primarily regarding waiting times and availability of services.

As of September 2024, 6,843 gynaecology patients had been waiting longer than 4 months for their first specialist assessment (FSA), while 2,745 had been waiting more than 4 months for treatment. This may mean many patients are living with painful symptoms and waiting too long for medical care.

Private health system

For many women, going private means being able to see a specialist and have their surgery scheduled within a few weeks after their initial consultation. You might decide to pay for a hysterectomy at a private health facility yourself. If you have private health insurance, you could be covered for this surgery, which will dramatically reduce your out-of-pocket costs.

Cost of hysterectomy in New Zealand

Choosing private healthcare typically means faster access to consultations and surgery. However, it comes at a high price. Estimates suggest the costs of undergoing a hysterectomy in a private facility range from $14,000 to $20,000.

Benefits of health insurance

Having a good health insurance plan can be a game-changer for individuals who might unknowingly need a hysterectomy or other elective procedure at some point in time. With the right policy, most, if not all, of the costs associated with surgical and non-surgical treatments are covered.

Health insurance also offers more control over the process, such as being able to select your preferred surgeon and hospital. For many, this can make a world of difference in receiving the care they need, when they need it.

RECOMMENDED READINGS

Buying health insurance if you have pre-existing conditions

Is health insurance worth it in New Zealand?

Long waiting lists in NZ's public health system: Causes and impacts on patients

Let Policywise guide you

Policywise is a 100% free service which tells you which health, life, and disability insurance provider best fits your needs. We offer fast, comprehensive, and easy-to-understand comparisons of all leading providers, and a simple summary clearly recommending which insurer is best for your situation.

Not all insurance policies are the same. Policywise can help you sort out the duds, avoid the lemons, understand the fine print and exclusions, and get the right insurance for you and your family.

We make the important decision of where to buy your insurance super easy. We’ll answer your questions, provide experienced advice, quotes, and comparisons, and manage all the back and forth throughout the application process. Taking out your cover through us means you'll have our lifetime support and claims advocacy, and we'll help you negotiate a positive outcome at claim time. We can also take care of lodging any claims on your behalf and back you up if the going gets tough.

Check out the reviews on our homepage for how other New Zealanders have found our service, because now is the time to get your comprehensive health insurance sorted. Give yourself, your family or someone you love the most outstanding financial support possible. Book a 5-minute callback with Policywise today; our service is fast and free.

^{Disclaimer: This article is for general information only. Nothing in this blog or on this website is intended as medical, dietary, or financial advice. Although we aim to update our content regularly, you are advised to consult a Policywise adviser, health professional, or an appropriate specialist before acting on any information herein. They can factor in your personal circumstances or preferences and help guide your decision-making process.}