Hysterectomy Surgery In Singapore: Procedure, Risks & Cost

Your gynaecologist has suggested a hysterectomy, and the questions start piling up. What will be removed? Is there another treatment worth trying first? How much may it cost?

Here’s how hysterectomy surgery in Singapore works, so you can consider several factors to help you make a more informed decision.

What does hysterectomy surgery involve?

A hysterectomy is surgery to remove the uterus. Depending on your condition and treatment plan, your surgeon may also remove the cervix (neck of the uterus), fallopian tubes, or one or both ovaries.

Total, subtotal, and radical hysterectomy

The type of hysterectomy recommended depends on your medical condition and treatment needs. The main difference is how much tissue is removed:

• Total hysterectomy: Your surgeon removes your entire uterus and cervix. This does not automatically include removal of the ovaries or fallopian tubes.
• Subtotal hysterectomy (partial or supracervical hysterectomy): This type of hysterectomy is less commonly performed. During the procedure, your surgeon removes the main body of the uterus while leaving the cervix in place. 
• Radical hysterectomy: This procedure is more extensive and commonly performed to treat certain cancers, such as cervical cancer. During the procedure, your surgeon removes the uterus, cervix, upper part of the vagina, and surrounding tissues. They may also remove the nearby lymph nodes as a part of cancer treatment. 

Whether the ovaries and fallopian tubes need to be removed

Removing the ovaries and removing the fallopian tubes are separate decisions. Your gynaecologist will discuss whether either is recommended based on your condition, age, menopausal status, and cancer risk.

If your ovaries are healthy, your gynaecologist may recommend keeping them, particularly before menopause, so they can continue producing hormones. They may recommend removing one or both ovaries for conditions such as ovarian disease, certain cancers, or severe endometriosis, or if you have a high inherited risk of ovarian cancer. This procedure is called oophorectomy. 

Your gynaecologist may recommend removing the fallopian tubes while preserving the ovaries. This procedure, called salpingectomy, can reduce but does not eliminate ovarian cancer risk.

Removing both ovaries and both fallopian tubes is called bilateral salpingo-oophorectomy. Your surgeon may perform this alongside a hysterectomy if your condition requires it.

When might a hysterectomy be recommended?

Your gynaecologist may recommend a hysterectomy when symptoms substantially affect your quality of life or when your condition requires removal of the uterus. 

For non-cancerous conditions, it is generally considered when appropriate alternatives that preserve the uterus have not provided sufficient relief or are unsuitable.

Your gynaecologist may consider a hysterectomy for:

• Uterine fibroids that cause persistent heavy bleeding, anaemia, pelvic pain, or pressure on nearby organs. 
• Heavy or abnormal uterine bleeding that continues despite other treatments or significantly affects your health and daily activities.
• Adenomyosis, occurs when tissue similar to the uterine lining grows into the muscular wall of the uterus, causing heavy or painful periods that persist despite other treatments.
• Endometriosis with severe, persistent symptoms that do not respond to other treatments, provided you do not plan a future pregnancy.
• Uterine prolapse, where the uterus drops from its normal position into the vagina, causing troublesome symptoms. 
• Certain gynaecological cancers or precancerous changes, where removal of the uterus forms part of the recommended treatment. 
• Chronic pelvic pain that has been carefully assessed and is thought to arise from the uterus, particularly when other treatments have not helped.

What alternatives to hysterectomy could you consider?

Your gynaecologist will discuss alternatives based on your condition, the severity of your symptoms, treatments you have already tried, and whether you want a future pregnancy. Keeping the uterus does not always mean a treatment preserves fertility.

Depending on your condition, options may include:

• Medication or hormonal treatment: These options can help reduce heavy bleeding or pelvic pain. Your gynaecologist may suggest hormonal treatments, including a hormonal intrauterine device (IUD), for conditions such as heavy menstrual bleeding, adenomyosis, or endometriosis.
• Myomectomy: This operation removes fibroids while preserving your uterus. Your gynaecologist may consider myomectomy if fibroids are causing troublesome symptoms and you want to retain the possibility of a future pregnancy.
• Uterine artery embolisation (UAE): This procedure blocks the blood supply to fibroids, causing them to shrink while leaving the uterus in place. If you hope to become pregnant, discuss UAE carefully with your specialist because its effects on fertility and pregnancy remain uncertain.
• Endometrial ablation: This procedure removes the uterine lining to reduce heavy menstrual bleeding. Endometrial ablation is not suitable if you want a future pregnancy, as it damages the uterine lining and increases the risk of serious pregnancy complications.
• Surgery to remove endometriosis: Surgery can remove areas of endometriosis while preserving the uterus. It may be considered when medicines have not adequately controlled symptoms or when endometriosis is affecting fertility.

If you are unsure whether hysterectomy is the right next step, WhatsApp Our Care Team. We can help arrange a consultation or second opinion with a gynaecologist experienced in treating your condition.

Which surgical approach might be suitable for you?

The most suitable surgical approach depends on the size and accessibility of your uterus, the condition being treated, any previous surgery, and your surgeon’s expertise. Your surgeon will explain which approach best suits your needs.

Laparoscopic and robotic-assisted hysterectomy

During a laparoscopic hysterectomy, your surgeon inserts a camera and surgical instruments through small incisions in the abdomen. They introduce carbon dioxide gas into your abdomen to create space, making it easier to see and operate within the pelvis. They often remove the uterus through your vagina, although the removal method depends on its size and the planned procedure.

For non-cancerous conditions, your surgeon may recommend a laparoscopic approach when vaginal hysterectomy is unsuitable.

Robotic-assisted hysterectomy follows a similar approach as laparoscopic hysterectomy. Instead of holding the instruments directly, your surgeon controls them with robotic arms from a control station called a console. The system follows the surgeon’s movements and does not operate independently.

Compared with open abdominal surgery, these approaches generally require smaller incisions and offer a shorter hospital stay and faster recovery.

Vaginal hysterectomy and vNOTES

During a vaginal hysterectomy, your surgeon removes the uterus through an incision inside the vagina without making abdominal incisions. Your surgeon may recommend this approach for uterine prolapse or other non-cancerous conditions.

vNOTES stands for vaginal natural orifice transluminal endoscopic surgery. Surgeons need specific training to perform this procedure. With this approach, your surgeon inserts a camera and specialised instruments through the vagina to view and operate within the pelvic cavity. Although vNOTES avoids abdominal incisions, the surgeon still makes internal incisions.

Your surgeon will assess whether vNOTES suits your condition, taking into account vaginal access and factors such as significant pelvic scarring or endometriosis that could make surgery more difficult.

Open abdominal hysterectomy

During an open abdominal hysterectomy, your surgeon makes a horizontal or vertical incision in the lower abdomen, depending on the operation. They may recommend open surgery for a very enlarged uterus, a complex procedure, or when a minimally invasive approach would be unsafe.

After an open abdominal hysterectomy, you will generally stay in hospital longer and need more time to recover than you would after vaginal or laparoscopic surgery.

How could hysterectomy affect fertility, periods, and menopause?

A hysterectomy permanently ends your ability to carry a pregnancy. This applies to total, subtotal, and radical hysterectomy, because each removes the main body of the uterus, where a pregnancy develops. Keeping your ovaries does not change this, even if they continue releasing eggs.

Your periods will also stop because the uterine lining that sheds each month is removed. Stopping periods after surgery does not necessarily mean you have entered menopause:

• If one or both ovaries are preserved and continue functioning, you will not usually enter menopause immediately. Your remaining ovary or ovaries can continue producing hormones, so monthly hormonal changes may still cause bloating, breast tenderness or mood changes. Menopause may also arrive earlier than it otherwise would have.
• If both ovaries are removed before natural menopause, you will enter surgical menopause immediately because of the sudden drop in ovarian hormones.

What are the risks and possible complications?

Like any major operation, a hysterectomy carries risks. Your surgeon will explain which risks are most relevant to your health and planned procedure. Possible complications include:

• Bleeding during or after surgery. Heavy bleeding may require a blood transfusion or further treatment.
• Infection, which may affect the surgical wound, tissues inside the pelvis, or urinary tract. 
• Wound-healing problems, such as delayed healing or reopening of an abdominal or vaginal incision.
• Injury to nearby organs, which may affect the bladder, bowel or ureters (the tubes carrying urine from the kidneys to the bladder). An injury may require repair or further treatment.
• Blood clots may form in a deep vein in the legs or pelvis, known as deep vein thrombosis. If clot travels to the lungs, it can cause a serious condition called pulmonary embolism.
• Complications related to anaesthesia, including serious allergic reactions or breathing and heart-related problems.
• Vaginal cuff complications. When the cervix is removed, the top of the vagina is closed with stitches. Rarely, this closure can separate, causing pain, bleeding, or watery discharge and sometimes requiring emergency surgery.

What should you expect during recovery?

Your recovery will depend on your overall health, the extent of the procedure, and the surgical approach. 

Most people in Singapore stay in hospital for about two to three days after a hysterectomy. Recovery after an open abdominal hysterectomy commonly takes around six to eight weeks, while vaginal or laparoscopic surgery generally allows a quicker return to everyday activities.

Your surgical team will tell you when it’s safe to drive, lift heavy objects, return to work and have intimacy, as this depends on the approach used.

Symptoms that need medical attention

Several symptoms after a hysterectomy may need medical attention. These symptoms include:

• Heavy vaginal bleeding, blood clots, or foul-smelling discharge.
• Fever or chills.
• Increasing abdominal pain, particularly with vomiting or loss of appetite.
• Redness, swelling, worsening pain, or discharge around an incision.
• Burning or stinging when passing urine, or difficulty passing urine.
• A painful, red, swollen leg which may indicate a blood clot. 
• Chest pain, shortness of breath, or coughing up blood. These need emergency care, so call 995 or go to the nearest emergency department.

How much does hysterectomy surgery cost in Singapore?

The cost depends on the type of hysterectomy, the hospital and the ward class. Based on Ministry of Health (MOH) published bill data, typical bills for Singapore citizens undergoing a total hysterectomy are:

Uterus smaller than 12 weeks: SI713U, Table 4C:

Uterus equivalent to or larger than 12 weeks: SI712U, Table 5A:

These figures cover the middle 50% of bills, include GST and are before MediSave and insurance. They don’t cover radical hysterectomy for cancer. They are a guide, not a quotation. Before your surgery, ask your hospital for a written estimate that shows how much MediSave and your insurance are expected to cover and what you’ll need to pay yourself.

When might a second opinion be helpful?

A second opinion can help if you have been advised to undergo a hysterectomy but still feel unsure about proceeding. You may want another assessment to understand whether surgery is necessary, whether suitable alternatives remain, or whether your ovaries need to be removed.

Another gynaecologist can review your diagnosis, scan results, and previous treatments. They may confirm the recommendation or suggest a different option, helping you make a more informed decision.

Bring relevant medical records and a list of questions to the consultation. If treatment is time-sensitive, ask your current specialist whether there is time to obtain another opinion without delaying necessary care.

How can Health in Asia help you navigate your options?

If you have been advised to have a hysterectomy, several questions often come up together: which gynaecologist to see, which surgical approach suits you, and how much of the bill your insurance will cover. The approach offered can also depend on the surgeon, since not every gynaecologist performs laparoscopic, vaginal and robotic-assisted procedures.

Tell our Care Team about your symptoms, the treatment recommended so far, and whether keeping your fertility or ovaries matters to you. You can also share scan reports, previous treatments and your insurance details.

The Care Team can help with:

• A shortlist of one to three gynaecologists matched to your condition and preferences, with the reasons explained
• Checking your insurer’s panel eligibility, likely coverage and whether pre-authorisation applies
• Explaining estimated out-of-pocket costs before you book
• Appointment booking and care coordination
• Arranging a second opinion on the need for surgery or the recommended approach

We help you navigate your care, but we do not diagnose your condition or decide which treatment you need. Your gynaecologist will discuss whether a hysterectomy or an alternative is right for you.