I had an partial hysterectomy done in 10/06 when I was 43. It was done for uterine fibroids that caused such heavy bleeding, I basically lost a week of my life every month. (I had a D&C done 2 years prior to the hysterectomy, which help for about 3 months. Then the fibroids grew back and yuck resumed.) Despite my torrential flow and plum-sized clots, I was only mildly anemic. Happily, my insurance covered the procedure without question.
Anyway, I researched the bejesus out of everything! This is what I had done: Abdominal incision, uterus taken out, kept my ovaries AND my cervix. Keeping your cervix is supposed to help prevent bladder issues like someone else mentioned. If you have the hysterectomy vaginally done, you cannot keep your cervix.
My doctor was not trained to do laproscopic surgery, and I wanted to keep my cervix so that left me with abdominal incision. Yes, I could have gone to another doctor over 45 minutes - 1 hour from where I live, but I trusted my doctor completely having been her patient for over 6 years at that point. She had done hundred and hundreds of these operations so she was more than competant. No way I was going to have major surgery with a doctor I never met before, had no relationship with and no prior knowledge of my medical history other than a medical form.
The advantage of the abdomimal hysterectomy is every medical student learns to do them. They are pretty straightforward. You don't have to worry about the doctor knicking your bladder as they maneuver inside with the tiny razor sharp instruments or potentially missing a small piece of your uterus during the removal process. The doctor also gets a really good look at your insides!! It sounds kind of weird, but when else can you have a surgeon get a first hand look at your lower abdominal organs??
The recovery was surprisingly easy! I was in major pain for 1 day, until the gas subsided. Two days after surgery, I was only using advil for pain. 3 weeks after surgery I was walking 3 miles a day in 45 minutes. 6 weeks later, I had full clearance to resume ab, wt and full cardio work. I did do a lot of ab work and exercising before I had the surgery which I think helped with the recovery. I also drove within a week of surgery, but I put a small squishy pillow over my incision area to protect it from the pressure of the seatbelt.
I have no pooch from the surgery, and my scar is completely faded. I have not gone into early menopause. I don't even have any perimenopausal symptoms. There is skin numbness around the incision, but it's never bothered me. I had an awesome book that really covered everything in depth. I can look it up if you want the title.
I've talked to many women who wish they had just sucked it up and had a hysterectomy. They tried other measures like repeated D&Cs, arterial embolization, uterine cauterization etc. In every case, their fibroids grew back within months.
Hysterectomies have gotten a bad rap IMO and frankly I'm sick of it! I swear to god if men had to put up with the symptoms of fibroids for one frickin' month they'd stop all their ranting articles/commentaries about how women are being bamboozled by their doctors into having unnecessary hysterectomies when there are all these supposedly great alternatives. Yeah, we women are just so stupid about medical practice...Okay, rant over.
My hysterectomy changed my life! I get back 12 weeks of the year that I'd previously lost to my period. That's 3 whole months of doing whatever activity I want without having to think about my reproductive organs and whether they were going to leak through my clothing and onto the car seat, furniture or bed before I could change protection. Get it done ASAP and don't look back is my advice
HTH and good luck!