Some of the disorders that may be treated with a hysterectomy are:
• Constant heavy bleeding that has not been controlled by medicines or dilatation and curettage (D&C)
• Endometriosis that causes pain or bleeding and does not respond to other treatments
• Chronic pelvic pain
• Prolapse uterus - a fallen (sagging) uterus
• Precancerous or cancerous cells or tissue present in the uterus
• Tumours in the uterus.
Vaginal hysterectomy is a surgical procedure to remove the uterus through the vagina.
During a vaginal hysterectomy, the surgeon detaches the uterus from the ovaries, fallopian tubes and upper vagina, as well as from the blood vessels and connective tissue that support it. The uterus is then removed through the vagina. Other ways in which the uterus may be removed are:
• Abdominal Hysterectomy - Having the uterus removed through an incision in your lower abdomen.
• Laparoscopic Hysterectomy through key hole incisions made in the abdomen
• Doctor will have choice for the method of hysterectomy that is appropriate for your medical condition.
The IV and catheter are removed 1 or 2 days after the surgery. You may stay
in the hospital about 3 to 5 days.
After you go home, get plenty of rest. Do not do any heavy lifting or otherwise strain the abdomen muscles for 4 to 6 weeks.
Follow your consultant's instructions for dealing with pain and preventing constipation.
If you were having menstrual periods before the surgery, you will no longer have them after the operation. You also cannot become pregnant. If your ovaries were removed, menopause starts right away and your doctor may prescribe hormone therapy. Be sure to discuss any concerns you have about these effects and treatment with your doctor before the surgery.
After-effects of general anesthesia
Most modern anaesthetics are short lasting. You should not suffer from any after-effects for more than a day after your surgery. During the first 24 hours you may feel more sleepy than usual and your judgement may be impaired.
You may have a catheter in your bladder to allow drainage of your urine. This is usually for up to 24 hours after your operation until you are easily able to walk to the toilet to empty your bladder. If you have difficulties passing urine, you may need to have a catheter for a few more days.
A Vaginal Hysterectomy is performed through your vagina so the scar will be out of sight. However, if you have keyhole surgery as part of your operation, you will have between two and four small scars on different parts of your abdomen. The scar will be anywhere between 0.5 cm and 1 cm long.
Stitches and dressings
Removal of the stitches in your vagina is not required as they are dissolvable. You may notice a stitch, or part of a stitch, coming away after a few days or maybe after a few weeks. This is normal and nothing to worry about. If you have keyhole surgery, your cuts may be closed by stitches or glue. Glue and some stitches dissolve by themselves. Other stitches may need to be removed, you will be given information about this. Your cuts will initially be covered with a dressing.
You may have a pack in your vagina after the surgery to reduce the risk of bleeding. A nurse will remove this after your operation while you are still in the hospital.
You can anticipate having some vaginal bleeding for one to two weeks after your procedure. This is like a light period and is red or brown in colour. Some women have slight or no bleeding initially, and then have a sudden flow of old blood or fluid about 10 days later. This usually stops quickly. You should use sanitary towels rather than tampons as using tampons could rise the risk of infection.
Pain and discomfort
You can expect pain and uneasiness in your lower abdomen for the first few days after your surgery. When leaving hospital, you will be provided with painkillers for the pain you are undergoing.
Post-surgery your bowel may slow down for the time being, causing air or 'wind' to be trapped. This can cause some discomfort until it is passed. Getting out of bed and walking around will help. Once your bowels start to move, the trapped wind will ease.
Starting to eat and drink
After the surgery, you may have a drip in your arm to provide fluids. When you are able to drink again, the drip will be removed. You will be offered water or cup of tea and something light to eat.
Formation of blood clots - how to reduce the risk
There is a small possibility of formation of blood clots in the veins in your legs and pelvis (deep vein thrombosis) after any surgery. These clots can travel to the lungs (pulmonary embolism), which could be fatal. You can reduce the risk of clots by:
• Start walking/moving about as soon as you can after your operation.
• Perform exercises while you are resting, for example: pump each foot up and down briskly for 30 seconds by moving your ankle or move each foot in a circular motion for 30 seconds and bend and straighten your legs - one leg at a time, three times for each leg.
You may also advised other methods to reduce the risk of a clot formation, particularly if you are overweight or have other health issues.
You will be given guidance and information about exercises to help you recover fast and ways to gain mobility without difficulty.
Tiredness and feeling emotional
A hysterectomy can also be emotionally traumatic and many women during this stage feel tearful and emotional.
Recovery from a hysterectomy if can be longer if:
• You had health complications before your operation; for example, women with diabetes may heal at a slower pace and may be more prone to infection.
• You are overweight - Patients can take a longer duration to recuperate from the effects of the anaesthetic and there is also a higher risk of complications such as infection and thrombosis.
• There were any other complications during your surgery.
Get in touch with the hospital and your medical team:
• You develop a fever over 100 degree F
• You have nausea and vomiting
• You have chest pain or become short of breath
• You have bleeding from the vagina
• You have leakage from the incision or the incision opens up
• You have pain where you urinate
• You have swelling, redness or pain in your leg
Your own recovery will depend on:
• How fit you are before your operation
• The reason you are having a hysterectomy
• The exact type of hysterectomy that you have
• How smoothly the surgery goes and whether there are any complications.