Hysterectomy: Getting Ready

What can I do before surgery to make my recovery easier?

Take steps now to be in the best possible health before surgery. This will increase your chances of a quick recovery with fewer complications. Prepare now by eating a well-balanced diet, getting plenty of rest, and losing weight if you are overweight. Ask your doctor about exercises you can do before surgery to get your pelvic muscles in shape. If you smoke, this is the time to quit for good.

 

You also should make sure that your physician has as much information as possible about your medical history. Tell him or her about any allergies, major illnesses, or previous surgeries. Most important, provide a list of any medications you’re taking now or have taken recently. Your doctor does not want to prescribe medications after surgery that would interfere with anything else you might be taking.

Plan ahead for coming home after surgery

Make arrangements in advance for job coverage if you work. Try to prepare and freeze some meals ahead of time so you won’t feel pressured to cook when you get home. Get any necessary household chores out of the way. If friends and relatives offer to help, take them up on it.

 

What will happen on the day of my surgery?

Most patients are not allowed to have any solid foods or liquids after midnight the night before surgery. Most patients are admitted to the hospital early in the morning on the day of surgery. You can expect to undergo some tests to evaluate your overall health. Most patients get blood and urine tests. You may have a chest x-ray and an electrocardiogram (EKG). These tests may be done on an outpatient basis before the day of your surgery.

 

Depending on the type of surgery you are having, the surgical area may or may not be shaved with a clipper.

What will I experience during the surgery?

Most hysterectomies are performed under general anesthesia. This means you will be asleep during the surgery, and you won’t feel anything. However, some women receive an epidural (ep-eh-DUR-al), or spinal anesthetic. This anesthesia will not put you to sleep. It will numb the lower part of your body completely so that you will not feel any pain.

 

Most operations last from 1 to 3 hours. The length of the surgery depends on how big your uterus is, if you have had surgery before, and if you are having other procedures done at the same time. The surgery usually will last longer if you are having surgery for cancer.

What will happen after the surgery?

Once the surgery is over, you will be taken to the recovery room. Here you will be observed carefully until the anesthesia has worn off. Nurses will check your blood pressure, pulse, and breathing. When these have returned to normal, you will be taken to your hospital room.

 

The length of your stay in the hospital will depend on the type of hysterectomy that was done. With any type of surgery, you may feel some pressure in your pelvic area. If you have had an abdominal hysterectomy, you may feel some tenderness and pain in the area of your incision. Your doctor will prescribe medicine to relieve your pain and to help make you more comfortable.

You probably won’t feel like walking or moving around very much right after your surgery, but you will be encouraged to try. You will also be asked to cough and to breathe deeply. It’s important that you do these activities, even if you feel uncomfortable, because they help prevent complications.

What will the scar look like and when will my stitches be removed?

If you have had an abdominal hysterectomy, your incision will be closed with sutures (stitches) or surgical staples. They will be removed when your doctor decides it is appropriate. If dissolvable sutures are used, removal is not necessary.

 

If you’ve had a vertical incision, you’ll usually have a scar from your navel to your pubic area. If your uterus was very large, the doctor sometimes has to make the incision even bigger. In these cases, the incision usually goes around the navel and into your
upper belly.

A horizontal incision (sometimes called a “bikini” incision), results in a scar along the top of your pubic hairline; it may be barely visible.

Regardless of the type of incision you have, any swelling or redness in the area will usually disappear as the wound heals. For most women, the scar will fade in 3 to 6 months. If the redness and swelling do not decrease, or if you note any pus or drainage around the incision, tell your doctor.

If you had laparoscopic surgery, the small incisions in your belly will usually be closed with sutures (stitches) or surgical glue. The sutures are usually the dissolvable kind and will not need to be removed. The glue holds the skin edges together without the need for sutures.

If you had a vaginal hysterectomy, your internal incision is closed with stitches that your body will absorb.

After I go home, what can I expect?

During your first few weeks at home, you will go back to your normal activities gradually. As the stitches at the top of your vagina begin to dissolve, a little bleeding (about as much as a light menstrual period) is normal. If the bleeding is heavy or if you also have cramping, call your doctor. Let your doctor know if you have severe pain, fever, vomiting, or any other symptoms that concern you.

 

Are there activities I should avoid during my recovery?

During the first couple of weeks, you should avoid anything that places a strain on your abdominal area. Avoid standing for long periods, heavy lifting, moving furniture, exercise, or tasks such as vacuuming, ironing, and shopping.

 

The time needed for your recovery will depend on the type of surgery you had. Most women recover more quickly from a vaginal or laparoscopic hysterectomy than from an abdominal hysterectomy. You can expect to return to work about 6 weeks after an abdominal hysterectomy and probably sooner after a vaginal or laparoscopic
 hysterectomy.

Sexuality

A hysterectomy requires a temporary restriction on sexual activity. After the initial recovery period and when your doctor believes healing has occurred, you may resume sexual relations. A gentle approach and a water-soluble lubricant are recommended.

 

Because of the temporary shrinkage of tissues that occurs after surgery, your vagina may feel shorter or narrower even though no tissue has been removed. Resuming sexual activity can actually help relieve this discomfort by helping to stretch the vaginal tissues.

If your ovaries have been removed, you may find that your vagina is dry. A vaginal lubricant used before intercourse may lessen the dryness. Extending foreplay may also help. Hormone therapy is an option that can help relieve symptoms of surgical menopause. Ask your doctor for more information.

Large studies show that most women have an improvement in sexual interest and response after hysterectomy. But some women notice no change or have less interest or response. Talk with your doctor if you have any concerns.

Many women worry about their sexuality and how they will feel about themselves after surgery. If you had your hysterectomy before menopause, you may feel sadness about no longer being able to bear children. Discussing these and other feelings with a person you trust can help.

Surgical menopause

If your ovaries were removed during your surgery, you will go through what is known
as “surgical menopause,” an abrupt decrease in the production of hormones. One of these hormones, estrogen (ESS-tro-gen), has many important functions in the body besides helping to regulate the reproductive cycle. A lack of estrogen can have an immediate effect on the body, causing a variety of menopausal symptoms.

 

Therefore, many doctors recommend starting estrogen therapy as soon as possible after surgery involving removal of the ovaries.

Estrogen therapy is used to relieve menopausal symptoms, including:

  • Vasomotor (va-zo-MO-tor) symptoms, such as hot flashes and night sweats
  • Vaginal dryness or shrinkage

Questions to ask your doctor

  1. Will my ovaries be removed?
  2. If so, would estrogen therapy be a good idea for me or not?

List below any other questions you have.

For more information

For more information about the surgery, see the UPMC patient education page Hysterectomy.

 

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