This overview is a sample of the type of information available to you at Griffin Hospital's Community Health Resource Center. It is not intended to replace your physician's instructions in the management of your health problems, but to better inform you about a particular illness and alert you to the availability of other materials. If you have a question about any piece of information presented in theses fact sheets, please call your physician, or stop by the Community Health Resource Center at your convenience.
HYSTERECTOMY
A hysterectomy is a surgical procedure in which the uterus is removed. The uterus is the organ which holds the fetus (developing baby) when a woman is pregnant. The uterus can be removed through an incision in the abdomen (stomach) or through the vagina (the female passageway through which babies are born). Once you have a hysterectomy, you will no longer have periods or be able to become pregnant.
There are several types of hysterectomies:
WHAT IS THE PURPOSE?
A hysterectomy may be recommended for cancer of the cervix, uterus or endometrium (the lining of the uterus). A hysterectomy can also be recommended as treatment for severe vaginal bleeding, or severe pelvic pain or infections.
Bleeding, pain, or other symptoms may be due to uterine fibroids (non-cancerous tumors), endometriosis (a condition where pieces of the lining of the uterus are in the pelvis), and uterine prolapse (when ligaments supporting the uterus become weakened, allowing the uterus to “sag”). These conditions can cause heavy or irregular menstrual periods or pelvic pain. In these instances, a hysterectomy may be considered but only after other treatments, such as diet and exercise, hormone treatments and other medications, or other simpler procedures have been fully explored.
For example, some women have been able to improve uterine prolapse with special exercises. And other less invasive procedures such as a dilation and curettage (D&C) and other new surgical techniques can often alleviate pelvic pain and irregular or heavy bleeding without removing the uterus. Talk with a qualified health care professional about the potential benefits and risks of a hysterectomy in your individual circumstance.
WHAT TO EXPECT BEFORE THE OPERATION
Before your surgery, some laboratory tests and x-rays may be done. If your physician feels that significant blood loss may occur, donating your own blood for use at the time of your operation (autologous blood donation) may be considered. Your physician can make arrangements for you to do this about a month before your surgery.
Just before surgery, an anesthesiologist will talk with you about your anesthetic, which will put you in a deep sleep for the operation.
Your doctor may prescribe an antibiotic before or after surgery to help prevent an infection. You will not be able to eat or drink after midnight the night before surgery. Prior to surgery, an intravenous line (IV) will be placed in a vein so you can receive fluids and medications during the surgery. Your private areas will be shaved. You may be given an enema to clean out your colon.
WHAT TO EXPECT DURING SURGERY
You will be taken to surgery on a wheeled stretcher. The operating room staff will greet you. You may notice the air temperature is cool in the operating room. The surgeon needs to keep the room cool because so much heat is produced by the operating room lights and other equipment. Your anesthesiologist will give you medicine in your IV to make you sleep. If you have a general anesthetic, the anesthesiologist will place a breathing tube (endotracheal tube) in your windpipe after you are asleep to assist your breathing. If you are getting a spinal, the anesthesia will be placed in your back through a needle. A catheter (tube) will be placed in your bladder so your urine can be monitored.
After the anesthetic is working, one or several incisions will be made depending on the surgical approach planned. Your uterus will be removed through your abdomen or your vagina using special instruments. You may have one long (6 inch) abdominal incision or several very small incisions (<1/2 inch each) on your abdomen, depending on which technique your doctor uses. In general, women who have the uterus removed through the vagina tend to recover faster and have fewer complications than those who have the uterus removed through the abdomen. Talk with your doctor about your options before the operation.
WHAT TO EXPECT AFTER SURGERY
After the surgery, you will be closely monitored. Your blood pressure and pulse will be checked frequently and you will be asked to turn, cough, and breathe deeply. This will help clear your lungs and improve your circulation.
As the anesthetic wears off, you will be sore from your surgery. You may also have a sore throat for a few days from the endotracheal tube. Feel free to ask for pain medication when you need it.
Your bowels may take a day or more to start working normally. Your diet will start with only clear liquids (broth, jello, 7-Up), but you will probably be able to eat solid food on the first or second day after surgery. When you are able to drink enough fluids, your IV will be removed unless you need it for medications.
You can expect to be up and out of bed right away. The quicker you are up and moving, the faster you will recover. The activity and deep breathing will help expand your lungs, improve your circulation, and help you to pass gas.
Usually your urinary catheter is removed the morning after surgery. If you also had your bladder repaired, your catheter may stay in longer.
If you have an abdominal incision, you may have to wait a day or two before you can shower. There may be stitches or clips across your abdominal incision that will be removed in approximately five to eight days when you see your doctor for a follow up visit.
It is normal to have a small amount of blood drain from your vagina for a few days after surgery. Do not use tampons to absorb the blood - use only sanitary pads. You will have stitches at the top of your vagina that will dissolve as the incision heals. You may notice some spotting on your sanitary pads or panties.
Before you leave the hospital, your nurse and doctor will give you instructions on how best to take care of yourself once you are home. Be alert for signs of infection (fever, increased pain, swelling or drainage from your incision, or a frequent urge to urinate). Call your doctor if any of these symptoms occur or if you have vaginal bleeding that soaks more than one sanitary pad in an hour.
Your doctor will give you a prescription for pain pills. If your ovaries were removed, you may also need hormone replacement therapy. Ask your doctor or nurse whether this is recommended for you.
Your doctor will let you know when you may start driving again, how much you can lift (heavy lifting should be avoided for about two months), and when you can take a tub bath. Sexual activity can usually be resumed after about one month.
After your hysterectomy, you will no longer menstruate or need birth control as you will no longer be able to get pregnant.
COPING
Many women who have hysterectomy experience some degree of depression. The depression may be due to the loss of hormones, grief over the loss of part of your body, or the knowledge that you can no longer become pregnant. Talking to someone may help. Family, friends, a chaplain, or counselor can all lend support and understanding.
Give yourself time to heal. Physical healing will take about four to six weeks and sometimes longer. During your recovery period at home, try to increase your activity level slowly but remember to get some exercise every day. If you have ongoing medical concerns or questions, discuss them with your physician or other health care professional.
Please note that this information is intended to give you a general overview of the topic. It is not intended to replace advice or instruction of a health professional. We recommend that you consult your physician, nurse, or qualified health professional regarding the information in this publication. © 1994 Planetree, Inc. Reproduction of this material in any form is limited to license agreement.
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