Abdominal Hysterectomy

WHAT YOU SHOULD KNOW:

• An abdominal hysterectomy (AH) is surgery to take out your uterus (womb). The uterus is the reproductive organ in a woman's body where a baby grows during pregnancy. Your reproductive organs work together to help you have a baby. Your cervix is the narrow part of your uterus that is next to or above your vagina. During an AH, your uterus is removed through an incision (cut) in your lower abdomen (stomach). Other reproductive organs may be removed depending on the type of surgery you are having. After your uterus is removed, you will not be able to have a baby.
  
  
• You may need an abdominal hysterectomy if you have a tumor (growth) in your uterus or other reproductive organs. You may need an AH if you have an infection in your uterus, or to treat very bad pain caused by a disease called endometriosis. You may need to have an AH if you have problems with your menses (a woman's monthly period). You may need an urgent abdominal hysterectomy if you cannot stop bleeding right after you have a baby. After an abdominal hysterectomy, problems such as pain and bleeding may decrease or stop.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• An abdominal hysterectomy may cause you to have an infection or a fever. You may feel pain during sexual intercourse, or you may not want to have sex as much as before surgery. Your may not be able to control when you urinate. The nerves in your abdomen may be injured, and the muscles of your abdomen may become weak. The muscles in your vagina may weaken and cause your bladder or bowel to change positions. Your bladder or bowels may get damaged, and your bowels may become blocked. If you have cancer, you may need another surgery if all of the cancer cells are not removed.
  
  
• During surgery, you may bleed so much that you need a blood transfusion. You may bleed near your organs and form blood clots. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  
• After an abdominal hysterectomy, you will not be able to have a baby. Without a hysterectomy, you may continue to have pain and bleeding. These and other symptoms may become worse. If you have cancer in your uterus and do not have surgery, it may spread to other organs. Call your caregiver if you have questions or concerns about abdominal hysterectomy surgery, your medicine, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Pressure stockings: You may need to wear special stockings that put pressure on your legs. Wearing pressure stockings may help push blood up to your heart and help keep clots from forming.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Medicines:
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Blood thinners: This medicine helps stop clots from forming in your blood. Blood thinners may be given before, during, and after your surgery. Blood thinners make it easier for you to bleed or bruise. If you shave a part of your body, use an electric shaver. Use a soft toothbrush to help keep your gums from bleeding.
  
  
• Anesthesia: Anesthesia is medicine to make you comfortable during surgery. Caregivers work with you to decide which anesthesia is best, and whether you will be awake or completely asleep. Do not make important decisions for 24 hours after having anesthesia. Also, do not drive or use heavy equipment.
  
  
  • General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
    
    
  • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

During your surgery:

• Your caregiver makes an incision (cut) into your abdomen. The cut may start below your belly button and go down, or it may be made across your lower abdomen, below your belly button. Your caregiver cuts through fat and muscle tissue until he sees your uterus. He separates your uterus and cervix from the upper part of your vagina. Your caregiver uses special tools to remove your uterus.
  
  
• If you have a total abdominal hysterectomy, then your uterus as well as your cervix is removed. If you are having a subtotal (supracervical) hysterectomy, only your uterus is removed. In a radical hysterectomy, your entire uterus plus part of your vagina and nearby tissues are removed. Your caregiver may remove other organs if they are infected or have cancer in them. Lymph nodes (organs made of tissue that fight infection) may also be removed. Your caregiver will close your cut with stitches or staples, and cover it with bandages. Your caregiver may put bandages soaked with medicine into your vagina. Tissue or organs that were removed from your body may be sent to a lab for tests.

After your surgery:

You will be taken to a room where you can rest until you are fully awake. Caregivers will watch you closely for any problems. Do not get out of bed until your caregiver says it is okay. After your caregiver says it is okay, you will be taken back to your hospital room.

• Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. Blood tests can show how much blood you may have lost during surgery.
  
  
• Food and drink after surgery: You will able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft food easily, you may slowly begin to eat solid foods.
  
  
• Medicines:
  
  
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
  
  
• Foley catheter: This is a tube caregivers put into your bladder to drain your urine into a bag. Keep the bag below your waist. This will help prevent infection and other problems caused by urine flowing back into your bladder. Do not pull on the catheter, because this may cause pain and bleeding, and the catheter could come out. Keep the catheter tubing free of kinks so your urine will flow into the bag. Caregivers will remove the catheter as soon as possible, to help prevent infection.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Preventing blood clots: Around the time of your surgery or procedure you may need to take medicine to thin your blood. Blood thinning medicine helps prevent blood clots from forming in your veins. This medicine makes it easier for a person to bruise and bleed. You will need regular blood tests while taking this medicine. If you have a bleeding disorder or a history of bleeding or blood clots, tell your caregiver. Talk to your caregiver about all of the medicines that you use. Physical activity helps prevent blood clots. Caregivers will help you be as active as possible after your surgery or procedure.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Abdominal Hysterectomy (Inpatient Care)