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Abdominal Hysterectomy

What you should know

An abdominal hysterectomy (AH) is surgery to remove your uterus. Your uterus will be removed through an incision in your abdomen. You may need an AH if you have a tumor in your uterus or other reproductive organs. You may also need an AH if you have an infection, pain, or bleeding.

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.

Getting Ready

Before your surgery:

  • Caregivers may ask you about your current and past medical conditions. Tell your caregiver if you have had surgery in the past. Tell him if you know or think you might be pregnant. Your caregiver may do a pelvic exam. During this exam, your caregiver inserts a gloved finger into your vagina. He may also use a special tool called a speculum to help see your cervix. You may need to have a Pap smear. This test is done to remove cells from your cervix so that they can be tested.

  • Your caregiver may tell you to stop taking birth control pills or certain vitamins before your surgery. He may also tell you to stop taking medicine for pain or inflammation (redness and swelling). Your caregiver may want you to start taking iron or hormone pills. Always follow your caregiver's instructions about when to take your medicine. If you smoke, your caregiver may tell you to stop smoking before your surgery.

  • You may need to have blood and imaging tests done. You may need a urine or blood test to see if you are pregnant. A chest x-ray, pelvic ultrasound, or abdominal computed tomography (CT) scan may also be done. Ask your caregiver for more information about tests that you may need. Write down the date, time, and location of each test.

The night before your surgery:

  • Ask caregivers about directions for eating and drinking.

  • You may need to have your bowels emptied before the night before your surgery. Ask your caregiver if your bowel needs to be emptied out and how this is done.

The day of your surgery:

  • Write down the correct date, time, and location of your surgery.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.

  • 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 stop blood clots from forming.

  • 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: An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.

Treatment

What will happen:

  • You will be taken to the room where your surgery will be done. You will be given anesthesia medicine to make you sleep during your surgery. While you are asleep, your caregiver will place a catheter (tube) inside your urethra to drain your urine out into a bag. Your caregiver will make 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 will use special tools to remove your uterus. If you have a total abdominal hysterectomy, your entire uterus including your cervix will be removed. If you are having a subtotal (supracervical) hysterectomy, only your uterus will be removed. In a radical hysterectomy, your entire uterus and part of your vagina and nearby tissues will be removed. During surgery, your caregiver may remove other organs if they are infected, or have cancer in them. Your caregiver will close your cut with stitches or staples and cover the area with bandages. Your caregiver may put bandages soaked with medicine into your vagina. Pieces of tissue or organs that are removed 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. Your catheter may make you feel like you have to urinate. Relax and the catheter will drain the urine for you. When the catheter is taken out, you will be able to urinate on your own. After your caregiver says it is okay, you will be taken back to your hospital room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

  • You have a fever (high body temperature).

  • You cannot make it to your surgery.

  • You feel pain or fullness in your vagina.

  • You feel like something is sticking out of your vagina.

Seek Care Immediately if

  • You have bleeding from your vagina that does not stop.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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 (Precare)

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