Vaginal Hysterectomy

WHAT YOU SHOULD KNOW:

• A vaginal hysterectomy (VH) is surgery to remove 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 conceive, grow, and give birth to a baby. Your cervix is the narrow part of your uterus that is next to your vagina. In a vaginal hysterectomy, your uterus is removed through your vagina. Your caregiver may remove your entire uterus or leave your cervix. Other organs or tissues may be removed depending on the type of surgery you are having. After a vaginal hysterectomy, you will not be able to have a baby.
  
  
• You may need a vaginal hysterectomy if you have fibroid tumors (growths) in your uterus or other reproductive organs. You may need a VH if you have an infection in your uterus caused by germs called bacteria. A VH may treat severe (very bad) pain, which may be caused by a disease called endometriosis. A vaginal hysterectomy can be used to treat some causes of vaginal bleeding, or to treat uterine cancer. If your uterus has slipped down into your vagina, you may need this surgery. After having a vaginal hysterectomy, your pain and bleeding may decrease.

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:

• You may get a fever or an infection. Your vagina may become dry and you may have decreased interest in having sex. You may have incontinence (unable to control when you urinate). You may have pain in your lower abdomen that lasts for months or more. Your other pelvic organs may slip out of place and slide down into the vagina. You may have damage to your blood vessels and your organs, such as your bladder and bowels. You may bleed too much during surgery, and need a blood transfusion. During your surgery, caregivers may need to change from doing a vaginal hysterectomy, to doing an abdominal hysterectomy.
  
  
• You may get a blood clot in your leg or arm. Blood clots need treatment right away because they can stop blood flow in your body. Blood clots cause pain or swelling in your arm or leg. If a clot breaks loose, it can go to your lungs. A blood clot in your lungs causes chest pain and trouble breathing. This problem can be life-threatening.
  
  
• After a vaginal hysterectomy, you will not be able to have a baby. Without a vaginal hysterectomy, you may continue to have very heavy bleeding and severe pain. If you have tumors, they may continue to grow. If your uterus is loose, it may slide down further into your vagina. It may be harder to control your bladder. If you have cancer, it may spread to other parts of your body. If you have an infection, it can become very bad and you can die. Call your caregiver if you have concerns or questions about your surgery, condition, 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.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• 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.
  
  
• Blood thinners: This medicine helps prevent clots from forming in the blood. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise. Use an electric razor and soft toothbrush to help prevent bleeding.
  
  
• Pre-op care: You will be taken to the room where your surgery will be done. Your caregivers will move you to a table.
  
  
• Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.
  
  
  • 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:

• Through your vagina, your caregiver makes a cut around your cervix. He cuts and ties the ligaments (strong tissues) that hold your uterus in place. Your caregiver ties the blood vessels to your uterus to help prevent bleeding. Your caregiver may also give you a shot in your vagina to help decrease bleeding. Your caregiver removes your uterus through your vagina. Once your surgery is complete, caregivers may fill your vagina with bandages soaked with medicine.
  
  
• If you have a total vaginal hysterectomy, then your entire uterus including 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. Lymph nodes (organs made of tissue that fight infection) may also be removed. Pieces of tissue or organs removed from your body may be sent to a lab for testing.

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. Your caregiver may give you any of the following medicines:

• Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
  
  
• 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.

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.

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.

Blood transfusion:

You may need a blood transfusion for certain medical conditions. You may also need a transfusion if you lose a large amount of blood during surgery. You may ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation. Many people are worried about getting AIDS, hepatitis, or West Nile Virus from a blood transfusion. The risk of this happening is rare. Blood banks test all donated blood for AIDS, hepatitis, and West Nile Virus. If you refuse a blood transfusion, your condition may get worse, and you may die.

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 Vaginal Hysterectomy (Inpatient Care)