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What you need to know about a hysterectomy:
A hysterectomy is surgery to remove your uterus. Your ovaries, fallopian tubes, cervix, or part of your vagina may also need to be removed. The organs and tissue that will be removed depends on your medical condition.
How to prepare for a hysterectomy:
Your healthcare provider will talk to you about how to prepare for surgery. You will need to stop taking aspirin 7 to 10 days before your procedure. You will need to stop taking NSAIDs 3 days before you procedure. You will also need to stop taking certain herbal supplements 7 days before your procedure. These include garlic, gingko biloba, and ginseng. Your provider may tell you to shower the night before your surgery. He or she may tell you to use a certain soap to help prevent a surgical site infection. Your provider may tell you not to eat or drink anything after midnight on the day of your surgery. He or she will tell you what medicines to take or not take on the day of your surgery. You will be given an antibiotic through your IV to help prevent a bacterial infection. Arrange for someone to drive you home and stay with you after surgery.
What will happen during a hysterectomy:
- You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given regional anesthesia to numb the lower part of your body. Your uterus may be removed through your vagina (vaginal hysterectomy) or through a an incision in your abdomen (abdominal hysterectomy). It may also be done through several small incisions in your abdomen (laparoscopic hysterectomy). During a laparoscopic hysterectomy, a laparoscope and other tools will be put into your abdomen through the small incisions. The laparoscope is a long metal tube with a light and camera on the end. Your abdomen will be filled with a gas. This allows your surgeon to see inside your abdomen more clearly.
- Your surgeon will cut and tie the ligaments that hold your uterus in place. The blood vessels that go to your uterus will also be tied to help decrease bleeding. Your surgeon may also remove other organs or tissue such as your ovaries, fallopian tubes, cervix, lymph nodes, or part of your vagina.
- Your surgeon may instead use robotic arms to place a laparoscope and other tools inside your abdomen through the incisions. He or she will use the machine to look inside your abdomen and guide the robotic arms. Your surgeon will use the tools attached to the robotic arms to remove your uterus, cervix, or other tissues.
- Any incisions that were made during surgery will be closed with stitches, staples, surgical glue, or surgical tape. The incisions may be covered with a bandage. A vaginal pack or sanitary pad may be used to absorb the bleeding. A vaginal pack is a special gauze that is inserted into the vagina. It is removed before you go home or to a hospital room.
What will happen after a hysterectomy:
You may have a catheter to help drain your bladder for up to 24 hours. You may also have pain in your shoulders or near your ribs if gas was put in your abdomen. You will have pain for the first few days after surgery. You will need to wear sanitary pads for vaginal bleeding that occurs after surgery. You will be asked to walk as soon as possible after surgery. This will help to prevent blood clots in your legs. You may need to stay in the hospital for 1 to 4 days after surgery. The length of time depends on the type of hysterectomy you had.
Risks of a hysterectomy:
- The surgeon may need to change the type of surgery he or she was planning to do. For example, your surgeon may need to change from a laparoscopic surgery to an open abdominal surgery. You will not be able to become pregnant after you have a hysterectomy. You will go through menopause if your ovaries are removed.
- You may bleed more than expected or get an infection. Your bladder, ureters, or bowels may be damaged during surgery. If your ureters were injured, you may need a catheter to drain your bladder for several days to weeks. You may get scar tissue in your abdomen that blocks your intestine or causes pelvic pain. If you have a hysterectomy to treat cancer, this surgery may not take it away completely. There is also a chance that the cancer may return. You may get a blood clot in your leg or arm. This may become life-threatening.
Call 911 for any of the following:
- You feel lightheaded, short of breath, and have chest pain.
- You cough up blood.
Seek care immediately:
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- You have increasing abdominal or pelvic pain.
Contact your healthcare provider or gynecologist if:
- You have heavy vaginal bleeding that fills 1 or more sanitary pads in 1 hour.
- You have a fever.
- You have nausea or are vomiting.
- You feel pain or burning when you urinate, or you have trouble urinating.
- You have pus or a foul-smelling odor coming from your vagina.
- Your wound is red, swollen, or draining pus.
- You feel pressure in your rectum.
- You have questions or concerns about your condition or care.
- Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely.
- Stool softeners help treat or prevent constipation.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
- Wear an abdominal binder as directed. An abdominal binder will decrease pain when you move or cough.
- Rest as needed. Get up and move around as directed to help prevent blood clots. Start with short walks and slowly increase the distance every day. Limit the number of times you climb stairs to 2 times each day. Plan most of your daily activities on one level of your home.
- Do not lift objects heavier than 10 pounds for 6 weeks. Avoid strenuous activity for 2 weeks.
- Do not strain during bowel movements. High-fiber foods and extra liquids can help you prevent constipation. Examples of high-fiber foods are fruit and bran. Prune juice and water are good liquids to drink.
- Do not have sex, use tampons, or douche for up to 8 weeks. Ask your healthcare provider if it is okay to take a tub bath.
- Do not go in pools or hot tubs for 6 weeks or as directed.
- Ask when it is safe for you to drive, return to work, and return to other regular activities.
If you have abdominal incisions, care for them as directed. Carefully wash around the wound with soap and water. It is okay to let the soap and water run over your incision. Do not scrub your incision. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty. If you have strips of medical tape, let them fall off on their own. It may take 7 to 14 days for them to fall off. Check your incision every day for redness, swelling, or pus.
Take deep breaths and cough 10 times each hour. This will decrease your risk for a lung infection. Take a deep breath and hold it for as long as you can. Let the air out and then cough strongly. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath, then let the air out and cough. Repeat these steps 10 times every hour.
This surgery may be life-changing for you and your family. You will no longer be able to get pregnant. Sudden changes in the levels of your hormones may occur and cause mood swings and depression. You may feel angry, sad, or frightened, or cry frequently and unexpectedly. These feelings are normal. Talk to your healthcare provider about where you can get support. You can also ask if hormone replacement medicine is right for you.
Follow up with your healthcare provider or gynecologist as directed:
You may need to return to have stitches removed, and for other tests. Write down your questions so you remember to ask them during your visits.
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