For most women the decision to proceed with a hysterectomy is not an easy one. It can be quite an emotional journey and your Eve Health gynaecologist will support you through your decision making.
A hysterectomy is surgery to remove the uterus altogether. It can be performed for many different reasons such as fibroids, heavy menstrual bleeding, pelvic pain, endometriosis, fertility problems, abnormal cells and prolapse.
There are a several different ways that a hysterectomy can be done. These include –
- Laparoscopic hysterectomy – this is the most common approach to hysterectomy. Four small incisions, 1cm or less are made on the abdomen to allow the passage of surgical instruments. The uterus is “disconnected” then essentially “delivered” through the vagina before the top of the vagina is sutured. The majority of hysterectomies are performed this way, meaning that pain, time in hospital and the time to return back to usual activities is lessened.
- Abdominal hysterectomy – a 10-15cm incision is made on the bikini line (like a Caesarean Section), or occasionally for those with a very enlarged uterus, vertically from the pubic bone toward the belly-button.
- Vaginal hysterectomy – there are no surgical incisions on the abdomen and the uterus is removed entirely through the vagina. Usually performed for women who have some degree of pelvic organ prolapse and require a vaginal repair procedure at the same time.
Your Eve Health gynaecologist will discuss these three options with you and explain the benefits and risks of each one. While most surgeons will aim to perform minimally invasive surgery, sometimes it is necessary to undertake an abdominal hysterectomy due to the size of the uterus or a condition such as a large fibroid. They will also discuss other important options and make recommendations about whether to keep or remove the tubes, the ovaries and the cervix. In most cases the tubes and cervix will be removed and the ovaries will be conserved but each of these are important considerations and will be discussed and planned in relation to your particular circumstances.
What you can expect
Hysterectomy surgery usually lasts 1.5 to 2.5 hours and the length of your hospital stay will depend on the type of hysterectomy performed. A laparoscopic or vaginal hysterectomy may only require a 1-2 night hospital stay, whereas an abdominal hysterectomy may require a 3-4 day stay.
Recovery
During your stay in hospital most women are given paracetamol and anti-inflammatories, as well as occasional use of stronger pain medications such Endone and Tramadol. It is often recommended to start bowel softeners whilst in hospital to avoid constipation.
We usually recommend that women initially rest at home for 1 week and then after they may be able to commence gentle activity. More strenuous exercise and swimming is to be avoided for up to 6 weeks. Driving will be off limits for a minimum of 2 weeks and most women are advised to avoid vaginal intercourse for 8-10 weeks.
Laparoscopic surgery, the most common surgical procedure allows most women to return to work after 3-4 weeks. Your surgeon will discuss all of this further with you.
A hysterectomy is not a light undertaking and women give careful consideration to this. In our experience, once you have recovered and are relieved from the troublesome symptoms of pain, heavy bleeding and pressure that may have led you to surgery, you are likely to enjoy improved quality of life.
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