Text and list of links - 3 9925

 

Jargon buster - 0 9921

 

Gynaecology

Hysterectomy


IntroductionShow [+]Hide [-]

A hysterectomy involves removing the uterus (womb) and the cervix (neck of the womb) and sometimes one or both ovaries and tubes.

Having the uterus removed brings the obvious advantage of no more monthly periods, and also no need for contraception. It is a very common procedure and many women in the UK will have a hysterectomy at some time in their lives for one or more of the following reasons:

  • heavy or painful periods
  • prolapse of the uterus
  • fibroids that may have grown in the uterus
  • endometriosis where the lining of the womb may grow abnormally causing and pain.
  • ovarian cysts or tumours (benign and malignant)
  • cancer of the womb or cervix.

Before your procedureShow [+]Hide [-]

You will receive an appointment to attend the pre-assessment clinic to discuss your plan of care.

The nurse will take your medical history, note any medication you may be taking (please bring these with you). She will take your blood pressure (BP), temperature, pulse and some blood samples. You can also ask any questions you may have about your surgery.

You may be asked to have an ECG or a chest x-ray. The nurse may ask advice from one of the clinic anaesthetists.

To help improve your recovery after the operation, try to get yourself into the best physical condition you can: try to cut down or stop smoking; eat healthily and take regular exercise.

Don’t forget to make home arrangements before you are admitted to the hospital (eg childcare, shopping, washing, housework). You will be advised not to do any heavy housework or lifting for at least six weeks. For major open surgery instead of laparoscopic (keyhole) surgery, you may need longer to recover. The length of the hospital stay is variable, depending on the type of the operation and your general health. You can expect to be in hospital for the whole day of the surgery; more often, you could expect to leave on the first or second day after surgery, and up to a maximum of about seven days after surgery.

Admission to hospital

You will usually be admitted to hospital on the day of surgery. You should bring:

  • nightwear
  • dressing gown
  • slippers
  • toiletries
  • towels
  • any medicine which you take regularly.

The nurse will carry out a safety checklist to ensure we have the correct details about you, and that you're ready for your operation. She might give you swabs to routinely screen for the MRSA infection, if this hasn’t already been done. The nurse will measure for support stockings to help the circulation in your legs after surgery. You should wear these until you return to full activity, although you can remove them for washing.

The gynaecologist and the anaesthetist will see you before surgery and answer any questions. In theatre, you will be given an antibiotic to help prevent infection.

During your procedureShow [+]Hide [-]

The operation is done with you asleep, using a general anaesthetic (GA).

Occasionally, hysterectomy for a prolapse may be done using a spinal or epidural anaesthetic. You would be awake if we use an anaesthetic like this.

Smoking increases the risk when you have a GA, so if you are a smoker we strongly advise you to give up. Your GP or the nurse in our clinic can give you information to help.

Recovery after a hysterectomy takes on average six weeks. Some women will take longer, perhaps 8-12 weeks, depending on the type of hysterectomy (eg open surgery versus “keyhole” surgery). Try to arrange to have help around the home for the first few weeks if you can.

After your procedureShow [+]Hide [-]

When you wake up, you will be in the recovery room with an oxygen mask and a drip in the back of your hand. This is to help you have fluids until you are drinking as usual. There may be a catheter in place to help you pass urine until you are more mobile.

For women with prolapse surgery, there may be a gauze pack in the vagina to help stop any bleeding. For open and laparoscopic (“keyhole”) surgery, you may have a drain. This is to empty any residual blood from the operation that may still be in the abdominal cavity, it is often removed on the first day of surgery.

After open or prolapse surgery, women will often have a catheter to empty their bladder. A nurse will be checking your blood pressure and pulse regularly. We would like you to start the deep breathing you will be shown as soon as possible, and continue about five times every hour for the next few days. This will help reduce the effects of the anaesthetic.

Leg exercises will help your circulation. A nurse or physiotherapist will show you how to do these.

Recovery

To start with you may feel sleepy and uncomfortable. A doctor will visit you to check how you are after surgery and answer any questions you may have. The pain relief medication will be reviewed to make sure you are comfortable. We will help you out of bed so that you can sit up and start to walk around the ward

The physiotherapists will advise on leg exercises, pelvic floor exercises and breathing. Soon, you will feel like eating and drinking as you usually do. If you have a catheter or drain, it is often removed if you are ready to move to the toilet, and you can then also shower and bath as you wish.

It is quite normal not to open your bowels for the first couple of days, but you need to avoid constipation. Please drink plenty of water and eat fruit and vegetables when you feel hungry. Please tell the nurse if you are having trouble opening your bowels.  

Once you are home

It takes time for your body to heal and for you to get fit and well after your hysterectomy. There are number of positive steps you can take at this time:

  • While it is important to rest, it is also important to do light activities around the house in the first few weeks. Perhaps at the end of the first week, go for a short walk. If this feels ok, then gradually increase the distance and speed over the first few weeks. Ensure you don’t feel vaginal heaviness when walking.
  • Avoid constipation by eating plenty of fruit, vegetables and food containing whole grain. You can also discuss this problem with your GP.
  • After four weeks, gradually begin to do more housework, cooking, ironing, etc. By six weeks you may be back to normal, apart from prolonged standing and heavy lifting which should be avoided after prolapse surgery for about three months.
  • You may go anywhere as a passenger in a car, but if going long distances ensure you stretch your legs regularly.
  • You should avoid driving until you feel able to drive without any discomfort, and you're not taking any strong painkillers that may alter concentration. If uncertain, check with your insurance company regarding their policy.
  • Try to have a bath or shower regularly. It is safe to use soap, shampoo or bubble bath.
  • Cutting down or stopping smoking will help you reduce the risk of chest and wound infection.
  • You and your partner may need to discuss your ideas about sex when you feel ready. Some women feel tired or indifferent to sex after a major operation and it may take a while for things to return to normal. Resuming a sexual relationship depends on the extent of the vaginal surgery, the rate of healing and your own feelings. You may explore other ways of being intimate until you feel ready. We advise that you refrain from sexual intercourse for about six week. Lubricating gel may help if your vagina feels dry.  

Everyone recovers at a different rate, so when you are ready to go back to work will depend on the type of work you do, the number of hours you work, and how you get to work. Many women are able to go back to normal work in six to eight weeks - others may need 12 weeks or more for recovery.

You can get a sick note when you leave the ward, but for a note for more than six weeks we advise you to visit your GP before your sick note runs out.

More informationShow [+]Hide [-]

Leaflet to download

You can find out more information on this hysterectomy leaflet to download.pdf

© Copyright Newcastle upon Tyne Hospitals NHS Foundation Trust 2017 Site by TH_NK