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

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

• Heavy periods
• Prolapse of the uterus where the womb may drop down and press on the bladder or bowel
• Fibroids that may have grown in the uterus
• Endometriosis where the lining of the womb may grow abnormally causing heavy bleeding and pain

About two weeks before your operation we will invite you to the pre-assessment clinic on level two of the Leazes Wing, next to Ward 40. The appointment lasts for about an hour. 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 and pulse and some blood samples. This is a chance to ask any questions you may have about your surgery. You may be asked to have an ECG or a chest X-ray if this is necessary.

The secretary 0191 2820331

The nurse in charge of the pre-assessment clinic 0191 2825043

When you come to hospital

You will come to ward 40 the day before your surgery

Please bring

• Nightwear and slippers
• Toiletries
• Only a small amount of money for newspapers/payphone etc please do not bring large amounts of money or other valuables as we cannot ensure their safety

You will be visited by the anaesthetist and other members of the team who will explain the surgery you are having and the breathing and leg exercises you will do after the operation. You will have an enema to make sure the bowel is empty. We will inform you when you can last eat and drink.

The next morning, a nurse will come to help you get ready for theatre. Your pubic hair will be shaved; you may do this yourself if you wish. We will ask you to wear the support stockings that will help prevent thrombosis. An injection of heparin will help with this also.

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

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

Recovery after a hysterectomy may take up to 12 weeks. During this time there should be no heavy lifting or housework, don’t stand for long periods of time. Try to arrange to have help around the home for the first few weeks if you can.

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.

There will be a gauze pack in the vagina to help stop any bleeding. A nurse will be checking your blood pressure and pulse often. We would like you to start the deep breathing you were 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 about 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, the catheter will be removed and you can 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

You may feel ready to go home between four and seven days after your operation. Once home, please continue with the exercises you were shown to help you recover well. You may increase your activity gradually and take short walks starting with about ten minutes and gradually increasing as you feel able.

Rest often and especially when you feel tired. Please don’t ‘overdo’ things when you are home.

You may feel ready to drive a car within four – six weeks but please check with your insurance company who may advise you.

Sex

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.

Return to work

Depending on how strenuous your job is please consider taking a minimum of eight weeks off work. Some women stay off work up to three months. Ask you GP for more advice