Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor
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DefinitionHysterectomy is the surgical term for the removal of the uterus (womb). This results in the inability to become pregnant. There are different types of surgeries, such as: - Supracervical hysterectomy—removal of the uterus only
- Total hysterectomy—removal of the uterus and cervix (the opening of the uterus leading to the vagina)
- Radical hysterectomy—removal of the uterus, ovaries, fallopian tubes, upper part of the vagina, and the pelvic lymph nodes
- Salpingo-oophorectomy
—removal of the ovaries and fallopian tubes (may be combined with any of the above procedures)
Reasons for ProcedureYou may have a hysterectomy if your uterus is causing health problems that cannot be treated by other means. Some reasons a woman may have a hysterectomy are to: Explore your options before having a hysterectomy. There are other treatments for many of these problems. Possible ComplicationsIf you are planning to have hysterectomy, your doctor will review a list of possible complications, which may include: Some factors that may increase the risk of complications include: - Obesity
- Smoking
- Heart or lung disease
- Diabetes
- Previous pelvic surgery or serious infection
- Use of medicines during the past month
Discuss the risks with your doctor before surgery. What to ExpectYour doctor may do the following: - Blood and urine tests
- Pap smear
- X-ray
of abdomen and kidneys—a test that uses radiation to take a picture of structures inside the body
- Pelvic ultrasound
—a test that uses sound waves to show organs in the abdomen
- Dilation and curettage
(D&C)—surgical removal of tissue from the lining of the uterus
You should do the following: -
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin
or other anti-inflammatory drugs
-
Blood thinners, such as
warfarin
(Coumadin)
- Clopidogrel
(Plavix)
- Arrange for a ride home and for help at home.
- Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
You may be given antibiotics just before your surgery. Laparoscopic procedures are minimally invasive. This means that small incisions are made, rather than the large incisions that are used during open surgery. During this procedure, the doctor will make small incisions in the area of your navel and hip bone. A laparoscope (a small tool with a camera on one end) will be inserted through one of the incisions. The tool will allow the doctor to view your pelvic organs on a monitor. Other tools will also be inserted to do the surgery. Next, the doctor will detach the uterus from the cervix. A tool will be used to break down the uterus into smaller pieces. The doctor will then remove this tissue through the small incisions. Similar to the above surgery, the doctor will make small incisions in the abdominal area and insert tools. The doctor will then make an incision in the vagina to help detach the lower portion of the cervix and the uterus. The cervix and uterus will then be removed through the vaginal opening. A hysterectomy can also be done using robotic technology. Like the laparoscopic procedures, tools are placed through small incisions in the abdominal area. The doctor, though, sits at a console and views the organs via a monitor that displays a 3D image. The surgery is done using a joystick-like device to control the tools. You will be given IV fluids and medicines. You will not have pain during the surgery because of the anesthesia. During your recovery time, your doctor will give you pain medicine. You may be able to leave the hospital on the same day or the next day. You will stay longer if you have complications. While you are recovering at the hospital, you may receive the following care: - On the first night, the nurse will help you sit up and walk.
- During the next morning, the IV will be removed if you are eating and drinking well.
- You may need to wear special stockings or boots to help prevent blood clots.
- You may have a Foley catheter for a short time to help you urinate.
During the first few days, you may have pain, bloating, vaginal bleeding, and vaginal discharge. When at home, take these steps to care for yourself: - To prevent infection, take proper care of the incision areas.
- Slowly increase your activities. Begin with light chores and short walks.
- During the first two weeks, rest and avoid strenuous activities, like heavy lifting.
- Ask your doctor when it is safe for you to return to work and drive.
- Ask your doctor when you will be able to shower, bathe, or soak in water.
-
Eat a diet rich in
fruits and vegetables.
-
Pain medicines can cause
constipation. To avoid constipation:
- Ask your doctor when you can use tampons.
- Wait six weeks before resuming sexual activity.
-
Ask your doctor if you should do
Kegel exercises
to strengthen the pelvic floor muscles.
-
Follow your doctor's
instructions
.
Note:
If the doctor has not removed your cervix, you will need to continue to have
Pap smears
to check for cervical cancer.
Call Your DoctorAfter you leave the hospital, contact your doctor if any of the following occurs: - Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, leakage, or any discharge from the incision sites
- Nausea and/or vomiting
- Dizziness or fainting
- Cough, shortness of breath, or chest pain
- Heavy bleeding
- Pain that you cannot control with the medicines you have been given
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Swelling, redness, or pain in your leg
In case of an emergency, call for medical help right away.
Hysterectomy. American College of Obstetricians and Gynecologists website. Available at:
http://www.acog.org/~/media/For%20Patients/faq008.pdf?dmc=1&ts=20120815T1040007858. Published August 2011. Accessed August 16, 2012.
Hysterectomy. Bon Secours St. Francis Health System website. Available at:
http://www.stfrancishealth.org/our-services-surgical-care-surgical-procedures-hysterectomy.html. Accessed August 16, 2012.
Laparoscopic supracervical hysterectomy. Shawnee Mission Medical Center website. Available at:
http://videocenter.shawneemission.org/videos/laparoscopic-supracervical-hysterectomy. Accessed August 16, 2012.
McCoy K. Robot-assisted laparoscopic procedures. EBSCO Health Library website. Available at:
http://www.ebscohost.com/healthLibrary/. Updated December 30, 2011. Accessed August 16, 2012.
The treatment: robot-assisted laparoscopic hysterectomy. UC Davis Health System website. Available at:
http://www.ucdmc.ucdavis.edu/obgyn/specialties/robotic_surgery/hysterectomy.html. Accessed August 16, 2012.
Last reviewed March 2013 by Andrea Chisholm Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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