Talk with your doctor about what to expect during and after a vaginal hysterectomy, including physical and emotional effects.
During the procedure
You may have general anesthesia, so you won't be awake for the surgery. Alternatively, you may choose a spinal block (regional anesthesia) with a medication that makes you drowsy, or you may remain awake during your surgery.
You'll lie on your back, in a position similar to the one you're in for a Pap test. You may have a urinary catheter inserted to empty your bladder. A member of your surgical team will clean the surgical area with a sterile solution before surgery.
To perform the hysterectomy:
- Your surgeon makes an incision inside your vagina to get to the uterus
- Using long instruments, your surgeon clamps the uterine blood vessels and separates your uterus from the connective tissue, ovaries and fallopian tubes
- Your uterus is removed through the vaginal opening, and absorbable stitches are used to control any bleeding inside the pelvis
Except in cases of suspected uterine cancer, the surgeon may cut an enlarged uterus into smaller pieces and remove it in sections (morcellation).
Laparoscopic or robotic hysterectomy
You may be a candidate for a laparoscopically assisted vaginal hysterectomy (LAVH) or robotic hysterectomy. Both procedures allow your surgeon to remove the uterus vaginally while being able to see your pelvic organs through a laparoscope, a slender viewing instrument.
Your surgeon performs most of the procedure through small abdominal incisions aided by long, thin surgical instruments inserted through the incisions. Your surgeon then removes the uterus through an incision made in your vagina.
Your surgeon might recommend LAVH or robotic hysterectomy if you have scar tissue (pelvic adhesions) on your pelvic organs from prior surgeries or from endometriosis.
After the procedure
After surgery, you'll be in a recovery room for a few hours and in the hospital for one to two days, possibly longer.
You'll take medication for pain and to prevent infection. Your health care team will encourage you to get up and move as soon as you're able.
It's normal to have bloody vaginal discharge for several days to weeks after a hysterectomy, so you'll need to wear sanitary pads.
How you'll feel physically
Recovery after vaginal hysterectomy is shorter and less painful than after an abdominal hysterectomy. A full recovery may take three to four weeks.
Even if you feel like you're back to normal, don't lift anything heavy — more than 20 pounds (9.1 kilograms) — or have vaginal intercourse until six weeks after surgery.
Contact your doctor if pain worsens or if you develop nausea, vomiting or bleeding that's heavier than a menstrual period.
How you'll feel emotionally
After a hysterectomy, you may have an improved mood and increased sense of well-being. You may be relieved to no longer experience signs and symptoms such as heavy bleeding or pelvic pain.
For most women, there's no change in sexual function after hysterectomy. But for some women, heightened sexual satisfaction occurs after hysterectomy — perhaps because they no longer fear becoming pregnant or no longer have pain during intercourse.
You may feel a sense of loss and grief after hysterectomy, which is normal. Or you may experience depression related to the loss of your fertility, especially if you're young and hoped for a future pregnancy.
If sadness or negative feelings begin to interfere with your enjoyment of everyday life, talk to your doctor.
Aug. 10, 2017