What is Vaginal Hysterectomy

Vaginal hysterectomy is a procedure to remove all or part of the uterus through a small incision in the vagina. In this procedure, your health care provider may remove your entire uterus, including the lower end (cervix).

You may need a vaginal hysterectomy to treat:

• Uterine fibroids.
• A condition that causes the lining of the uterus to grow in other areas (endometriosis).
• Problems with pelvic support.
• Cancer of the cervix, ovaries, uterus, or tissue that lines the uterus (endometrium).
• Excessive (dysfunctional) uterine bleeding.

When removing your uterus, your health care provider may also remove the organs that produce eggs (ovaries) and the tubes that carry eggs to your uterus (fallopian tubes). After a vaginal hysterectomy, you will no longer be able to have a baby. You will also no longer get your menstrual period.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Bleeding.
• Infection.
• A blood clot that forms in your leg and travels to your lungs (pulmonary embolism).
• Damage to surrounding organs.
• Pain during sex.

What happens before the procedure?

• Ask your health care provider what organs will be removed during surgery.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
• Plan to have someone take you home after discharge from the hospital.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You may be given antibiotic medicine to help prevent infection.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into an area of your body to numb everything beyond the injection site (regional anesthetic).
• Your surgeon will make an incision in your vagina.
• Your surgeon will locate and remove all or part of your uterus.
• Your ovaries and fallopian tubes may be removed at the same time.
• The incision will be closed with stitches (sutures) that dissolve over time.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You will be encouraged to get up and walk around after a few hours to help prevent complications.
• You may have IV tubes in place for a few days.
• You will be given pain medicine as needed.
• Do not drive for 24 hours if you were given a sedative.

Care After Vaginal Hysterectomy

These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain.
• Soreness and numbness in your incision areas.
• Vaginal bleeding and discharge.
• Constipation.
• Temporary problems emptying the bladder.
• Feelings of sadness or other emotions.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Do not drive or operate heavy machinery while taking prescription pain medicine.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Get regular exercise as told by your health care provider. You may be told to take short walks every day and go farther each time.
• Do not lift anything that is heavier than 10 lb (4.5 kg).

General instructions

• Do not put anything in your vagina for 6 weeks after your surgery or as told by your health care provider. This includes tampons and douches.
• Do not have sex until your health care provider says you can.
• Do not take baths, swim, or use a hot tub until your health care provider approves.
• Drink enough fluid to keep your urine clear or pale yellow.
• Do not drive for 24 hours if you were given a sedative.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your pain medicine is not helping.
• You have a fever.
• You have redness, swelling, or pain at your incision site.
• You have blood, pus, or a bad-smelling discharge from your vagina.
• You continue to have difficulty urinating.

Get help right away if:

• You have severe abdominal or back pain.
• You have heavy bleeding from your vagina.
• You have chest pain or shortness of breath.