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Hysterectomy is a major surgery done to remove the uterus/womb, an area where your child grows when you are pregnant. It is recommended if you have:
Cancer of the uterus, most often endometrial cancer
Cancer of the cervix or a precancerous condition of the cervix called cervical dysplasia
Cancer of the ovary
Childbirth complications, such as uncontrolled bleeding
Long-term (chronic) pelvic pain
Severe endometriosis that does not get better with other treatments
Severe, long-term vaginal bleeding that is not controlled with other treatments
Slipping of the uterus into the vagina (uterine prolapse)
Tumours in the uterus, such as uterine fibroids
Adenomyosis, which causes heavy, painful periods
Your doctor may remove the entire uterus or just part of it while performing hysterectomy. The fallopian tubes and ovaries may also be removed. But what type of hysterectomy is required for you is best decided by your doctor depending on your symptom and the medical history. Hysterectomy will prevent you from having children in future.
Types of hysterectomy:
Partial (supracervical) hysterectomy: The upper part of the uterus is removed. The cervix is left in place.
Total hysterectomy: The entire uterus and cervix are removed.
Radical hysterectomy: The uterus, upper part of the vagina, and tissue on both sides of the cervix are removed most often done if you have cancer
You should not drink or eat anything for 8 hours before the surgery.
If you smoke, it would benefit you greatly if you stop smoking or cut down before you have your operation. This will reduce the risk of chest troubles as smoking makes your lungs sensitive to the anaesthetic.
You should also eat a well balanced diet and if you feel well enough, take some gentle exercise before your operation, as this will also help your recovery afterwards.
The procedure is done under anaesthesia (general/spinal). Once the pelvis is entered by any of the above mentioned routes, uterus is separated from surrounding organs and is extracted out.
A tube called the catheter is placed inside your bladder throughout the surgery to drain the urine. It will be removed in a day or two if there are no other complications.
Increased risk of heart disease if the ovaries are removed before menopause
Hernias, cysto-vaginal and recto-vaginal fistulae
Risk commonly seen due to any surgery are:
Infection deep or at skin level
Bleeding during or after the surgery
Scar that is painful and ugly
Risk due to anaesthesia like heart attack, stroke and pneumonia
Blood clots in the legs which can later get dislodged etc.
Do's and Don'ts after hysterectomy surgery:
Once you are out of anaesthesia effect you can start moving your legs in the lying down position itself. This helps to improve the blood circulation in the legs and prevent any clot formation.
Move around the house but also take as much rest as possible.
You can take a shower but cover the wound with a plastic wrap so that the dressing does not get wet.
You can begin your everyday activities as soon as you feel up to it but never over exert yourself.
Do not drive for the first 2 weeks. Later if you are not on any medications and you are not feeling dizzy, you may drive.
Lifting heavy weights and straining is prohibited for first 3 weeks
Do not put anything into your vagina for the first 8 - 12 weeks. This includes douching and using tampons.
Keep the wound area clean by washing it with mild soap and water. Later mop it with a dry cloth. Always keep the wound clean and dry
Common things to expect at home:
Full recovery might take 6-8 weeks but depends on the type of surgery you have (Abdominal hysterectomy: 4 to 6 weeks, Vaginal hysterectomy: 3 to 4 weeks, laparoscopic hysterectomy: 2 to 4 weeks)
You will probably get tired easily during this time.
You may not feel like eating much.
You may have light spotting for 2 - 4 weeks which will be pink, red, or brownish in colour. But be cautious that it does not smell bad.
If you have undergone an abdominal hysterectomy, then press a pillow over your incision when you cough or sneeze to ease discomfort and protect your incision.
Never get up from lying position upright. Turn to one side and get up slowly.
If your ovaries were removed during the surgery you may have symptoms of menopause like hot flashes, depression, vaginal dryness, insomnia (sleep problems), fatigue and night sweats immediately after the surgery as the ovaries were the organs that produce hormones in your body. If the menopausal symptoms are disturbing, then your doctor might prescribe you hormonal tablets which help replacing some of the hormones that your ovaries used to produce. This helps in relieving the menopausal symptoms that you have.
Eating smaller meals at frequent intervals is found to be better than normal heavy meals.
You can have healthy snacks in between.
Eat plenty of fruits and vegetables
Drink 8 cups of water a day to avoid constipation.
Increase your fibre intake by including foods like whole grains like oatmeal, brown rice, whole-wheat pasta and cereals.
Give priority to lean protein (like skinless chicken), fatty fish like salmon (with omega-3 fats), and vegetable protein but avoid trans and saturated fats, like fats found in butter, margarine, salad dressing, fried foods, snack foods, sweets. Vegetable oils like olive oil and peanut oil are always good fats and are healthy also.