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Date issued: March 2023

Review date: March 2025 

Ref: A-575/HF/Gynae/Having a hysterectomy

PDF:  Having a hysterectomy final March 2023.pdf [pdf] 252KB

Information for patients having a hysterectomy

You have been given this leaflet because you have had or are considering having a hysterectomy (removal of the womb/uterus).

Hysterectomy explained

A hysterectomy can be done in several different ways. The way that a hysterectomy is performed depends upon a lot of different factors and your gynaecologist will explain why they have advised a particular route.

A total abdominal hysterectomy means removing the womb and the cervix. It is done through an abdominal incision (cut). The incision is generally horizontal, “bikini line”, along the top of the pubic hairline so any scaring is largely hidden. Sometimes a vertical incision has to be used and this is done on the lower abdomen. The reasons for choosing either route will be discussed by the Doctor. A subtotal abdominal hysterectomy is a similar operation but the cervix (neck of the womb) is left inside.

A vaginal hysterectomy means removing the womb through the vagina, possibly because of a prolapse. This is often done with a vaginal repair, there is separate information available about repairs. A repair is the lifting and strengthening of the tissue supporting the vaginal walls and the uterus. Surgery performed through the vagina is repaired with internal stitches that dissolve.

A laparoscopic hysterectomy means removal of the womb through keyhole surgery. Some laparoscopic hysterectomies are done partially through the vagina (this is called a laparoscopic assisted vaginal hysterectomy or LAVH) and some are done entirely laparoscopically (this is a total laparoscopic hysterectomy, the uterus is removed from the vagina.) A laparoscopic subtotal hysterectomy is removal of the uterus through key hole surgery but the cervix is left behind.

A robotic assisted laparoscopic hysterectomy is similar to a traditional laparoscopy but the surgeon is able to sit at a control consol. This is only used for specific patients at present where more complex surgical tasks are involved.

The ovaries and fallopian tubes

Many people have their fallopian tubes removed (salpingectomy) at the same time as a hysterectomy as this can reduce the risk of developing ovarian cancer.

It is generally not possible to remove the fallopian tubes or ovaries during a vaginal hysterectomy.

Deciding on whether to have your ovaries removed is, for many women, a separate decision to having a hysterectomy. Removal of one or both of your ovaries can be performed at the same time as your hysterectomy. If needed, ovaries can be removed after a hysterectomy but this means another operation and the surgery may be more complex. Some women need to have a hysterectomy because of cancer and in this situation the ovaries are generally removed.

If you have not reached the menopause yet then the removal of both ovaries will make you menopausal and you may start to experience symptoms of the menopause immediately after surgery, this is called a surgical menopause.  This may be noticed as the onset of hot flushes, night sweats or vaginal dryness. Early menopause may have adverse effects on health including affecting mood (increased depression) and cognition (thinking).  The ovaries produce several female hormones that can help protect against health problems such as weak bones (osteoporosis), cardiovascular disease and dementia.  They also play a part in feelings of sexual desire and pleasure. Although your hormone levels decrease after the menopause, your ovaries continue producing testosterone for many years. Testosterone is a hormone that plays an important part in stimulating sexual desire and sexual pleasure.

Some premenopausal women will want to have their ovaries removed due to pain, such as from endometriosis or chronic pelvic pain.  Depending on the circumstances, removal of the ovaries may improve pain, but it is not always effective.  Some women chose to have their ovaries removed due to ovarian cysts or premenstrual syndrome.

You may be offered a drug to bring on a short term “chemical menopause” before surgery to try and mimic the effects of surgical menopause with a medication called decapeptyl.

Hormone replacement therapy (HRT) is usually used to help with menopausal symptoms that occur after a hysterectomy. We would advise that you should continue on HRT until at least the age of the natural menopause, which is around 52 years. Increasingly there is evidence to suggest that it is beneficial to stay on the treatment for a further 5-10 years.

Hysterectomy without the removal of the ovaries does not cause menopause but it may cause the menopause to happen sooner than it would have done.

If you have already gone through the menopause or you’re close to it, removing your ovaries may be recommended regardless of the reason for having a hysterectomy. This is to protect against the possibility of ovarian cancer developing, for some women it may also reduce the risk of breast cancer.

If you’d prefer to keep your ovaries, make sure you have made this clear to your surgeon before your operation. You may still be asked to give consent for having your ovaries removed if an abnormality is found during the operation.

Before your operation

After you and the surgeon have agreed that surgery is appropriate you will have a pre-op assessment appointment.  Sometimes you will attend the pre-op assessment clinic on the same day (depending on the date of the operation) or via telephone. You should allow about 2 hours for the pre-op assessment appointment. 

You will normally be given a few weeks’ notice of your surgery date and may see your surgeon before the surgery date to discuss the operation, the risks involved and to give you the chance to ask questions before you sign your consent form.

Risks of surgery

Risks are different depending on the reason for your operation, your overall health, your previous surgeries and your weight.

The following table shows serious risks associated with a total abdominal hysterectomy. Various reports have shown that the risk of damage to the bladder or ureter and the risk of bleeding, is higher with a laparoscopic procedure.

Risk of surgery

Overall risk of serious complication	4 in 100 (common)
Damage to the bladder and/or the ureter and/or long-term disturbance to the bladder function	7 in every 1000 (uncommon)
Damage to the bowel	4 in 10000 (rare)
Haemorrhage requiring blood transfusion	23 in 1000 (common)
Return to theatre with complication	7 in 1000 (uncommon)
Pelvic abscess/infection	2 in 1000 (uncommon)
Venous thrombosis or pulmonary embolism	4 in 1000 (uncommon)
Risk of death within 6 weeks	32 in 100000 (rare)
Serious complication of the general anaesthetic	1 in 10000 (rare)

Frequent risks include:

• Wound infection, pain, bruising, delayed wound healing or keloid formation

• Numbness, tingling or burning sensation around the scar (the woman should be reassured that this is usually self-limiting but warned that it could take weeks or months to resolve)

• Frequency of micturition and urinary tract infection

• Ovarian failure

Admission day

Before coming to hospital

The University Hospital Plymouth website will be updated regularly on any COVID-19 restrictions and testing that is required before coming in.

Set up your plans for going home before you come into hospital.  The time you will be in hospital is not long.  

You can:

• Arrange your transport for getting to and home from hospital

• Check you have the right equipment and support for when you get home

• Get some pain killers, such as paracetamol or non-steroidal anti-inflammatories (e.g., Ibuprofen, Nurofen, Voltarol).  If you are allergic to or not sure which pain killers are suitable for you, discuss with your GP or a pharmacist.

• Buy some sanitary towels

• Freeze some milk, bread and meals to cover your first few days back at home

• Tell family and friends where you will be

• Pack your bags. Consider bringing in comfortable underwear, nightwear and loose-fitting clothing. Some patients have recommended headphones, ear plugs, eye masks, mints, healthy snacks, toiletries, and slippers. Some people find a V pillow more comfortable after the operation; you can bring one to hospital with you if you want to. Please remember that all belongings that you bring to the hospital are your responsibility, do not bring expensive or unnecessary items. We cannot provide refrigeration for any food.

On the morning of surgery

• Follow the advice on your admission letter about the time to finish drinking clear fluids

• Have a shower or bath before coming into hospital.

• DO NOT shave or wax around your operation site, as this can increase the risk of developing a post-operative surgical site infection. Where necessary, the clinical team will remove hair.

Coming into Hospital

Go to the Admissions Unit / Ward as advised on your admission letter. You will be checked in by a nurse and seen by members of the surgical and anaesthetic team before you are taken to theatre for your operation

Removal of the womb is a major operation and good post-operative care is essential for recovery.

Regardless of the route you need to be aware of the following facts:

Every patient has different needs and recovers in different ways. Your own recovery will depend on:

• How fit and well you are before your operation

• The reason you are having a hysterectomy

• The exact type of hysterectomy that you have

• How smoothly the operation goes and whether there are any complications

After the hysterectomy

The information given below will guide you on different aspects after Hysterectomy.

1. After effects of a general anaesthetic: Most modern anaesthetics are short lasting. You should not have, or suffer from, any after- effects for more than a day after your operation. During the first 24 hours you may feel more sleepy than usual, and your judgement may be impaired. You are likely to be in hospital during the first 24 hours but, if not, you should have an adult with you during this time and you should not drive or make any important decisions.

2. Starting to eat and drink: After your operation, you will have a drip in your arm to provide you with fluids. When you are able to drink again, the drip will be removed. You will be offered a drink of water or cup of tea and something light to eat. If you are not hungry initially, you should drink fluid. It is not advisable to eat fruit until you are eating normally. It is advisable to have healthy snacks with you during your stay in hospital for example yogurts, shakes, fruits etc.

3. Catheter: You may have a catheter (tube) in your bladder to allow drainage of your urine. This is often removed within 24 hours of surgery when you will be able to walk to the toilet to empty your bladder. Sometimes we try to remove the catheter in the middle of the night so that you are ready to pass urine when you wake in the morning. If you have difficulty passing urine, you may need to have a catheter for a few days. If it burns or stings when you pass urine, or you have to go to the toilet very frequently, it could be a sign of a urinary tract infection.

4. Trapped wind: Following your operation your bowel may temporarily slow down, causing air or ‘wind’ to be trapped. This can cause some pain or discomfort until it is passed. Getting out of bed and walking around will help. Peppermint water and over-the- counter products like windeze may also ease your discomfort. Once your bowels start to move, the trapped wind will ease.

5. Scars: A vaginal hysterectomy is carried out through your vagina so your scar will be out of sight. However, if you have keyhole surgery as part of your operation, you will have between two and four small scars on different parts of your abdomen. Each scar will be generally be between 0.5cm and 1cm long. An abdominal hysterectomy is usually carried out through a cut that is approximately 10 cm long. This is usually made across the top of your pubic hairline, but sometimes it may rundown from your tummy button to your pubic hairline instead.

All wounds progress through several stages of healing and you will be able to see changes in your wound. The following points are frequently experienced:

• Unusual sensations such as tingling, numbness or itching.

• A lightly hard lumpy feeling as new tissue forms.

• Slight pulling around the stitches as the wound heals.

Do not to pull off any scabs as they protect the new tissues underneath and act as “natural dressing”. They will fall off without any help when ready.

Gentle massage around the wound will help to stop the new tissue ‘sticking’ to the underlying structures, particularly if your wound lies over a hard surface such as bone.

Seek help if your pain increases, or if you have redness, swelling or discharge from your wound as this may indicate infection.

6. Stitches and dressings: The stitches in your vagina will not need to be removed, as they are dissolvable. You may notice a stitch, or part of a stitch, coming away after a few days or maybe after a few weeks. This is normal and nothing to worry about. If you have keyhole surgery, your cuts may be closed by stitches or glue. Glue and some stitches dissolve by themselves. Other stitches may need to be removed, usually by the practice nurse at your GP surgery about five to seven days after your operation. You will be given information about this. Your cuts will initially be covered with a dressing. You should be able to take this off about 24 hours after your operation and have a wash or shower (see section on washing and showering).

7. Packs: You may have a pack (a length of gauze like a large tampon) in your vagina after the operation to reduce the risk of bleeding. A nurse will remove this after your operation while you are still in hospital.

8.  Drain: Occasionally, a drain (small tube) is inserted through your vagina or your abdomen to drain off any blood or fluid that may accumulate immediately after your operation. This will be removed by a nurse after your surgery while you are still in hospital.

9.  Usual length of stay in hospital: You may be able to go home within 24 hours or, depending on your circumstances, you may need to stay in hospital for several days. You will be able to go home when your observations (such as blood pressure and pulse) are stable, your pain is well managed, you can walk, you can eat and drink and you feel that you have adequate support at home.

 When you get home from hospital, you will need to take things easy at least for the first week. Ask family or friends to help you with chores so you can rest as much as you need to. Generally, you should try to mobilize as much as your body accepts to avoid the risk of getting clots in your legs or lungs.

10. Reducing the risk of venous thromboembolism: Any major surgery increases your risk of developing clots in your legs/lungs. You can reduce this risk by keeping well hydrated, mobile and doing exercises when you are resting. The exercises include:

• Pumping each foot up and down briskly for 30 seconds by moving your ankle.

• Moving each foot in a circular motion for 30 seconds.

• Bend and straighten your legs, one leg at a time, three times for each leg.

If you are considered to be at a high risk of developing a clot, your surgeon will advise you to have Clexane injections for a specific number of days. If you are low risk or not suitable for Clexane, you will still need to wear graduated compression stockings, day and night until your movement has improved and your mobility is no longer significantly reduced.

The symptoms of clots in legs (DVT) and lungs (Pulmonary embolus) are:

1. A painful, red, swollen, hot leg or difficulty bearing weight on your legs may be caused by a deep vein thrombosis (DVT).
2. If you have shortness of breath, chest pain or cough up blood, it could be a sign that a blood clot has travelled to the lungs (pulmonary embolus). If you have these symptoms, you should seek medical help immediately.

11. Deep breathing exercises:

An anaesthetic slows the normal clearing of your lungs down, and you may find you need to cough after your operation even if you do not usually do so. Deep breathing exercises (explained below) can help this.

However, the best way to keep your chest clear and maintain good circulation is sitting out of bed and walking, ideally from the first day after your operation. Regular use of pain relief can help you to move and cough while keeping you comfortable.

Make sure you are sitting as upright as possible

Take a slow deep breath in through your nose and hold for the count of 2.

If possible, sniff an extra bit of air in before you let your breath out.

Repeat 3 times, resting in between.

Support your wound and try to ‘huff’. This is a short, sharp breath out with your mouth open, as if to steam up a window.

Now try to cough to clear your chest.

Repeat this every hour until your chest is clear and you are fully mobile

12. Vaginal bleeding: You can expect to have some vaginal bleeding for one to two weeks after your operation. This is like a light period and is red or brown in colour. Some patients have little or no bleeding initially, and then have a sudden gush of old blood or fluid about 10 days later. This usually stops quickly. You should use sanitary towels rather than tampons as using tampons could increase the risk of infection.

Heavy or smelly vaginal bleeding or bleeding which starts again is not normal. If you are also feeling unwell and have a temperature (fever), this may be because of an infection or a small collection of blood in the pelvis, called a pelvic haematoma. Treatment is usually with a course of antibiotics. Occasionally you may need to be admitted to hospital for the antibiotics to be administered intravenously (into a vein). Rarely, this may need to be drained.

13. Diet care and avoiding constipation: Adequate nutrition is the key to recovery after any operation. A healthy diet is a high-fibre diet (fruit, vegetables, wholegrain bread and cereal) with up to two liters per day of fluid intake, mainly water. Remember to eat at least five portions of fruit and vegetables each day.  As long as you are exercising enough and don’t eat more than you need to, you don’t need to worry about weight gain.

It is very important to avoid straining after hysterectomy. This can breakdown your wound. This may also weaken your pelvic floor muscles. Take diet rich in fibre for example Weetabix. Keep well hydrated. If you are constipated you can take laxatives that can be purchased over the counter including Lactulose, Dulcolax, Senokot etc. If you do have problems opening your bowels, it may help to place a small footstool under your feet when you are sitting on the toilet so that your knees are higher than your hips. If possible lean forwards and rest your arms on top of your legs to avoid straining.

14. Vaginal discharge

A slight discharge/bleeding is usual for up to 6 weeks following hysterectomy or repair. If it should become offensive smelling or bright red/heavy, then please inform your own G.P. It is possible for the discharge to contain threads from dissolving vaginal stitches. It is very important to give yourself a good wash down below at least twice a day and change your pads frequently. Clean pads can be found in all the toilets and bathrooms on the ward. If you are worried about any discharge while you are in hospital, please save your pad and ask one of the nurses to look at it.

15. Starting HRT: (Hormone Replacement Therapy) If your ovaries have been removed during your operation, you may be offered hormone replacement therapy (HRT). This will be discussed with you by your gynaecologist and together you can decide the best way forward. Many patients wish to start HRT immediately, but the hospital can only provide you with a small supply. There will be a discharge letter that will be sent to the GP so that they are aware which HRT to continue to prescribe but the repeat prescription will need to be requested by you.

16. Pain and discomfort: You can expect pain and discomfort in your lower abdomen for at least the first few days after your operation. If you have had laparoscopic surgery, you may also have some pain in your shoulder. The degree of pain and discomfort experienced following surgery varies a great deal. Pain is controlled in a variety of ways, and this often depends on the type of operation that you have had. You may have an anaesthetic injection into your back (spinal or epidural anaesthetic) or patient-controlled analgesia (an infusion into the arm, which is triggered by you pushing a button) or local anaesthetic catheters inside the abdominal wall. Some patients just require regular simple pain killers taken orally. We advise that you have paracetamol and ibuprofen at home, and you may also wish to buy laxatives and peppermint capsules. When leaving hospital, you may be provided with stronger painkillers if needed. Sometimes painkillers that contain codeine or dihydrocodeine can make you sleepy, slightly sick and constipated. If you do need to take these medications, try to eat extra fruit, fibre and/or laxatives to reduce the chances of becoming constipated.

Taking painkillers regularly in the first few weeks after surgery to reduce your pain will enable you to get out of bed sooner, stand up straight and move around - all of which will speed up your recovery and help to prevent the formation of blood clots in your legs or your lungs.

Some people report abdominal bloating which generally tends to get better after 3-6 months.

Increasing abdominal pain can indicate a complication, especially if you also have a temperature (fever), have lost your appetite and are vomiting as this may be because of damage to your bowel or bladder, in which case you will need to be admitted to hospital.

17. Keeping clean: A shower is advisable instead of a bath for 4-5 weeks. Avoid using soap on the stitches, warm water is sufficient to keep them clean. Don't worry about getting your scars wet - just ensure that you pat them dry with clean disposable tissues or let them dry in the air. Keeping scars clean and dry helps healing. If you have had keyhole surgery and have scars on your abdomen, you should be able to have a shower or bath and remove any dressings the day after your operation.

18. Sex: It is advisable to avoid sexual intercourse for at least six weeks after your operation to allow your scars to heal, some surgeons would prefer you to wait for 3 months. This is because the vaginal wall stitches can break easily which might need emergency operation to be repaired (Vaginal vault dehiscence). Obviously, your partner should be gentle at first and you may find that a vaginal lubricant is helpful which you can buy from your local pharmacy. Most people find it reassuring to know that their own sexual responses should not change by the operation, as the external reproductive organs are unaltered. If a climax is normally experienced during love making this should continue to be so. For most people the cause of some miserable, painful, uncomfortable and tiring symptoms will have been removed with the operation and therefore they feel much happier about themselves.

19. Around the house: It is helpful to break jobs up into smaller parts, such as ironing a couple of items of clothing at a time, and to take rests regularly. You can also try sitting down while preparing food or sorting laundry. For the first one to two weeks, you should restrict lifting to light loads such as a one litre bottle of water, kettles or small saucepans. You should not lift heavy objects such as full shopping bags or children or do any strenuous housework such as vacuuming until at least three to four weeks after your operation as this may affect how you heal internally. Try getting down to children rather than lifting them up to you. Remember to lift correctly by having your feet slightly apart, bending your knees, keeping your back straight and bracing (tightening or strengthening) your pelvic floor and stomach muscles as you lift. Hold the object close to you and lift by straightening your knees.

20. Lifting: Avoid heavy lifting (more than 3–4 kg) for up to 12 weeks, depending on the advice of your surgeon. This will depend on the type of surgery you have had.

21. Returning to work: Depending on the nature of your job, you will probably need at least 6 weeks leave from work. Your surgeon or doctor (General Practitioner) can provide you sick note for your employer. People who have laparoscopic surgery and have office jobs that don't require heavy lifting may be able to return to work sooner.

If you have an occupational health department, they will advise on this. Returning to work can help your recovery by getting you back into your normal routine again. Some people start to feel depressed if they are off work for longer periods. It is normal to have some discomfort as you are adjusting back in your work life. It might be possible for you to do a phased return to work.

22. Driving: You should not drive for 24 hours after a general anaesthetic. Each insurance company will have its own conditions for when you are insured to start driving again. Check your policy. Before you drive you should be free from the sedative effects of any painkillers, able to sit in the car comfortably and work the controls, able to wear the seatbelt comfortably, able to make an emergency stop, able to comfortably look over your shoulder to perform maneuvers. In general, it can take two to four weeks before you are able to do all of the above. It is a good idea to practice without the keys in the ignition. See whether you can do the movements you would need for an emergency stop and a three-point turn without causing yourself any discomfort or pain. When you are ready to start driving again, build up gradually, starting with a short journey.

23. Exercise: The ward physiotherapist may visit you if you have been identified as needing some additional support to help you get out of bed and start mobilizing. While everyone will recover at a different rate, there is no reason why you should not start walking on the day you return home. You should be able to increase your activity levels gradually over the first few weeks and this will also assist your recovery. Start with short steady walks close to your home a couple of times a day for the first few days. When this is comfortable, you can gradually increase the time while walking at a relaxed steady pace. After 2-3 weeks at home, aim to walk for 10 minutes each day, increasing to a 30-45 minute walk by 6 weeks, or 3 short walks if you prefer. Remember only walk the distance and speed your body dictates and that however far you walk you have to walk back again. Therefore, to start with walk for 5 minutes then turn around and walk back.

It is quite safe to go up and down stairs from the day you go home. Climbing stairs, however, can be surprisingly tiring, but is a useful way of getting exercise and judging progress.

Swimming is an ideal exercise that can usually be resumed within two to three weeks provided that vaginal bleeding and discharge has stopped. Contact sports and power sports should be avoided for at least twelve weeks, although this will depend on your level of fitness before surgery.

24.  Cervical screening (smears): Some women who have had a hysterectomy will need to continue to have smears from the top of the vagina or the cervix if it has not been removed (sub-total hysterectomy). Check with your GP or gynaecologist whether this applies to you.

25. Tiredness and feeling emotional: You may feel much more tired than usual after your operation as your body is using a lot of energy to heal itself. You may need to take a nap during the day for the first few days. A hysterectomy can also be emotionally stressful, and many women feel tearful and emotional at first, when you are tired, these feelings can seem worse. For many women this is the last symptom to improve.

26. A pelvic floor muscle exercise programme: It is important for you to get pelvic floor muscles working properly after your operation, even if you have stitches. To identify your pelvic floor muscles imagine you are trying to stop yourself from passing wind, or you could think of yourself squeezing tightly inside your vagina. When you do this, you should feel your muscles lift and squeeze. It is important to breathe normally while you are doing pelvic floor muscle exercises. You may also feel some gentle tightening in your lower abdominal muscles. This is normal. Women used to be told to practise their pelvic floor muscle exercises by stopping the flow of urine mid-stream. This is no longer recommended, as your bladder function could be affected in the longer term. You can begin these exercises gently once your catheter has been removed and you are able to pass urine on your own. You need to practice short squeezes as well as long squeezes:

• Short squeezes are when you tighten your pelvic floor muscles for one second, and then relax

• Long squeezes are when you tighten your pelvic floor muscles, hold for several seconds, and then relax.

Start with what is comfortable and then gradually increase, aiming for 10 long squeezes, up to 10 seconds each, followed by 10 short squeezes. You should do pelvic floor muscle exercises at least three times a day. At first you may find it easier to do them lying down or sitting. As your muscles improve, aim to do your exercises when you are standing up.

It is very important to tighten your pelvic floor muscles before you do anything that may put them under pressure, such as lifting, coughing or sneezing. Make these exercises part of your daily routine for the rest of your life. Some people use triggers to remind themselves, such as brushing their teeth, washing up or commercial breaks on television.

27. Stop smoking: Stopping smoking will benefit your health in all sorts of ways, such as lessening the risk of a wound infection or chest problems after your anesthetic. By not smoking, even if it is just while you are recovering, you will bring immediate benefits to your health. If you are unable to stop smoking before your operation, you may need to bring nicotine replacements for use during your hospital stay. You will not be able to smoke in hospital. If you would like information about a smoking cessation clinic in your area, speak with the nurse in your GP surgery.

28. Travel plans: If you are considering travelling during your recovery, it is helpful to think about:

• The length of your journey, journeys over four hours where you are not able to move around (in a car, coach, train or plane) can increase your risk of deep vein thrombosis (DVT); this is especially so if you are travelling soon after your operation

• How comfortable you will be during your journey, particularly if you are wearing a seatbelt

• Overseas travel: Would you have access to appropriate medical advice at your destination if you were to have a problem after your operation? Does your travel insurance cover any necessary medical treatment in the event of a problem after your operation?

• Whether your plans are in line with the levels of activity recommended in this information. If you have concerns about your travel plans, it is important to discuss these with your GP or the hospital where you have your operation before travelling.

28.  A positive outlook: Your attitude towards how you are recovering is an important factor in determining how your body heals and how you feel in yourself. You may want to use your recovery time as a chance to make some longer-term positive lifestyle choices such as:

• Starting to exercise regularly if you are not doing so already and gradually building up the levels of exercise that you take

• Eating a healthy diet, if you are overweight, it is best to eat healthily without trying to lose weight for the first couple of weeks after the operation; after that, you may want to lose weight by combining a healthy diet with exercise. Whatever your situation and however you are feeling, try to continue to do the things that are helpful to your long-term recovery

Will I have any follow up at the hospital?

Some Consultants will organize either a face to face or telephone follow up with you after a few months, some may provide you with an open follow up where you are left to contact the hospital if you have any concerns during the first few weeks after surgery. Not all patients will be followed up.

Who to Contact:

Within the first 7 days of discharge from hospital

Contact: Ocean ward on 01752 430019/30026/39877

After 7 days: contact your own GP

In an emergency: dial 999 or 111

Table 1: Recovery Tracker for Vaginal Hysterectomy

Recovery tracker for vaginal hysterectomy

Time after Operation	How might I feel	What is safe to do	Fit to work
1-2 days	You are likely to be in hospital during this time. You will have some generalized aches in your abdomen. You may feel sore moving in and out of bed You may have some bleeding like a light period.	Get up and move about. Go to the toilet. Get yourself dressed. Start eating and drinking as usual.	No
3-7 days	You should be at home by now. Your pains should slowly be reducing in intensity, and you will be able to move about more comfortably. You will still tire easily and may need a nap in the afternoon.	Continue as for days 1-2. Go for short walks. Continue with exercises that have been recommended. Wash and shower as normal.	No
1-2 weeks	There will be less pain as you continue to move about, and you will find your energy levels slowly returning. Bleeding should have settled or be very little.	Build up your activity slowly and steadily. You are encouraged to go for longer and more frequent walks. Restrict lifting to light loads.	Not yet
2-4 weeks	There should be lesser pain as you move more and more. You will find your energy levels are returning to normal. You should feel stronger every day.	Continue to build up the amount of activity you are doing towards your normal levels. You can start to do low impact sports. Make a plan for going back to work.	Yes, possibly on reduced number of hours or lighter duties at first. Some patients are fit for full time work after 4 weeks.
4-6 weeks	Almost back to normal. You may still feel tired and need to rest more than usual.	All daily activities including lifting. Usual exercise. Driving. Have sex if you feel ready.	Yes, but if you don’t feel ready talk to your GP or employer about the reason for this.

   

 

 

 

Table 2: Recovery tracker after Abdominal Hysterectomy

Recovery tracker after abdominal hysterectomy

Time after operation	How might I feel	What is safe to do?	Fit to work
1-4 days	You are likely to be in hospital during this time. You will have some generalized aches in your abdomen. You may feel sore moving in and out of bed You may have some bleeding like a light period.	Get up and move about. Go to the toilet. Get yourself dressed. Start eating and drinking as usual.	No
5-7 days	You should be at home by now. Your pains should slowly be reducing in intensity, and you will be able to move about more comfortably. You will still tire easily and may need a nap in the afternoon.	Continue as for days 1-4. Go for short walks. Continue with exercises that have been recommended. Wash and shower as normal. Take afternoon nap if needed.	No
1-2 weeks	There will be less pain as you continue to move about, and you will find your energy levels slowly returning. Bleeding should have settled or be very little.	Build up your activity slowly and steadily. You are encouraged to go for longer and more frequent walks. Restrict lifting to light loads.	No
2-4 weeks	There should be lesser pain as you move more and more. You will find your energy levels are returning to normal.	Continue to build up the amount of activity you are doing towards your normal levels. You can start to do low impact sports. Make a plan for going back to work	Yes, on reduced hours or lighter duties.
4-6 weeks	Almost back to normal. You may still feel tired and need to rest more than usual.	All daily activities including lifting. Usual exercise. Driving. Have sex if you feel ready.	Yes, but not heavy work.
6-8 +weeks	Back to Normal	Everything	Yes, including heavy work. If you don’t feel ready talk to your GP or employer for the reason.

 

Table 3: Recovery tracker for Laparoscopic Hysterectomy

Recovery tracker for laparoscopic hysterectomy

Time after operation	How might I feel	What is safe to do?	Fit to work
1-2 days	You are likely to be in hospital during this time. You will have some pain and discomfort in abdomen. You may feel sore moving in and out of bed You may have some bleeding like a light period.	Get up and move about. Go to the toilet. Get yourself dressed. Start eating and drinking as usual. You may feel tired and feel the need for a nap in the afternoon.	No
3-7 days	You should be at home by now. Your pains should slowly be reducing in intensity, and you will be able to move about more comfortably. You will still tire easily.	Continue as for days 1-2. Go for short walks. Continue with exercises that have been recommended. Wash and shower as normal. Take afternoon nap if needed.	No
1-2 weeks	There will be less pain as you continue to move about and you will find your energy levels slowly returning. Bleeding should have settled or be very little.	Build up your activity slowly and steadily. You are encouraged to go for longer and more frequent walks. Restrict lifting to light loads.	No
2-4 weeks	There should be lesser pain as you move more and more. You will find your energy levels are returning to normal.	Continue to build up the amount of activity you are doing towards your normal levels. You can start to do low impact sports. Make a plan for going back to work	Yes, on reduced hours or lighter duties.
4-6 weeks	Almost back to normal. You may still feel tired and need to rest more than usual.	All daily activities including lifting. Usual exercise. Driving. Have sex if you feel ready.	Yes, but not heavy work.
6-8 +weeks	Back to Normal	Everything	Yes, including heavy work. If you don’t feel ready talk to your GP or employer for the reason.

 

Table 4: Possible complication after Hysterectomy

Possible complication after hysterectomy

Name of the complication	Possible  symptoms	Action needed to be taken	Possible consequences.
Intra abdominal bleeding	You will feel very poorly, might faint. Your Heart rate will increase. You might observe increased vaginal bleeding but this is not always the case.	You need to inform ocean ward straight away. In an emergency for example if you faint you should call the Ambulance.	You will receive medications to stop bleeding or if it is considered very heavy you might be taken back to theatre. Additional imaging like Ultrasound or CT scan might be considered. You will be offered some antibiotics.
Post operative infection	You will have temperature, Increased heart rate. You might have rigors, chills, abdominal pain, increased vaginal bleeding and/or offensive vaginal discharge etc,	You need to inform ocean ward straight away. In an emergency for example if you faint you should call the Ambulance.	You will be given antibiotics. Additional scans might be done to look for post operative collection of blood/pus in the abdomen.
Damage to ureters/urinary bladder.	You will have back ache, loin pain and temperature. You might have rigors, chills, urinary retention etc.	You need to inform ocean ward straight away.	Additional scans will be done to confirm the diagnosis and Urology surgeons will be involved if ureteric/Bladder damage is recognised post operatively.
Damage to Bowels	Your abdomen will be very distended and painful. You are likely to have vomiting. Your bowel movements will be affected.	You need to inform ocean ward straight away.	Additional scans to confirm the diagnosis. General surgeons will be involved if damage is recognised.
Clots in Legs/Lungs	One of your calves will be swollen and painful if it’s in legs. You are likely to be increasingly short of breath and will have some chest pain if it’s in the lungs.	You need to inform ocean ward straight away.	Ct scan or doppler imaging will be done to confirm the diagnosis. You will receive high doses of clexane until the suspicion has been ruled out. If confirmed the clexane will be continued for 3 months.
Wound Problems	Your laparoscopy or Laparotomy wound can feel bruised, get infected or breakdown.	You need to inform ocean ward or discuss with your GP if its mild infection.	Pain relief medication +/- return to theatre if it has broken down significantly. Antibiotics if its infected.
Urine infection	Burning and stinging while passing urine.	Take a sample of Urine to GP.	Course of Antibiotics.
Vault Hematoma	Increased Vaginal bleeding if infected you will feel unwell with abdominal pain and fever.	You need to inform ocean ward straight away.	Course of antibiotics +/- further imaging.