Why it’s done
Vaginal hysterectomy treats various gynaecological problems, including:
Although vaginal hysterectomy is generally safe, any surgery has risks. Risks of vaginal hysterectomy include:
• Heavy bleeding
• Blood clots in the legs or lungs
• Damage to surrounding organs
• Adverse reaction to anaesthetic
Severe endometriosis or scar tissue (pelvic adhesions) might force your surgeon to switch from vaginal hysterectomy to laparoscopic or abdominal hysterectomy during the surgery.
How you prepare
As with any surgery, it’s normal to feel nervous about having a hysterectomy. Here’s what you can do to prepare:
• Gather information. Before the surgery, get all the information you need to feel confident about it. Ask your doctor and surgeon questions.
• Follow your doctor’s instructions about medication. Find out whether you should take your usual medications in the days before your hysterectomy. Be sure to tell your doctor about over-the-counter medications, dietary supplements or herbal preparations that you take.
• Discuss anaesthesia. You might prefer general anaesthesia, which makes you unconscious during surgery, but regional anaesthesia — also called spinal block or epidural block — might be an option. During a vaginal hysterectomy, regional anaesthesia will block the feelings in the lower half of your body. With general anaesthesia, you’ll be asleep.
• Arrange for help. Although you’re likely to recover sooner after a vaginal hysterectomy than after an abdominal one, it still takes time. Ask someone to help you out at home for the first week or so.
What you can expect
Talk with your doctor about what to expect during and after a vaginal hysterectomy, including physical and emotional effects.
During the procedure
You’ll lie on your back, in a position similar to the one you’re in for a Pap test. You might 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 might cut an enlarged uterus into smaller pieces and remove it in sections (morcellation).
When to Call a Doctor and Seek Medical Help for a Prolapsed Vagina
Laparoscopic or robotic hysterectomy
After the procedure
How you’ll feel physically
Recovery after vaginal hysterectomy is shorter and less painful than it is after an abdominal hysterectomy. A full recovery might take three to four weeks.
Even if you feel recovered, 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’ll no longer have periods or be able to get pregnant.