ABDOMINAL HYSTERECTOMY

Abdominal Hysterectomy is the removal of the uterus (body & cervix), through a surgical incision made on the abdominal wall. The incision is normally between 15 – 20cm in length and usually below the bikini line.DSC07391

You may need removal of one or both ovaries (BSO), but this depends on the reason for your hysterectomy and your age. This can be discussed with Dr. Kamal

Following the operation you will no longer have periods, or any further pregnancies. The operation lasts less than one hour and is performed under a General Anaesthetic. The after effects can last for up to six weeks and you may find that you feel tired and that it is difficult to concentrate for periods of time. These effects will wear off after time.

Preparation for Surgery

You can eat and drink as normal up until 12 midnight the night before surgery. No food or fluids may be taken after midnight. If your surgery is not scheduled until the afternoon, it may be appropriate that you be allowed to have a light breakfast before 6.00am. You are also advised not to smoke on the day of surgery.

There will be discussion of your surgery/care including any special needs or requirements you may have. Your medical/surgical history will be recorded and any relevant history relating to your admission. Please bring all medications with you, in their original containers i.e. as given to you by the pharmacy as these need to be documented.

An examination may be undertaken recording your temperature, pulse and blood pressure. A urine sample will be required for analysis. A blood sample may also be obtained. A small pubic shave is necessary (you may do this prior to admission if you wish).

You will be admitted and consented for the procedure by Dr. Kamal (if not already undertaken). Routinely you will be seen by the anaesthetist prior to the surgery, to discuss the anaesthesia.
Preparation for Theatre
You will be asked to change into a hospital gown. You may be given a light sedative/premedication. On arrival, you will be greeted and checked-in by a member of the theatre nursing staff. A Nurse will accompany you from the waiting room to the theatre where the anaesthetic is administered.

Recovery after Hysterectomy

Initially you will be closely observed in the recovery room. Once sufficiently recovered, you will go back to the ward to continue post-operative care. You will be assisted out of bed for a short walk the morning after surgery. This walk is very important to ensure the early return of normal circulation and is repeated 3-4 times the first day. An injection of Heparin is given daily to prevent deep vein thrombosis (DVT).

You will be catheterised during your operation, meaning that straight after the operation you do not have to worry about going to a toilet to pass urine, this is simply passed into a bag at your side and emptied regularly by the nurses. It will be removed after the first 24 hours/or as your doctor orders and is painless.

You will have an intravenous (IV) drip to help you re-hydrate for 24-48 hours. It is not unusual to feel sick for a day or two after the surgery. Should you experience nausea or vomiting, tell the nurse so that you can have medication to help it settle. To begin with, you can have small sips of water, then, slowly take more until you are eating normally.

A mild laxative may be necessary to help open your bowels and make you feel more comfortable. You might also have pain from trapped wind and indigestion due to lack of movement, this can be relieved by medication and/or by gentle exercise.

Pain Relief

It is normal during the first 24-36 hours after surgery to feel aches and pains all over your body (backache, shoulder paid and a stiff neck as well as abdominal pain). A PCA (Patient Controlled Analgesia) device may be provided for your use, ensuring optimal, ongoing pain control. This allows you control your own pain relief. Alternatively, morphine by injection may be given until day 2-3 when pain relief by mouth should be sufficient. It will be necessary to continue taking oral pain relief to 2-3 weeks after your surgery. It is important to tell the nursing staff if you are having pain or if you feel your pain relief is not effective.

Wound Care
Your wound dressing is removed on the second day. You may then have a shower. It is important to keep your wound clean. Disposable stitches are commonly used, as these do not require removal. If you do have stitches/clips that are not absorbable, they will be removed on day 5-6 after surgery.
You may have a drain. This is removed after 1-3 days depending on the amount of drainage. You may have some slight vaginal bleeding. This is normal and should soon clear up. If the bleeding is heavy you must tell your nurse/doctor.
On Discharge

Once home, you must make sure that you are taking things easy. The physiotherapist will give you some exercises to help you get back to full mobility. Gentle walking, a little further each day, helps your circulation. You should not lift anything heavy, such as shopping. If you live alone ask your nurse for the details of the local support network that can help.

You can usually begin to have sex again six weeks after surgery. You may wish to refer to the leaflet “Sexual Activity after Hysterectomy”.

Recovery rates differ from person to person. Rest is essential for a few weeks after the operation. A six week check-up will be arranged for you. It is normally at this time that women think about a return to work. However, it will depend on the type of work you do. Backache or discomfort in the abdomen is common for the first few weeks after surgery. A brown discharge should change to creamy white. Any fresh blood or smelly discharge should be notified to your doctor immediately for assessment.