Name of the surgery : HYSTERECTOMY

• Abdominal Hysterectomy
  
  
• Vaginal hysterectomy
  
  
• Laparoscopic Hysterectomy
  

Some conditions are better suited to one type of hysterectomy than another Women who have prolapsed uterus ,for example ,usually have a vaginal hysterectomy so the weakened supporting tissues of the vagina can be repaired at the same time The hysterectomy may involve just the removal of the uterus or it could also include the removal of the fallopian tubes, ovaries and sometimes the cervix. The gynecologist will explain which procedure is recommended in your situation and explain the reasons why.

You can expect to be in hospital for 5-7 days although the total recovery time before you can resume full activities can be upto 8 weeks.

Any special test before surgery: It is important to be physically prepared for surgery Sometimes this involves emptying your bowel with enema preoperatively. You will be encouraged to get good nights sleep prior to coming into hospital and have a shower and wash your hair prior to admission.

The anaesthetist will discuss the anaesthesia for operation and seek your consent

Preparations before surgery: Depending upon what time your surgery is planned for ,you will not be able to eat or drink, suck or chew for a number of hours beforehand (Nil by Mouth ) If your surgery is planned for the morning ,you will not be able to eat or drink from 12 o' clock midnight and if the surgery is in the afternoon, you will be unable to eat or drink from 6o' clock in the morning . you can have a light breakfast before 6 am if you are booked for an afternoon surgery.

Any make up, hairpins body piercing and jewellery will need to be removed. You will be given a gown to wear. The nurse will come and check your identity bracelet. She will also check your blood pressure and temperature and that you have had all your questions answered about the surgery and that you have signed the consent form. Once all of this is checked you are ready for the theatre

Risk of Surgery: The gynecologist will discuss the risks involved with having a hysterectomy The surgical process involves the risk of:

• haemorrhage (heavy blood loss )
  
  
• infection
  
  
• deep venous thrombosis (blood clot )
  
  
• bladder function problems
  
  
• constipation
  
  
• adhesions ( scar tissue that forms after surgery )

During the surgery a drain (Long thin tube with suction holes ) may be placed in your abdomen to remove any excess fluids during the initial healing time and help to reduce the bruising .This is removed 24-36 hours after the surgery .A dressing is placed over your wound and that will stay for 3-5 days

VAGINAL HYSTERECTOMY: The role of the Anaesthesist is the same as for Abdominal Hysterectomy However, with a vaginal hysterectomy, the surgeon removes the uterus from an incision made in the top of your vagina Once the uterus is removed the cut is stitched

Occasionally a pack is placed in the vagina post operatively to help reduce bleeding. This feels like a very large tampoon and usually remains for 24 hours before being removed A sterile pad is worn at the entrance to the vagina after the surgery.

You will have a tube to drain urine away from the bladder This is called the catheter and is removed 24-48 hours after your surgery . It is usual to have a bloody discharge on your sanitary pad; which will heal off as healing begins.

LAPAROSCOPIC HYSTERECTOMY: The role of anaesthetist is same as other types of hysterectomy. Your abdomen will be pumped with carbon dioxide gas to make the procedure safer and easier for the gynecologist to see . A small telescope (laparoscope ) is inserted into your abdomen through a small cut in the navel . It has a tiny video camera attached to it so the view of your insides can be seen by the gynecologist on a screen .Two or three small incisions(cuts ) are made in the abdomen to allow surgery to take place . When the uterus is cut free it is removed through the vagina and the small incisions are then stitched up.

AFTER SURGERY: It is common for IV (intravenous drip ) to remain in your arm or hand for at least 12-24 hours after surgery

It is usual for anti emetic medication to be given to counteract any nausea experienced.

Constipation: Women are often concerned if their bowels are not working on the day after surgery . It is usual for the bowels not to move for 2-3 days after surgery. If your bowels have not moved on Day 3 after surgery ,we will offer you a laxative or a small enema to get things moving

Care at home :

• Diet : Your usual diet can be resumed once you go home
  
  
• Bath: continue to have your daily showers Avoid spa pools and swimming pools until all the bleeding and discharge has stopped following surgery ,to avoid sources of possibe infection
  
  
• Care of incision : keep it clean and dry
  
  
• Activity :Returning to work will depend on what sort of work you do . If your work involves heavy lifting, bending and stretching you will need at least 6 weeks before returning to work .However if your work is sitting with very little assistants can do their work as soon as the feel fit .
  
  
• Medications: Complete taking your antibiotics that have been prescribed to you

• Coping with stress :Women’s sexuality remains following hysterectomy. Sexuality is the way a woman feels, looks, acts, and related to others. It does not change because of removal of the uterus. However, it would be untrue to say that all women feel the same without their uterus. Some feel unfeminine and unattractive. For some it can take time to deal with the grief of losing their uterus.