Before surgery

Preparing for a hysterectomy involves discussing the procedure in detail with the doctor, including potential complications and side effects. Before undergoing a hysterectomy, the doctor may order several tests to assess overall health and evaluate any specific conditions that may influence the surgical approach. Some common tests done include blood tests, urine tests, imaging tests like ultrasound, CT, or MRI if needed, and preoperative consultation with an anesthetist.  Informed consent is obtained from the patient or their relatives before performing surgery.

During surgery

During the hysterectomy, the doctor will determine the appropriate type of hysterectomy and surgical method. The patient will be asked to change into a hospital gown and be connected to monitors for heart rate monitoring.

An intravenous (IV) line will be placed in the arm to administer medications and fluids.

The patient will receive either general anesthesia, which renders the patient unconscious during the procedure, or regional anesthesia (epidural or spinal anesthesia), which numbs the lower back area while maintaining wakefulness.

There are several surgical approaches for a hysterectomy:

• Vaginal hysterectomy: The uterus is removed through an incision at the top of the vagina without any external incisions. Dissolvable stitches are placed inside the vagina. This approach is commonly used for uterine prolapse and nonmalignant conditions, with fewer complications and faster recovery (up to four weeks).
• Laparoscopic hysterectomy: A laparoscope is inserted through a small incision in the belly button. Surgical tools are inserted through other small incisions, and the uterus can be removed in small pieces through the abdomen or vagina. Recovery is shorter and less painful compared to an abdominal hysterectomy, and some patients may go home the same day or after one night in the hospital.
• Abdominal hysterectomy: The uterus is removed through a six- to eight-inch-long incision in the abdomen. The incision is made either from the belly button to the pubic bone or across the top of the pubic hairline. The surgeon will use stitches or staples to close the incision. This approach is most commonly used for cancer, or when the uterus is enlarged, or the disease has spread to other pelvic areas. Compared to other methods, abdominal hysterectomy generally requires a more extended hospital stay of two or three days and a longer recovery time.

After surgery

The duration of the hospital stay after a hysterectomy depends on the type of surgery the patient underwent. The doctor will carefully monitor the patient to ensure there are no signs of complications, such as blood clots or bleeding.

To prevent blood clots in the legs, the patient will be encouraged to start walking around as soon as possible after the surgery. This early mobility helps improve blood circulation and reduces the risk of developing blood clots.

Recovery period

The recovery period can vary based on the type of hysterectomy.

After a hysterectomy, here are some common instructions to follow:

• Expect light vaginal bleeding for one to six weeks. Use only a light panty liner or sanitary pad to manage the discharge.
• Avoid lifting heavy objects (over 10 pounds) for at least four to six weeks.
• Avoid inserting anything into the vagina for four to six weeks or as per the doctor’s advice.
• Abstain from sexual activity for six weeks after surgery.
• The patient may take a shower and wash the incision with soap and water. Stitches will dissolve in about six weeks. Surgical strips may fall off within a week, and the doctor should remove staples.
• Resume the exercise routine in four to six weeks, depending on how one feels.
• The patient can go back to work in three to six weeks, depending on the nature of an individual’s work.