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A.
Usual length of stay in hospital: In most instances, you will be admitted to hospital on the day of your operation.
Most women are able to go home between two and four days after their operation.
After-effects of general anaesthesia: 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.
Catheter: You may have a catheter (tube) in your bladder to allow drainage of your urine.
This is usually for up to 24 hours after your operation until you are easily able to walk to the toilet to empty your bladder. If you have problems passing urine, you may need to have a catheter for a few days.
Drain: Occasionally, a drain (small tube) is inserted through your lower abdominal wall to drain off any blood or fluid that may accumulate immediately after your operation.
This will be removed after your surgery.
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. Check with your nurse that this has been done before you go home.
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 may also ease your discomfort. Once your bowels start to move, the trapped wind will ease.
Starting to eat and drink: After your operation, you may 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. Try eating something later on.
A. you will need to take care of the following after discharge:
Scar: You will have between two and four small scars on different parts of your abdomen. Each scar will be between 0.5 cm and 1 cm long. If you have had your cervix removed, you will also have a scar at the top of your vagina.
Stitches and dressings: Your cut will be closed by stitches, staples, clips or glue.
Glue and some stitches dissolve by themselves. Other stitches, clips or staples need to be removed.
Your cut 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.
Any 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.
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 women 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.
Pain and discomfort: You can expect pain and discomfort in your lower abdomen for at least the first few days after your operation.
When leaving hospital, you should be provided with painkillers for the pain you are experiencing.
Taking painkillers as prescribed 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.
Washing and showering: You should be able to have a shower or bath and remove any dressings the day after your operation. 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.
A. There is a small risk of blood clots forming in the veins in your legs and pelvis (deep vein thrombosis) after any operation.
These clots can travel to the lungs (pulmonary embolism), which could be serious.
You can reduce the risk of clots by:
You may also be given other measures to reduce the risk of a clot developing, particularly if you are overweight or have other health issues.
These may include:
A. You will be given advice and information about exercises to help you recover and about ways to move easily and rest comfortably. You will be advised about how to progress with getting out of bed and mobilising. You will also receive advice on how to do pelvic floor muscle exercises.
A. 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.
A. Some women who have had laparoscopic hysterectomy will need to continue to have smears from the top of the vagina. Check with your gynaecologist whether this applies to you.
A. The following may help you recover faster:
Rest: Rest as much as you can for the first few days after you get home. It is important to relax, but avoid crossing your legs for too long when you are lying down.
Rest does not mean doing nothing at all throughout the day, as it is important to start exercising and doing light activities around the house within the first few days.
Pelvic floor muscle exercise programme: Your pelvic floor muscles span the base of your pelvis. They work to keep your pelvic organs in the correct position (prevent prolapse), tightly close your bladder and bowel (stop urinary or anal incontinence) and improve sexual satisfaction.
It is important for you to get these 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 practise short squeezes as well as long squeezes:
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 when you are 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 women use triggers to remind themselves, such as brushing their teeth, washing up or commercial breaks on television.
Straining to empty your bowels (constipation) may also weaken your pelvic floor muscles and should be avoided.
A daily routine: Establish a daily routine and keep it up.
Eat a healthy balanced diet: Ensure that your body has all the nutrients it needs by eating a healthy balanced diet.
A healthy diet is a high fibre diet (fruit, vegetables, wholegrain bread and cereal) with up to two litres 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 gaining weight.
Keep your bowels working: Your bowels may take time to return to normal after your operation. Your motions should be soft and easy to pass.
You may initially need to take laxatives to avoid straining and constipation.
You may find it more comfortable to hold your abdomen (provide support) the first one or two times your bowels move.
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 forward and rest your arms on top of your legs to avoid straining.
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 anaesthetic.
Support from your family and friends
A positive outlook
A. It can take longer to recover from a hysterectomy if:
A. While most women recover well after laparoscopic hysterectomy, complications can occur – as with any operation.
You should seek medical advice if you experience:
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 blood may need to be drained.
If you have these symptoms, you should seek medical help immediately.
A. You may experience more tiredness than normal after any operation, so your return to work should be like your return to physical activity, with a gradual increase in the hours and activities at work.
Some women are fit to work after three to four weeks and will not be harmed by this if there are no complications from surgery.
Many women are able to go back to normal work after six to eight weeks if they have been building up their levels of physical activity at home.
Returning to work can help your recovery by getting you back into your normal routine again.
Everyone recovers at a different rate, so when you are ready to return to work will depend on the type of work you do, the number of hours and how you get to and from work.