Hysterectomy is the second most common operation performed on women in the United States. Approximately one out of every three American women will have a hysterectomy by age sixty. In recent years, the number of hysterectomies performed on women in their thirties and forties has been increasing. In fact, 55 percent of all hysterectomies are performed on women aged thirty-five to forty-nine. Even though there is a lot of talk about hysterectomies, the impact on younger women is usually ignored. As a result, it isn’t a popular topic of discussion among younger women and thus women remain uninformed.
If you are one of the women who must have this type of surgery, what should you expect in terms of the surgery?
Questions to Ask Your Doctor About the Surgery
- What surgical approach will you use? (Laparoscopic, abdominal, vaginal, etc.)
- What side effects can I expect from the surgery?
- What kind of bleeding should I expect?
- What type of incision will I have, and what type of sutures will you use?
- How long will I be in the hospital?
- When can I resume my normal activities (work, child care, etc.)?
- What types of pain medication or other prescriptions will you prescribe after the surgery?
- What limitations will I have on sexual activity, and for how long?
- What will happen to my ovaries?
- Are there any other options that will let me leave my ovaries intact?
- What types of nonsurgical alternatives are currently available?
- What will happen if I don’t have the surgery?
- What types of complications should I expect?
- How will this surgery affect my hormones?
- What if I want to have children?
I had what I considered a very enlightened ob‑gyn who discussed the operation and what I could expect following it quite thoroughly. He said that in his experience many women tended to experience exactly what they had been led to believe would happen. If the formative culture assumed that a woman without ovaries and womb was a sexless being, then the woman was more likely to feel negative than one who had never been told anything of the sort. As it turns out, I had not really ever discussed hysterectomy with anyone and my feelings had not been influenced one way or another. I am so grateful that I had time to process what the hysterectomy would mean to me before the surgery. I went into training for my operation, eating in a very healthy way and taking extra vitamin E for healing. I was up and about the following day and felt better than I had for years. — Elsie
A hysterectomy is an inpatient procedure performed in a hospital setting. Before your surgery, your doctor will order a number of blood and urine tests. An enema is sometimes given to clean out your bowels before the surgery. Also, the abdominal and pelvic areas may be shaved and cleaned in order to prepare for surgery. You should also meet with an anesthesiologist to evaluate any special needs or conditions you have that might affect the anesthesia. Start eating soft foods three days before the surgery. On the night before the operation, you should eat a light meal and then have nothing to eat or drink for about twelve hours prior to your scheduled surgery.
Doctors, nurses, and women who have “been there” will all have experiences and advice for your recovery. How to remember everything? Buy a notebook small enough to keep in your purse. As questions or tips strike you, write them down in there. As Maggie says, “I have carried it with me everywhere for the past three weeks, and it is worth its weight in gold!”
Know Your Hormone Levels
If you are scheduled for a hysterectomy, it is imperative to have a complete hormonal blood workup. That way there is a baseline to go by when determining your hormonal needs. You can look back at those tests, see what the levels were when you felt normal, and try to achieve those levels again with the right hormones. Because hormones fluctuate, talk to your health care provider about the timing of hormone testing.
Depending on the exact surgical method, the entire procedure should take somewhere between one and three hours. Regardless of the approach, the procedure involves separating the uterus from the ligaments and tissue that hold it in place. Once separated, it is then removed. Afterward, the instruments are removed and the incisions are closed. Laparoscopic incisions may be closed with absorbable sutures and sterile tape, while surgical incisions will be held together with staples and sutures that will be removed a couple of weeks later by your doctor.
This is an elastic, stretchy wrap that is wrapped around and around the abdomen, similar to an Ace bandage for a sprained ankle. Some doctors routinely wrap their hysterectomy patients with them after surgery, but ask beforehand if you should bring your own. Some brands even include a cooling gel pack to ease postoperative pain.
The best advice I never got: have a family member there as much as possible to see that you get what you are supposed to get at the scheduled time. I can’t stress this enough. Having someone with you all the time means they will make sure you get your pain medications when you need them and not after the pain becomes miserable. — Liz
After your surgery, you will feel some discomfort. If you had an abdominal hysterectomy, this discomfort will include the location of the incision. A typical hospital stay varies from same day to a few days depending on the type of surgery and any complications.
While you are in the hospital, ask for a recommendation for a stool softener. Having a bowel movement can be a little uncomfortable at first. Drink lots of water, and avoid foods like chocolate and dairy products, which may cause constipation.
Don’t put yourself in a situation where you have to climb the stairs every day, at least for the first ten days. Consider buying (used is cheaper) or renting the following medical equipment to make the recovery much easier:
- A hospital table that easily wheels away from the bed but can also straddle the bed. This will allow you to read, use the computer, and eat without putting any pressure on your stomach or twisting around.
- Toilet hand-hold bars (there are temporary ones that rest on the toilet base; no need to attach them to the wall) to allow you to lower and raise yourself with your arms.
- A “grabber” that enables you to reach and pick up items on the floor or nearby.
- A walker with a seat for assistance getting into and out of bed and for the shower.
- Spa bags you can heat in the microwave or cool in the fridge, including a long, narrow one to cover the area of the incision (with a sheet between the spa bag and the incision).
- Wedge pillows, available at the local bed and bath store, which make sitting in bed much more comfortable.
- A body pillow or a large stuffed animal to hold on to.
Buy a short nightgown and robe of a silky material, both above knee length. That way you won’t get all wrapped up in your nightclothes. Pajamas are not comfortable against the incision for the first two weeks.