Life after hysterectomy – A recovery road map

A hysterectomy can be a life-altering decision. For some it may relieve pelvic pain, heavy periods or even, cancer. When a woman is beyond childbearing years, she may choose a hysterectomy to treat other gynecologic concerns.

“If you’re considering a hysterectomy, recovery takes time, but life after hysterectomy can be a much more pleasant one,” said Rebecca Downs, M.D., women’s health provider at Marshfield Clinic Health System. “Many hysterectomies are now performed in a minimally invasive approach, which means we can do more types of surgery through smaller incisions, or sometimes no incisions at all.”

Types of hysterectomy

There are two different types of hysterectomies (total and supracervical). A total hysterectomy means removal of the uterus and cervix. Supracervical hysterectomy is only the uterus is removed but cervix is left in place. Sometimes, along with removal of the uterus, fallopian tubes and/or ovaries are removed. (Salpingectomy and oophorectomy).

“Based on your medical history and concerns, you and your provider will determine what hysterectomy treatment is needed,” Downs said.

The hysterectomy procedure may depend on your health concerns and history. The uterus is removed through the vagina in a vaginal hysterectomy procedure and no incision in made in the abdomen.  For an abdominal hysterectomy there is a larger incision made in the lower abdomen.

“A larger incision comes with a longer hospital stay and longer recovery time,” Downs said.

Laparoscopic hysterectomy involves disconnecting the uterus and cervix through small incisions, less than a centimeter each in size, with use of a laparoscope (camera) to guide the surgery and other instruments. From there, the uterus and cervix are removed, in most cases, through the vagina, and then the top of the vagina where the cervix used to be is closed with suture material that dissolves over time as the body heals around it.

“Sometimes we perform theses surgeries with use of the robot system to allow for the ability to do larger, more complex surgery through smaller incisions, as well as aid in shorter recovery for the patient compared with an abdominal hysterectomy approach,” Downs said.

Depending on your procedure, your recovery may look or feel different. Here is a recovery road map for after a hysterectomy:

Week 1

Once your surgery is over, you’ll be encouraged to take a walk around as soon as you can. This will prevent deep vein thrombosis, a condition where a blood clot forms in a deep vein. You will experience some pain, but you’ll be given medication to manage it.

“Most of the time with a minimally invasive gynecologic surgery (MIGS) procedure – either vaginal or laparoscopic/robotic hysterectomy – patients are able to recover using acetaminophen (Tylenol) and ibuprofen alone and need to take none or very few narcotic medications,” Downs said.

Weeks 2 through 6

For several weeks following surgery, you’ll likely experience light bleeding and spotting. This is normal and it will eventually stop. You will be discouraged from placing anything in your vagina for the first six weeks of recovery, including having sex and using tampons, but you can still use pads to combat spotting and discharge.

Additionally, Downs requires no heavy lifting (nothing more than 10-15 pounds) for four-six weeks. Specifics will depend on your surgeon’s recommendations.

“Lifting can activate the core muscles and put tension on the healing area at the top of the vagina, where suture material is still present,” she said. “Once your body heals over this suture/stitches, then lifting is safe.”

Week 6 and Beyond

• If your hysterectomy leaves your ovaries in place and if you haven’t started menopause yet, your ovaries will still produce estrogen, the female hormone that regulates many processes in your body. However, Downs said after initial surgery, you will no longer have bleeding. Any future vaginal bleeding would require a medical evaluation.
• If your hysterectomy removes your ovaries, you’ll experience the common symptoms of lowered estrogen, which resemble the symptoms of menopause (unless you have already transitioned through menopause). You might experience hot flashes, vaginal dryness and sleep problems.

Talk to your provider

Dealing with symptoms like heavy periods, pelvic pain and more can be detrimental to your quality of life. Discuss with your provider treatment options available, and if a hysterectomy is your best option and what life may be like post-procedure.

For more information or to schedule an appointment, contact your women’s health provider.