What is a vaginal hysterectomy?

A vaginal hysterectomy is an operation to remove your uterus and cervix through your vagina. It is possible also to remove your ovaries but they will usually be left alone (see figure 1).

Common reasons for having a vaginal hysterectomy include uterine prolapse, heavy or painful periods, and fibroids, where the muscle of your womb becomes overgrown.

What are the benefits of surgery?

A hysterectomy may cure or improve your symptoms. You will no longer have periods.

Are there any alternatives to a vaginal hysterectomy?

Symptoms of a uterine prolapse may be improved by doing pelvic floor exercises.

Heavy periods can be treated using oral medications, an IUD (intra-uterine device), or by removing only the lining of your womb.

Depending on the size and position of fibroids, you can take medication to try to control the symptoms. Other treatments include surgery to remove the fibroids only or uterine artery embolisation.

What does the operation involve?

The operation is usually performed under a general anaesthetic. The operation usually takes about 45 minutes.

Your gynaecologist will make a cut around your cervix at the top of your vagina so they can remove your womb and cervix.

They will usually stitch the support ligaments of your womb to the top of your vagina to reduce the risk of a future prolapse.

What complications can happen?

1 General complications

  • Pain
  • Feeling or being sick
  • Bleeding
  • Infection of the surgical site (wound)
  • Blood clots

2 Specific complications

  • Pelvic infection or abscess
  • Damage to structures close to your womb
  • Developing a fistula
  • Conversion to an abdominal hysterectomy
  • Developing a haematoma
  • Vaginal cuff dehiscence

Long-term problems

  • Prolapse
  • Continued pain
  • Adhesions
  • Stress incontinence
  • Feelings of loss (a hysterectomy will make you infertile)
  • Menopause, even if your ovaries are not removed

How soon will I recover?

You will usually be able to go home after one to three days. Rest for two weeks and continue to do the exercises that you were shown in hospital. You can usually return to work after four to six weeks, depending on your type of work.

You should be feeling more or less back to normal after two to three months.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Summary

A hysterectomy is a major operation usually recommended after simpler treatments have failed. Your symptoms should improve.

Acknowledgements

Author: Mr Jeremy Hawe MBChB MRCOG

Illustrations: Medical Illustration Copyright © Nucleus Medical Art. All rights reserved. www.nucleusinc.com

 

This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.

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