Short- and Long-Term, Questions to Ask

A hysterectomy is a surgery to remove the uterus, which may be necessary to help treat certain conditions. It can cause short- and long-term side effects, and like any major surgery, it also carries some immediate risks.

There a several types of hysterectomy, depending on what’s removed:

• A partial hysterectomy removes some or all of the uterus but leaves the cervix intact.
• A total hysterectomy removes both uterus and cervix.
• A total hysterectomy with salpingo-oophorectomy removes the uterus, cervix, and one or both ovaries and fallopian tubes.

Hysterectomies are performed through either the abdomen or the vagina. Some can be done laparoscopically or with robot-assisted technology. The approach your doctor uses can play a role in the side effects you might experience after surgery.

Read on to learn more about hysterectomy side effects.

Having a hysterectomy can cause several short-term physical side effects. Some may also experience emotional side effects during the recovery process.

Physical side effects

Following a hysterectomy, you may need to stay in the hospital for a day or two. During your stay, you’ll likely be given medication to help with any pain as your body heals. A laparoscopic hysterectomy sometimes doesn’t require a hospital stay.

As you recover, you’ll likely notice some bloody vaginal discharge in the days or weeks after the procedure. This is completely normal. You may find that wearing a pad during this part of recovery helps.

The actual amount of time you’ll need to recover depends on the type of surgery you have and how active you are. Most people can return to their usual activity level about six weeks after an abdominal hysterectomy.

If you have a vaginal hysterectomy, your recovery time is typically shorter. You should be able to return to your usual activities within three or four weeks.

In the weeks following your hysterectomy, you may notice:

• pain at the incision site
• swelling, redness, or bruising at the incision site
• burning or itching near the incision
• a numb feeling near the incision or down your leg

Keep in mind that if you have a total hysterectomy that removes your ovaries, you’ll immediately begin menopause. This can cause:

• hot flashes
• vaginal dryness
• night sweats
• insomnia

Emotional side effects

The uterus is a crucial organ for pregnancy. Removing it means that you won’t be able to get pregnant, which can be a hard adjustment for some. You’ll also stop menstruating after having a hysterectomy. For some, this is a huge relief. But even if you’re feeling relieved, you can still experience a sense of loss.

For some, pregnancy and menstruation are crucial aspects of femininity. Losing the capacity for both in a single procedure can be a lot to process for some people. Even if you’re excited by the prospect of not having to worry about pregnancy or menstruation, conflicting feelings can come up after the procedure.

Before you have a hysterectomy, consider checking out HysterSisters, an organization dedicated to providing information and support to those considering a hysterectomy.

Here’s one woman’s take on the emotional aspects of having a hysterectomy.

Following any type of hysterectomy, you’ll no longer have your period. You also can’t get pregnant. These are permanent effects of having a hysterectomy.

Problems with organ prolapse can happen after a hysterectomy. A 2014 study of more than 150,000 patient records reported that 12 percent of hysterectomy patients required pelvic organ prolapse surgery.

In some organ prolapse cases, the vagina is no longer connected to the uterus and cervix. The vagina can telescope down on itself, or even bulge outside the body.

Other organs such as the bowel or the bladder can prolapse down to where the uterus used to be and push on the vagina. If the bladder is involved, this can lead to urinary problems. Surgery can correct these issues.

Most women do not experience prolapse after hysterectomy. To prevent prolapse problems, if you know you are going to have a hysterectomy, consider doing pelvic floor exercises to strengthen the muscles supporting your internal organs. Kegel exercises can be done anytime and anywhere.

If you have your ovaries removed during the procedure, your menopause symptoms can last for several years. If you don’t have your ovaries removed and haven’t gone through menopause yet, you may begin menopause sooner than expected.

If you have your ovaries removed and go into menopause, some of your symptoms may impact your sex life. Sexual side effects of menopause can include:

• vaginal dryness
• pain during sex
• decreased sex drive

These are all due to the change in estrogen produced by your body. There are several things you can consider to counteract these effects, such as hormone replacement therapy.

However, many women who have a hysterectomy do not experience a negative impact on their sex life. In some cases, relief from chronic pain and bleeding improves sex drive.

Learn more about sex after a hysterectomy.

Hysterectomy is a major surgery. Like all surgeries, it comes with a number of immediate risks. These risks include:

• major blood loss
• damage to surrounding tissues, including the bladder, urethra, blood vessels, and nerves
• blood clots
• infection
• anesthesia side effects
• bowel blockage

These types of risks accompany most surgeries and don’t mean that having a hysterectomy isn’t safe. Your doctor should go over these risks with you before the procedure and inform you about steps they’ll take to minimize your risks of more serious side effects.

If they don’t go over this with you, don’t feel uncomfortable asking. If they can’t provide this information or answer your questions, they may not be the doctor for you.

A hysterectomy can be a life-changing procedure with major benefits and some potential risks. That’s why it’s so important to find a doctor that you trust and feel comfortable talking to before having the procedure.

A good doctor will set aside time to listen to your questions and concerns before surgery. While you should bring up any questions on your mind, here are some specific questions to consider asking:

• Are there any nonsurgical treatments that may improve my symptoms?
• Which type of hysterectomy do you recommend and why?
• What are the risks of leaving my ovaries, fallopian tubes, or cervix in place?
• Which approach to surgery will you take and why?
• Am I a good candidate for vaginal hysterectomy, laparoscopic surgery, or robotic surgery?
• Do you use the latest surgical techniques?
• Is there any new research related to my condition?
• Will I continue to need Pap smears after my hysterectomy?
• If you remove my ovaries, would you recommend hormone replacement therapy?
• Is general anesthesia always necessary?
• How long will I need to be hospitalized after my surgery?
• What is the standard at-home recovery time?
• Will I have scars, and where?

Hysterectomies can cause several short- and long-term side effects. They can also help to alleviate excruciating pain, heavy bleeding, and other frustrating symptoms. Work with your doctor to weigh the benefits and risks of the procedure and get a better idea of what to expect after surgery.

Having Sex After a Hysterectomy

Overview

A hysterectomy is surgery to remove the uterus (womb) — the hollow organ where babies grow and develop during pregnancy.

Having this procedure can relieve pain and other symptoms from conditions like fibroids or endometriosis. And if you have uterine or cervical cancer, it could save your life.

Any surgery can have both short-term and long-term side effects. A hysterectomy can cause side effects like pain and bleeding. Once you have this procedure, you won’t be able to carry a child.

A hysterectomy can also impact your sex life in the weeks following the procedure. Yet it shouldn’t prevent you from having sex — and enjoying it — once you’re healed.

Here’s a look at how a hysterectomy can affect your sexuality and what you can do to ensure you don’t lose this important part of your life.

Most of the surgery-related side effects should go away and your body should heal within two months.

The American College of Obstetricians and Gynecologists and U.S. Department of Health and Human Services recommend that you not insert anything in your vagina for the first six weeks after your surgery.

Doctors can perform different types of hysterectomy:

• Total hysterectomy. This is the most common type. It removes the whole uterus, including the bottom part, the cervix. The surgeon might also remove your ovaries and fallopian tubes.
• Partial (also called subtotal or supracervical) hysterectomy. Only the top part of the uterus is removed. The cervix is left in place.
• Radical hysterectomy. The surgeon removes the uterus, cervix, tissue on either side of the cervix, and the top part of the vagina. This type is often used to treat cancer of the cervix or uterus.

You might have some light bleeding and discharge after your surgery, and you’ll no longer get regular menstrual periods.

Pain, burning, and itching around the incision site are also normal. If your ovaries were removed, you’ll likely have menopause-like side effects like hot flashes and night sweats.

A hysterectomy will put your sex life on pause for a few weeks, but it shouldn’t end it.

According to one review of studies, most women said their sex life either stayed the same or improved after the procedure. They were finally free from the pain or heavy bleeding that caused them to have the surgery.

Having your ovaries removed during the procedure could dampen your desire for sex, though. That’s because your ovaries produce testosterone and estrogen — hormones that are integral to your libido.

Can I still have an orgasm?

Some women do report that they have less intense orgasms or no orgasms at all after surgery. This is because removing the uterus can cut nerves that enable you to climax.

Also, the cervix contains nerves that are stimulated during sex. If your cervix was removed during the procedure, the surgeon may have cut these nerves. This is rare and not the norm for most people who have the surgery, though.

Will sex still feel the same?

A hysterectomy shouldn’t affect sensation in your vagina. However, removing your ovaries will put you into menopause, which can dry out the tissues of the vagina and make sex more painful.

What’s the safest way to start having sex again?

First, make sure you wait at least six weeks — or as long as your doctor recommends — before you start having sex again. Take your time easing back into sex.

If vaginal dryness is making sex too painful, ask your doctor about using vaginal estrogen creams, rings, or tablets. Or, try a water-based or silicone-based lubricant like K-Y or Astroglide when you have sex.

If you’re having difficulty getting back to your normal sex life after a hysterectomy, try these tips to get back on track:

1. Take your time

When you have sex, don’t rush. Give yourself time to get aroused.

2. Experiment

Try different positions until you find one that’s most comfortable. Explore options other than vaginal sex, like oral or manual stimulation.

3. Be honest

Be open with your partner about what feels good and what hurts.

If these tips don’t work, consider seeing a sex therapist or counselor with your partner.

Once you pass the six-week mark after your surgery, you should be able to go back to a normal sex life. If you’re still having problems with arousal, orgasm, or comfort during sex, don’t just accept it. See your doctor.

Here are a few questions to ask your doctor:

• What’s the safest way to ease back into sex after my surgery?
• What should I do if sex is painful?
• How can I overcome a lack of desire?
• What should I do if my partner is getting frustrated or isn’t helping?

Together, you and your doctor can strategize ways to make your sex life as good as — or even better than it was — before your surgery.

procedure, recovery after surgery and consequences for the woman

10/16/2016

Contents

• Purpose of hysterectomy
• Indications for surgery
• Preparation
• Contraindications
• Procedure
• Rehabilitation
• Benefits of contacting MEDSI

Removal of the uterus (hysterectomy) is one of the most frequently performed operations in gynecology. Intervention is a real test for a woman. Not surprisingly, patients experience not only the fear of the operation itself, but also depression and vulnerability, confusion and inferiority. We will try to answer all the questions that women have. We will understand how the removal of the uterus is carried out, and how life can change after such an intervention.

Purpose of hysterectomy

Surgery is performed when other treatments have failed or are inappropriate. Emergency interventions often help save the patient’s life.

Interestingly, in a number of European countries and the United States, the operation is common among women after 40–45 years of age. This is due to the fact that it makes it possible to reduce the risks of developing fibroids and tissue growth, if any, and also avoids the appearance of malignant tumors.

Indications for surgery

Hysterectomy is performed in the following pathological conditions and diseases:

• Uterine cancer. After surgery, chemotherapy and radiation therapy are also carried out
• Multiple nodules of fibroids
• Internal bleeding with risk of anemia and other life-threatening conditions
• Acute pain syndrome
• Vaginal bleeding
• Growth of uterine lining tissue in ovaries and fallopian tubes

Preparation

Before the removal of the uterus, the woman undergoes a comprehensive examination. It allows you to assess the patient’s health status and identify possible contraindications.

The following diagnostic tests are usually performed:

• Pelvic ultrasound or MRI with contrast agent
• Vaginal swab
• Endometrial biopsy

The so-called hospital complex is obligatory.

It includes:

• general and biochemical blood test
• urinalysis
• blood test for group and Rh factor, as well as infections, clotting disorders, HIV and other diseases
• fluorography
• ECG

The patient consults with a gynecologist, internist and anesthetist.

Important! If temporary (relative) contraindications to the intervention are identified, the necessary treatment is carried out. If, for example, infectious diseases are detected, the doctor prescribes antibiotics and anti-inflammatory drugs. It is very important to achieve complete recovery or remission. Otherwise, there will be a high risk of surgical and postoperative complications. In addition, existing diseases negatively affect the rehabilitation process, lengthening it.

If a cervicalectomy or other operation is performed to remove a malignant tumor, hormonal and other drugs are prescribed. They help stop tumor growth. The therapy can make it possible to reduce the size of the formation, which will positively affect the course of the intervention, reducing tissue trauma.

Contraindications

Surgery to remove the uterus is not performed if there are the following contraindications:

• low blood clotting
• arterial hypertension
• acute infectious diseases (including small pelvis)
• angina pectoris
• anemia
• diabetes mellitus
• liver failure
• kidney failure
• allergic reactions to anesthetics

Important! There are both absolute and relative contraindications to intervention. In this case, the doctor makes the final decision on the operation. If necessary, the patient is consulted by specialists of narrow profiles.

Procedure

Hysterectomy of the uterus (including appendages) is performed under general anesthesia. The intervention usually takes 1-1.5 hours.

3 methods are used to access organs:

• Laparoscopic. The intervention is carried out through punctures in the area of ​​the abdominal wall. The technique allows to reduce tissue injuries and shorten the rehabilitation period. Usually only 4 small punctures and a specialized tool are required. It is inserted into the cervical canal. First, the ligaments of the uterus are excised, and then it is removed. After that, the walls of the vagina are coagulated and sutured
• Abdominal. This operation is traditional and the most traumatic. It requires a large incision in the abdominal wall. Mandatory for standard intervention is the fixation of intestinal loops. This avoids damage to them. The cervix is ​​cut off in the inner zone of the pharynx. After that, her stump and vaginal vaults are sutured. Then drain pipes are installed. They are removed after a few days
• Transvaginal. Access is provided through an incision in the vaginal area. After that, the surgeon peels off the bladder. Then the vessels and fallopian tubes, as well as ligaments, are separated and cut. After that, the uterus is cut off. The stumps of the pipes are sewn together

There are also 3 types of hysterectomy.

Radical

It involves the removal of the uterus, fallopian tubes, ovaries, regional lymph nodes and fatty tissue. The operation is performed for endometriosis and cancer.

Total

This hysterectomy involves the removal of the uterus with the cervix and appendages. It is prescribed for oncological diseases. The technique allows to reduce the risks of the spread of the tumor process. It is often combined with other methods of cancer therapy (chemotherapy, etc. ). Total hysterectomy can also be performed in emergency situations.

Subtotal

The cervix is ​​not removed during this operation. This intervention eliminates the risk of damage to the ureters and large vessels. It is prescribed for adhesions, pelvic endometriosis and some other pathologies.

Rehabilitation

Recovery after a hysterectomy is a lengthy process. Conventionally, rehabilitation is divided into 2 periods:

1. Early. 3-4 days after the intervention, the woman is under the control of medical personnel. The therapy is aimed at eliminating pain, preventing bleeding, restoring the body, reducing the risk of developing anemia and inflammation. The doctor also monitors the work of the intestines, the condition of the suture and the amount of discharge from the genitals. To remove fluid from the body, a urinary catheter is installed on the first day. During this time, the patient only drinks and does not eat anything. Then, low-fat broths and yogurts are gradually introduced into the diet. Eat light foods that are quickly digested. Chocolate, cabbage, legumes, corn are completely excluded, i.e. products that can cause increased gas formation and constipation. A woman should eat in small portions and at least 4-5 times a day
2. Late. With the classical method of the operation, it lasts about 1.5 months, with laparoscopic – no more than 30 days. The late rehabilitation period begins after discharge from the hospital. At this time, a woman should be attentive to her health and direct all actions towards its full recovery

There are certain recommendations that the patient should follow during rehabilitation:

• Mandatory intake of medicines prescribed by the doctor. Painkillers, anti-inflammatory, hormonal, enzymatic and general tonic agents are usually recommended
• Restriction of physical activity. It is especially important to avoid excessive pressure on the muscles of the abdomen and pelvic floor
• Do simple exercises (if recommended by a doctor)
• Refusal of sexual life. Return to it is carried out with caution. If a woman experiences discomfort, you need to contact a gynecologist. Perhaps it will prolong the period of sexual dormancy
• Healthy eating. Even after discharge from the clinic, you need to adhere to the correct diet with the restriction of alcohol, pastries, fatty foods, smoked meats, marinades
• Proper drinking regimen. A woman should drink about 1.5-2 liters of water per day. This will allow the natural detoxification of the body

Of course, the main consequence of the removal of the uterus is that the woman loses her childbearing function. Otherwise, life can remain as fulfilling as it was before.

Over time, the menstrual cycle is restored, the level of hormones returns to normal. After the removal of the uterus, even the libido can remain the same. At the same time, the ability to lead an active sex life fully returns.

Benefits of contacting MEDSI

• Experienced doctors. Our specialists are not only professionally trained to solve women’s problems, but also provide patients with an attentive and delicate approach
• Comprehensive surveys. They are carried out using modern equipment and ensure the accuracy of diagnosis and the identification of all pathologies
• Possibilities of using sparing techniques for hysterectomy of the uterus and ovaries. Operations are performed using minimally invasive methods, which increases their safety and shortens the rehabilitation period
• New high-tech equipment. It minimizes the risk of bleeding and the occurrence of complications and relapses
• Comfortable hospital stay before and after hysterectomy
• Outpatient rehabilitation and monitoring facilities

To clarify information or make an appointment, just call +7 (812) 336-33-33. Our specialist will answer all questions. Recording is also possible through the SmartMed application.

Do not delay treatment, see a doctor right now:

• Gastroenterologist appointment
• General practitioner appointment
• Gynecological appointment

Removal of the uterus – pain and complications after surgery

Complications after hysterectomy are early and late. Pain after removal of the uterus appears on the first day and is directly related to the operation. In the late period, pain syndrome may be associated with the formation of adhesions. In women, after the intervention, bleeding, suppuration of the postoperative wound may occur. If after the operation the legs begin to hurt sharply, or chest pain and shortness of breath appear, this may be evidence of pulmonary embolism or veins of the lower extremities. The slightest violations and problems that a woman feels after the operation should be reported to the attending physician.

The period after removal of the uterus, pain and other symptoms

The postoperative period for removal of the uterus is divided into early and late. During the early period, the woman stays in the hospital, under medical supervision. Then he is rehabilitated at home. The duration of recovery depends on the type of intervention. Hysterectomy is performed in several ways. The organ is removed through an incision on the anterior wall of the abdomen, through the vagina, or by laparoscopy. In the first two cases, the early postoperative period lasts 8-10 days; in the last case, the patient is discharged home already on the 3rd-5th day. Laparoscopic removal of the uterus can significantly reduce pain and other unpleasant consequences.

The first day is the most difficult in the postoperative period. After the removal of the uterus, the stomach begins to hurt, and this is a normal reaction. After all, a serious surgical intervention was performed. Hypersensitivity persists for 3-10 days. Women come out of anesthesia differently, some may experience nausea, sometimes vomiting, confusion, severe weakness, increased thirst. In the first day, most have no appetite. Also in the first days after the operation, intoxication associated with the effects of anesthesia and blood loss may occur.

Pain after surgery is relieved with non-steroidal anti-inflammatory drugs and narcotic analgesics. Antibiotics are mandatory to prevent bacterial infections. In the first 2-3 days, anticoagulants are prescribed to prevent thrombosis. Patients are also shown intravenous infusions of glucose and saline to relieve intoxication and replenish the volume of circulating blood. With significant blood loss, transfusion of plasma or erythrocyte mass is indicated. It is recommended to get out of bed after laparotomy after a day, and after laparoscopy – after 7-8 hours. Early activity of patients prevents the occurrence of many complications.

Complications in the early postoperative period

The early postoperative period requires constant monitoring by doctors, since it is in the first days that there is a high risk of complications. Pain after removal of the uterus may increase if there is inflammation in the area of ​​​​the sutures or a purulent complication. In this case, the skin around the wound turns red, swelling, serous or purulent discharge appears. In some cases, the seams may diverge, the healing of the postoperative wound slows down. The patient may have a fever.

A formidable complication of hysterectomy is peritonitis. Most often, it is observed during operations performed according to emergency indications, necrosis of fibromatous nodes, and the decay of cancerous tumors. The abdomen begins to hurt after removal of the uterus, its walls are tense, due to sharp pain it is difficult to palpate. The general condition of the patient worsens, the temperature rises to 39 degrees and above, symptoms of general intoxication appear. The sutures may not change, but more often in the area of ​​​​the postoperative wound there is swelling, purulent discharge, and divergence of the edges. First, conservative therapy is carried out with the use of 2-3 antibiotics, intravenous infusions. If it turned out to be ineffective, a second operation is performed.

Another complication that may occur after removal of the uterus is pain – impaired urination. It manifests itself in the form of pain, resembling the symptoms of cystitis, and is associated with trauma to the urethra during surgery. In rare cases, women experience acute urinary retention. A dangerous complication is bleeding. It can be external (from the vagina or postoperative wound) or internal. The only symptoms of massive internal bleeding may be abdominal pain, weakness, and a drop in blood pressure. Clarify the diagnosis with the help of ultrasound. To stop bleeding, anticoagulants are administered, with massive blood loss, a second operation, blood transfusion may be necessary.

If a woman begins to get sick after removal of the uterus behind the sternum, shortness of breath, tachycardia, pressure drops, this may be evidence of pulmonary embolism. The severity of the condition depends on the level of blockage. When blood clots enter small arteries, the patient’s condition deteriorates slightly, she may experience pneumonia, bronchospasm, and a heart attack in a small area of ​​the lung. When a blood clot enters a large artery, the complication can be fatal. For relief, thrombolytics, infusion therapy, oxygen masks are prescribed. Treatment is carried out in intensive care.

Pain in the legs, redness of the skin in the area of ​​the lower leg, may be associated with thrombophlebitis. This complication does not occur very often. For its prevention, anticoagulants are administered, it is recommended to wear compression underwear on the lower extremities immediately after the operation.

Pain after removal of the uterus and complications in the long term after surgery

Rehabilitation after removal of the uterus takes approximately 1.5-2 months. During this period, late complications may occur that require medical attention. Most common:

• Urinary incontinence
• Vaginal prolapse
• Fistula formation
• Chronic pain after hysterectomy

Urinary incontinence and vaginal prolapse occur due to a violation of the anatomical relationship between the organs of the small pelvis and the weakening of its muscles. Women may complain of both a slight leakage of the contents of the bladder, and the complete inability to hold urine. This condition creates discomfort, limits the physical activity of a woman, leads to frequent urethritis, cystitis and even pyelonephritis. Sometimes the lower back begins to hurt after removal of the uterus, there is discomfort or a sensation of a foreign body in the perineum. These signs are symptoms of vaginal prolapse. Although in many cases the complication is asymptomatic.

Fistulas are abnormal channels that can connect the vagina to the bladder or rectum. A complication rarely occurs. The main symptoms are the discharge of feces or urine from the vagina. Removal of the uterus can cause chronic pain in the late postoperative period due to the formation of adhesions. They occur more frequently with laparotomy than with laparoscopy. The adhesive process can provoke early postoperative complications (peritonitis, suppuration of sutures, bleeding). Also, a number of patients have a genetic predisposition to the formation of adhesions and keloid scars. In such situations, the stomach can not only hurt after removal of the uterus. The adhesive process is accompanied by flatulence, constipation, urinary incontinence.

Consequences of removal of the uterus

Hysterectomy is a major operation in which one of the organs is removed, so it cannot be without consequences. They depend on the volume of surgical intervention, the presence of complications after the operation. A woman after the operation will not be able to conceive and endure a baby. If the uterus was removed along with the appendages, she has a menopause. It is associated with a sharp decrease in the amount of hormones that are synthesized in the ovaries. It can be accompanied by hot flashes, mood swings, weight gain, decreased sex drive. Removing the uterus can cause bone pain. They are also associated with hormonal changes. In menopause, the amount of calcium in the blood and bone tissue decreases, which leads to osteoporosis. To prevent these complications and relieve the symptoms of early menopause, patients are prescribed maintenance hormone therapy.

If the uterus was removed without appendages, there are no sharp hormonal disorders. The woman does not have her period, she remains infertile. If a small stump remains, minor bleeding may occur once a month. The stomach will hurt after removal of the uterus while it will be insignificant. Many patients ask if it is possible to have sex after a hysterectomy. In most cases, sexual life is not disturbed, sexual desire can persist even when the ovaries are removed. Sometimes pain after surgery during sex is associated with the surgical removal of part of the vagina and a decrease in its length. But many partners adapt to this situation, find certain positions that do not cause discomfort.

In most cases, removal of the uterus does not cause pain after 2-3 months. In addition to the above consequences, no other symptoms are observed in women. They can live normally, work, relax, and engage in moderate sports. The operation does not affect life expectancy. If the hysterectomy was due to cancer, a course of chemotherapy or radiation therapy may be needed.