What is Hysterectomy?

Hysterectomy is a surgical procedure to remove the uterus, and sometimes the cervix, fallopian tubes, and ovaries as well. This Gynaec surgery is the most common non-obstetrical surgical procedure in the world. After a hysterectomy, a woman can no longer have menstrual periods or become pregnant. Typically performed through the abdomen or the vagina, hysterectomy is used to treat several conditions, including heavy or painful periods, fibroids and uterine prolapse.

• What to expect from post operative Hysterectomy

      Immediately after hysterectomy, one can expect to:

• • Wake up in the healing area
  • Feel some soreness around the surgery site – and will be supplied pain-relieving medication to facilitate pain relief under the post operative care for hysterectomy
  • Experience end pain for a couple of days
  • Have the intravenous (IV) tubing removed from arm sometime during the first one or two days, depending upon the process and illness
  • Have the catheter or the urine drainage tube, removed from the bladder within a day of operation. However, if the bladder was traumatised during the operation, then it will stay in for a little longer
  • Be invited to get out of bed and go for short walks around the hospital ward whenever possible and hence the need for pain relief is quite important
  • Remain in the hospital for two to four days, depending on the kind of operation; sometimes this may be for more days.
  • With proper pain relief, recovery is quite similar for many kinds of hysterectomy. Typically, more care is required to retrain the pelvic floor, manage urination and bowel function following vaginal hysterectomy
  • It is crucial to start abdominal exercises and pelvic floor exercises within the first couple of weeks. These exercises help preserve muscle tone and bladder function and strengthen the muscles in your pelvis. Physiotherapist or your doctor will inform you just how long you can begin these exercises.

• Do I need to limit my activity during the phase of post operative Hysterectomy ?

• • It is common to feel tired for 3-4 days following surgery, particularly if general anaesthesia has been used. One may feel tired of a longer duration depending on the type of surgery. Taking a few short naps when you’re tired or resting might help.
  • While rest is vital, it is also very important to walk around a few times every day, right from the afternoon of operation. This will help to prevent complications, such as pneumonia, blood clots, and gas accidents. You can resume your usual activities, walks and climbing the staircase are all fine as long as one increases the activity levels gradually and basis her own ability and endurance.
  • Other activities like exercise, housework, sports may be resumed gradually, once one is capable and comfortable with the daily routines. However, it is best to seek a physician’s advice for any rigorous exercises.

• Shower or bathtub – what is a preferred option

• • Showers are allowed, but swimming and tub bathrooms ought to be avoided until the doctor says it is safe to do so and that maybe after about 2 weeks post-surgery.

• Are there any limitations on what I could lift?

• • Lifting weights may cause strain and hamper healing. Hence most patients are requested to avoid lifting heavy items greater than or equal to weights greater than six and a half kgs.  Restrictions on lifting are usually suggested for around six weeks following a significant abdominal or vaginal operation – e.g., open abdominal hysterectomy, also for a couple of weeks following smaller surgeries e.g. laparoscopy.
  • Women who don’t have an incision e.g., hysteroscopy, D&C don’t have to restrict lifting.

• Can I drive?

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  • One should not drive a car until the pain is no more. However, once there is no pain and hence there is no need for pain medicines, one can process for driving. However, one should be confident on her ability to drive, move, walk and respond to crisis situations if any arise before slipping in the driver’s seat.
  • Some surgeons advocate preventing long trips by automobile, train, or plane during the first fourteen days after major gynaecologic surgery like hysterectomy. If you have queries, speak to your health care provider.

• Is it possible to have sex? Could I use tampons?

• • Despite the surgery being abdominal, laparoscopic or vaginal, until the area is completely cured, you shouldn’t place anything inside the vagina and you might develop an infection or this may interfere with recovery.
  • All activities that demand any type of penetration in vagina, including douches, tampons sex or any other type of vaginal sexual activity should be totally avoided.
  • These actions should be avoided for two to six weeks. About when one can resume these activities, one must consult your healthcare provider.

• Returning to work

• • When pain is minimal and you are ready to work, you may go back to work. Generally, after minor processes, you should have the ability to work within a day or 2, while for major surgical process (e.g., hysterectomy), you might need four to six months to recuperate.
  • Time off from work is also dependent on the type of work which may or may not involve much travel and depending on the degree of manual work required.

• What can I eat?

• • As soon as the physicians on the ward have reviewed, you will eat and drink after operation. You might have a diminished appetite for the first day and successive few days following operation.
  • However, if nausea develops you may be unable to drink or eat anything, in which case it is good to consult your physician.
  • Even though remedies for constipation are also offered a high fibre diet may help to avoid constipation. Also make sure you drink enough water also helps to reduce constipation and to stay hydrated.

• How can I treat constipation?

• • Constipation is common after surgery and typically resolves with treatment or time. Constipation means stools are difficult or hard to pass or you don’t have a bowel movement. Constipation may become worse with narcotic pain medicines e.g. Panadeine.
  • In case your operation entailed the stomach or intestines, or if you’re having vomiting along with constipation, call your healthcare provider.
  • Consuming psyllium fibres to avoid constipation after surgery is helpful or sometimes one may also take stool softeners.
  • If this treatment doesn’t create a bowel movement in 24 to 48 hours, the next step it’s to choose a stimulant laxative which includes Senna (e.g. Senokot) or bisacodyl (Dulcolax). But before using those remedies, read the instructions and guidelines on the package and finally, call your healthcare provider, if these remedies don’t produce a bowel movement within one day.
  • After the bowels starts to proceed, you might choose to keep on with a stool softener daily to keep the stools soft.
  • This therapy might be followed for as long as desired.

• Imagine if I have diarrhoea?

• • Some people have diarrhoea for a couple of days following operation esp. after taking drugs for stool softening/ stool regulation, so it is perfectly normal. However, in case of any blood in your stool or if you have stools greater than twice every day, you need to call your physician.

Recovery and departure

• The duration of time in the hospital is dependent upon the overall level of well being and age.
• Follow up appointments with the doctor aren’t normally required unless there are complications. Generally, the patient could be requested to see General Practitioner in 4 to 6 months.
• After an abdominal hysterectomy, it takes more time for recovery.
• Recovery time is shorter following a vaginal hysterectomy.
• During the time under the post operative hysterectomy, one needs to rest as much as possible and never lift anything heavy, like shopping bags, etc.
• The tissues along with muscles require time to heal.
• If the patient lives alone, one should take help from friends/family so that adequate rest is obtained for recovery.

Managing pain during the post operative care for Hysterectomy

Some pain or discomfort follows most procedures and it can be managed with pain killers for the first few days post which, the pain starts reducing and one can also wean off from pain medications. The severity and the location of the pain is dependent upon the form of procedure. For instance, patients with an abdominal/laparoscopic hysterectomy involved abdominal incisions and the abdominal region may pain more additional the uteral region may be injured and there could be endometrial ablation and the same can be accompanied with a discomfort feeling like menstrual cramps.

• Gas pain – It is normal to have bloating and very poor pain after any abdominal surgery. Because of surgery, there is a gas built up in the intestines. The distress is temporary and will resolve after having a bowel movement or passing gas. If bloating and the pain are severe or do not self-resolve, one should reach out to the treating physician.
• Shoulder pain – Patients may have shoulder pain because of the gasoline used to enlarge the abdomen and this pain typically lasts for about a week and may be eased with heat packs- applied very carefully to prevent burns.

Some women find it useful to avoid awkward positions or actions, support their belly with a folded blanket or cushion, or to keep a hot water bag over the painful area.

Even while having continuous pain immediately following the surgery, one must continue to take pain killers as prescribed by the treating doctor and communicate if the pain is not reduced and the discomfort persists.

When pain reduced, or once it goes away, the patient can totally get off from the pain medicine as it is not essential for healing purpose.

Taking pain drugs or more frequently than prescribed could be harmful.

Pain medication can be obtained over-the-counter basis prescription during the period of post operative care for hysterectomy. Your physician will provide you a prescription for pain medication if he/she believes it will be required. Normally after a day process, you might just require over-the-counter pain medicines including paracetamol (e.g. Panadol) or aspirin (e.g., Neurofen).

Occasionally more powerful medications are prescribed for example narcotics (e.g., oxycodone, hydrocodone), or mixtures of both paracetamol and codeine (e.g., Panadeine Forte).

If you are currently taking any drugs, you should discuss the safety aspects beforehand with your physician. Don’t drink alcoholic beverages, or/and drive, or do any other tasks that require attention while taking narcotic pain medicines. If the pain becomes intense and isn’t relieved from pain medications’ dose, call your physician.

How can we help in pre and post operative care for hysterectomy?

As that the patient recovery is ensured by a post operative nursing care, postoperative care is a vital element of the curing process. Post-operative care may be short term or long term or may entail procedure and its benefits are manifold.

If there is major surgery and a long-term requirement of nursing care, a patient may feel better and recover faster in the loving and warm family environment and it is better to assist such patients while they are at their homes. Aiding this kind of care is easily possible through our home services. We have nurses and other caregivers as needed, who are on our rolls and these would come to see with you and offer the care required while resting at home with family.

Therefore, if you require care in your home, look no farther! Care24 is very well equipped to help your speedy and comfortable recovery within the confines of your home and alongside your loved ones.