A vaginal hysterectomy is a surgery to remove the uterus (womb) and sometimes the cervix through the vagina. It is less invasive than abdominal surgery, with no external incisions, resulting in less scarring and a faster recovery.
Why is it Performed?
Your gynaecologist may recommend this procedure for:
- Uterine prolapse (when the uterus slips into the vaginal canal).
- Heavy or irregular bleeding unresponsive to treatment.
- Fibroids, endometriosis, or adenomyosis.
- Precancerous conditions (e.g., complex hyperplasia).
Before Surgery
- Pre-operative consultation:
- Discuss medical history, allergies, and medications (e.g., blood thinners).
- Tests: Pelvic exam, ultrasound, or blood work.
- Preparation:
- Fasting: No food/drink for 6–12 hours before surgery.
- Bowel prep: Rarely required (your doctor will advise).
- Hygiene: Shower with antibacterial soap; avoid lotions/perfumes.
- Arrange support: Plan for someone to drive you home and assist for 1–3 days.
During the Procedure
- Anaesthesia: General or spinal/epidural (you’ll be asleep or numb).
- Surgery:
The uterus is detached and removed through the vagina.
Laparoscopic tools may assist if needed.
Dissolvable stitches close internal incisions. - Duration: 1–2 hours.
Risks and Complications
- Common (temporary):
- Vaginal bleeding/discharge (up to 6 weeks).
- Mild pain, urinary discomfort, or fatigue.
- Rare but serious:
- Infection, bleeding, or injury to nearby organs (bladder, bowel).
- Blood clots, anaesthesia reactions, or vaginal prolapse later in life.
- Early menopause (if ovaries removed).
Contact your doctor immediately if you experience:
- Fever >38°C, heavy bleeding (>1 pad/hour), or severe pain.
- Foul-smelling discharge or difficulty urinating.
Recovery
In the hospital:
- Stay for 1–2 days (most go home the same day).
- Pain relief and guidance on wound care.
At home:
- Rest: Avoid lifting >5kg, driving, or sex for 6 weeks.
- Hygiene: Use sanitary pads (no tampons); keep the vaginal area clean.
- Activity:
- Gentle walks encouraged; avoid strenuous exercise.
- Gradually resume normal tasks over 2–6 weeks.
- Follow-up: Stitch check at 2 weeks; discuss results/biopsies.
Return to work: Typically, 4–6 weeks (adjust based on job demands).
Long-Term Effects
- Menopause: Occurs immediately if ovaries are removed (hormone replacement therapy may be offered).
- No periods: Permanent end to menstrual bleeding.
- Sexual health: Most resume normal activity after healing; discuss concerns with your doctor.
Frequently Asked Questions
Q: Will there be visible scars?
A: No external scars—incisions are internal.
Q: Can the surgery affect bladder function?
A: Temporary urinary changes are possible but rare.
Q: When can I travel?
A: Avoid long trips for 2–3 weeks to reduce clot risk.
Q: Will sex feel different?
A: Most report no change; some note improved comfort if prolapse was repaired.
eGynaecologist Advice:
- Vaginal hysterectomy may not be suitable for very large uteruses or certain cancers and should discuss your suitability if you are considering hysterectomy.
- You should seek gynaecological help if you have severe pain, fever, or chills after hysterectomy procedure or notice heavy bleeding or foul-smelling discharge from incisions
- You must seek urgent gynaecological review if you develop chest pain, shortness of breath, or calf swelling after while you are recovering from surgical procedure
- Hysterectomy procedurestops menstrual periods permanently and if ovaries are removed, menopause begins immediately. You should consult your gynaecologist if you need hormone replacement after hysterectomy
