Abdominal Hysterectomy

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What is an abdominal hysterectomy?

An abdominal hysterectomy is a procedure in which the uterus is removed through a cut in the abdomen. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus. Other female organs may also be removed when the uterus is removed:

• A radical hysterectomy is the removal of the uterus, cervix, ovaries, fallopian tubes, and pelvic lymph nodes.
• A total hysterectomy is the removal of the uterus and the cervix, but not the ovaries or tubes.
• A subtotal hysterectomy is the removal of the uterus, but the ovaries, cervix, and fallopian tubes are left in place.

When is it used?

There are many reasons why you and your healthcare provider may decide to take out your uterus. Some of the problems that may be treated with a hysterectomy are:

• Tumors in the uterus.
• Constant heavy bleeding that has not been controlled by medicine or dilatation and curettage (D&C).
• Endometriosis that causes pain or bleeding and does not respond to other treatments.
• Chronic pelvic pain.
• A fallen (sagging) uterus.
• Precancerous or cancerous cells or tissue on the cervix or in the uterus.

What are the benefits of this procedure?

A hysterectomy takes care of problems you may have been having with your uterus. For example, it removes any tumors that may have been in your uterus and it stops menstrual periods and any pain you may have been having.

What are the risks associated with this procedure?

There are some risks when you have general anesthesia. Discuss these risks with your healthcare provider. A regional anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Regional anesthesia is considered safer than general anesthesia. Additional risks include:

• The cut in your abdomen (incision) may have to be reopened to stop any bleeding.
• Your bladder or the tube leading to it may be injured and need surgical repair.
• A piece of blood clot may break off, enter your bloodstream, and block an artery in the lung.
• You may develop an infection or bleeding.
• The incision may open.
• You may develop a hernia, weakening of the abdominal muscles, causing the intestines to push into the weakened area in the incision.
• Your intestine (bowel) may be injured during the surgery.
• You may have damage to a vein or artery that could cause serious bleeding.
• You may have damage to your intestine or tract (fistula) between your intestine and skin, vagina, or other organs and need additional surgery.
• You may have difficulty emptying your bladder.
• You may develop bulging in your rectum (rectocele) or your vagina (vaginal vault eversion).
• There may be damage to your ureters, the tubes that carry urine from your kidneys to your bladder.

How do I prepare for an abdominal hysterectomy?

Be sure to tell your health care provider what medicines you are taking, including nonprescription drugs and herbal remedies.

Follow your health care provider’s instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.

If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen.  This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your surgery. Also, your wounds will heal much better if you do not smoke after surgery. Be sure to tell your healthcare provider what medicines you are taking, including nonprescription drugs and herbal remedies.

Follow any other instructions your provider gives you. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before midnight.  Do not eat or drink after midnight. Do not even drink coffee, tea, or water.

Your provider may give you a bowel prep to begin a day or so before the surgery. And your provider may shave your lower abdomen down to the top of the pelvis.

What happens after the procedure?

The IV and catheter are removed 1 or 2 days after the surgery. You may stay in the hospital for 2 to 5 days. If the walls of your vagina were repaired, you may stay in the hospital longer while the bladder heals and starts working again. You may go home with a catheter, which is a tube used to drain urine from the bladder until the bladder starts working well again. Your provider will check how well your bladder is working at a follow-up visit.

After you go home, get plenty of rest. Do not do any heavy lifting or otherwise strain the stomach muscles for 4 to 6 weeks. Follow your health care provider’s instructions for activity, dealing with pain, and preventing constipation. Ask your provider what other steps you should take and when you should come back for a checkup.

If you were having menstrual periods before the surgery, you will no longer have them after the operation. You also cannot become pregnant. If you have concerns about this, discuss them with your health care provider before the surgery.

When should I call Greenville OB/GYN?

Call our emergency number at any time if:

• You develop a fever over 100 F (37.8 C).
• You have chest pain.
• You have diarrhea that does not stop.
• You have leakage from the incision or the incision opens up.
• You become dizzy and faint.
• You cannot urinate or you have pain or a burning feeling when you urinate.
• You have nausea and vomiting.
• You become short of breath or have chest pain.
• You develop a rash.
• You have heavy bleeding from the vagina.
• You have swelling, redness, or pain in your leg.

Call during regular office hours if:

• You have questions about the procedure or its results.
• You want to make another appointment.