Vaginal Hysterectomy

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What is a vaginal hysterectomy?

A vaginal hysterectomy is surgery to remove the uterus through the vagina. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus.

When is it used?

A vaginal hysterectomy may be done for several reasons.  Sometimes the uterus loses support of the ligaments and falls down through the vagina.  Ligament are fibrous tissues that help support organs and hold them in place.  The uterus may fall far enough to produce a lot of discomfort and may cause other problems.  This problem is known as uterine prolapse.  If your vaginal walls are also dropping or sagging, your doctor may repair them during the hysterectomy.  Vaginal hysterectomy is also performed when you have noncancerous (benign) tumors in your uterus or abnormal bleeding from your uterus.

What are the benefits of this procedure?

You no longer have bleeding from the uterus or discomfort there. You will probably have less pain and discomfort after this operation than if your uterus were removed through a cut in your abdomen. The recovery time is usually faster for a vaginal hysterectomy than an abdominal procedure. The vaginal procedure does not leave a visible scar.

What are the risks associated with this procedure?

There are some risks when you have general anesthesia. Discuss these risks with your health care 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. However, regional anesthesia is considered safer than general anesthesia.

• If your blood vessels leak or are injured, your health care provider may open your stitches to stop the bleeding.
• Your bladder or rectum might be injured and need repair.
• The tubes leading from your kidneys to your bladder (ureters) could be injured and need surgical repair.
• If your doctor has trouble removing your uterus through the vagina, it may be removed through an abdominal cut instead.
• You may develop an infection or bleeding.
• You may experience nausea and vomiting.
• You may develop a hernia in the top of the vagina.
• You may develop a blood clot in your legs, pelvis, or lungs.
• You may have difficulty emptying your bladder.
• The physician may decide they cannot complete the procedure vaginally and an abdominal approach may be attempted through a large incision in your abdomen.
• You may have damage to your intestine or track (fistula) between your intestine and skin, vagina, or other organ and need additional surgery.
• You may develop bulging in your rectum (rectocele) or your vagina (vaginal vault eversion) or your bladder (cystocele).

How do I prepare for a 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. Also, your wounds will heal much better if you do not smoke after surgery.

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 even drink coffee, tea, or water.

What happens after the procedure?

You may stay in the hospital for 1 to 2 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 cannot urinate or you have pain or a burning feeling when you urinate.
• You have pain in your abdomen or your abdomen becomes swollen.
• You become dizzy or faint.
• 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 result.
• You want to make another appointment.