Total Abdominal Hysterectomy
What Is Total Abdominal Hysterectomy?
This is a very common operation where the uterus (womb) and cervix (neck of the womb) are removed. After a hysterectomy, you will not have any more menstrual periods and will not be able to bear any more children. The ovaries may or may not be removed at the same time.
Are There Any Risks Involved?
Complications are rare but there are risks involved with any operation. These may be related to the anaesthesia or the operation. Risks related to the operation include bleeding, infection and injury to the abdominal organs such as the intestines, urinary bladder or ureter. Blood clots may occur in the legs or lungs; and occasionally, there may be slow return of bowels and bladder function.
The risks are higher in overweight patients, patients with poorly controlled medical problems (diabetes, high blood pressure, heart disease) and patients with previous abdominal surgery.
How Can These Risks Be Reduced?
Prior to the operation, you may be referred to a physician and / or anaesthetist to ensure that your medical problems are well controlled. On your part, you should remember to follow the doctor's instructions and take your medicine regularly.
What Happens On The Day Before My Operation?
You will be admitted the day before the operation. The routine blood tests and / or chest X-ray or ECG will be carried out prior to your admission. In some cases, however, you may be admitted in the morning if your operation is scheduled in the afternoon.
Your doctor may order bowel preparation for you. This usually in the form of a liquid medication to clear your bowel, and may cause you to pass motion several times.
The anaesthetist will see you to discuss the types of anaesthesia and the pain relief that you will require. He may order some sedative medication before the operation and often some medicine to help you sleep well the night before the operation.
If you usually take medication in the morning (for your heart or high blood pressure, for instance), do ask the anaesthetist whether you should take them with a sip of water on the morning of your surgery. Otherwise, you must not have anything to eat or drink after midnight. If you are on aspirin for a heart condition, you will need to inform your surgeon of this; and stop taking it for at least a week before your operation.
What Happens On The Day Of My Operation?
The ward nurse will shave the pubic hair on your abdomen just before your operation. You will then be transferred to the operating theatre on Level 2 for your surgery. After the operation, you will be monitored in the recovery area and once your condition stablises, you will be transferred back to your ward.
In the ward, the nurse will check your condition frequently. Your blood pressure, pulse and temperature will be monitored regularly.
You will have a line into your vein supplying nutrients to your body until you are able to eat and drink normally.
You will also have a catheter in your bladder to drain your urine.
No food or drink is allowed until the next day.
You will be prescribed regular pain relief and antibiotics.
What Happens On The Days After The Operation?
You may be given fluids to drink on the first day after the operation (1st post-operative day). The line into your arm vein and the catheter will usually be taken out on that day. Oral pain relief medication will be prescribed for your comfort.
You will be able to pass urine on your own once the catheter is taken out.
You are strongly urged to sit out of bed on the 1st post-operative day to prevent the blood in your leg veins from clotting; and if well, to start walking to aid in a speedier recovery.
In the days to follow, you will gradually resume your normal diet. Your usual bowel habits will return once you start eating normally.
When Will I Be Discharged?
The average hospital stay is 3 to 5 days. Before you are discharged, the abdominal wound will be checked and stitches may need to be removed. You will also be given adequate pain relief medication to bring home. The oral antibiotics prescribed must be completed to prevent infection from occurring. You may notice a reddish-brown discharge from the vagina for 1 to 2 weeks. This is part of the normal healing process.
What Must I Avoid?
You must avoid driving, sex and vaginal douching for 4 weeks after surgery.
When Do I Come Back To The Clinic For Check-up?
Your doctor will see you again in the clinic 1 week and 1 month after the operation. During this month, you will be given hospitalisation leave to recuperate at home.
What Are The Signs To Look For After Discharge?
You have to return to the O&G 24-hour Clinic on Basement 1 if you notice any of the following:
- Excessive bleeding from the vagina
- Pain or swelling of the legs
- Unusual discharge from the vagina or wound
- Severe abdominal pain
Will I Need To Take Hormone After Surgery?
Many women believe that a hysterectomy will cause menopausal (change of life) symptoms such as hot flushes, night sweats, mood changes, vaginal dryness and premature ageing. However, it is the removal of the ovaries, not the uterus, which produces these symptoms.
If your ovaries are removed and you do experience these symptoms, your doctor may prescribe medication to alleviate these symptoms.
What About My Sex Life?
Your sexual life should not be affected after the hysterectomy. In fact, you can resume sexual intercourse 4 to 6 weeks after surgery.