Hysterectomy, Vaginal

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. The type of surgery you have to remove the uterus may be one of the following:

• Total hysterectomy: Surgery to remove the uterus and the cervix. The ovaries and fallopian tubes may also be removed.
• Subtotal hysterectomy: Surgery to remove the top part of the uterus (called the fundus), but leave the cervix in place
• Radical hysterectomy: Surgery to remove the uterus (womb), the cervix, and possibly part of the vagina

Some of the problems that may be treated with a hysterectomy are:

• Tumors in the uterus
• Constant heavy bleeding that has not been controlled with other treatments
• Abnormal growth of uterine tissue outside the uterus (endometriosis) that causes pain or bleeding not controlled with other treatments
• Chronic pelvic pain
• A fallen (sagging) uterus
• Precancerous or cancerous cells or tissue on the cervix, in the uterus, or on the lining of the inside of the uterus (called the endometrium)

How is a vaginal hysterectomy done?

Before the procedure:

• Your healthcare provider will ask you to sign a consent form for a vaginal hysterectomy. The consent form will state the reason you are having the procedure, what happens during the procedure, and what you may expect afterward.
• There is risk with every treatment or procedure. Talk to your healthcare provider for complete information about whether any of these risks apply to you:
  • Anesthesia problems
  • Bleeding
  • Blood clots
  • Infection
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or recreational or illegal drugs.
• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.

During the procedure:

• You may be given a sedative through your IV to help you to relax.
• You will be given medicines to prevent pain during your surgery. These may include:
  • Regional anesthesia numbs a large area of your body. Depending on the medicine, you may be awake or asleep during the procedure.
  • General anesthesia relaxes your muscles and puts you into a deep sleep. It also keeps you from remembering the operation. While you are asleep, you will have a tube in your throat to help you breath and to make sure you are getting enough oxygen. The tube may be removed before you wake up after the surgery.
• You may have a small tube (catheter) placed into your bladder to drain and measure urine.
• Your surgeon will determine the best surgery for you. Depending on the reason you need the hysterectomy, surgery may include:
  • Vaginal hysterectomy: Surgery to remove the uterus through a cut in the vagina
  • Laparoscopic-assisted vaginal hysterectomy: Surgery to remove the uterus through a cut in the vagina. Your provider may use a tool called a laparoscope inserted through a small cut in the abdomen to help with the removal. A laparoscope is a thin tube with a light and tiny camera.
  • Lymphectomy: Surgery to remove lymph nodes near the uterus if you have cancer to check if the cancer has already spread
• The top of the vagina is stitched closed so that a hole into the abdomen is not left open.

After the procedure:

• You will be checked often by nursing staff.
• Your blood oxygen level will be monitored by a sensor that is attached to your finger or earlobe.
• Your heart rate, blood pressure, and temperature will be checked regularly.
• If you have had a laparoscopic-assisted hysterectomy, there may be a dressing or surgical tape strips on your belly. The surgical wound will be checked and dressings will be changed by your provider or the nursing staff as needed.
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Soften your bowel movement to reduce straining
  • Help relieve the symptoms of menopause if your ovaries were removed
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Belly pain or cramping
  • Heavy vaginal bleeding
  • Dizziness or lightheadedness
  • Swelling, redness, or pain in your legs
  • Chest pain
  • Shortness of breath
  • Trouble emptying your bladder
  • Change in bowel habits, such as pain, mucus, diarrhea, constipation
  • Redness, swelling, pain, warmth, or drainage from your surgical wound
  • Fever, chills, or muscle aches
• Ask questions about any medicine or treatment or information that you do not understand.

How long will I be in the hospital?

How long you will need to stay in the hospital will depend on the reason you needed the hysterectomy and how well you recover. This is often 2 to 3 days after you have the procedure.