Hysterectomy

If you are considering opting for a hysterectomy or you are already booked in for your surgery, it is likely that you are feeling apprehensive about this.

We have put together some useful information below to help you prepare for your operation and aid you in your physical, mental and emotional recovery.

What is removed during a hysterectomy?
Hysterectomy is a broad term for many different types of procedures. It is not uncommon for some women who have had a hysterectomy to not be entirely sure of what has been removed after having their surgery. This is why it is important to understand the different types of hysterectomies and speak with your consultant about this if you are unclear.

Sub-total abdominal hysterectomy
Only the uterus is removed.
The fallopian tubes, ovaries, cervix and vagina remain.

Total abdominal hysterectomy
The uterus and cervix are removed
The fallopian tubes, ovaries and vagina remain.

Total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH BSO)
The uterus, cervix, ovaries and fallopian tubes are removed
The vagina remains

Radical hysterectomy
The uterus, cervix, fallopian tubes, ovaries, top part of the vagina, supporting tissues and lymph nodes are removed

  • Plan ahead

    We understand that going into hospital can be very daunting. Planning ahead for your hospital stay and recovery can help reduce stress.

    Take some time to think of any questions to ask your consultant, such as, expected date of discharge.

    Make arrangements at work, put your out of office on.

    Arrange transport to and from the hospital.

    If you’re a parent make childcare arrangements, it’s okay to ask for help.

    Pack your hospital bag. We found it helpful to include the following items:

    Loose comfortable clothes

    Comfortable shoes

    Essential toiletries

    Reading material

    Phone charger

    Earphones

    Earplugs

    Eye mask

    Hospital wards can be noisy and busy. It can help to switch off from these surroundings with an eye mask and using earphones to listen to something which will relax you.

    You may need your bank card to purchase wi-fi because in some hospitals there is not a good mobile phone signal, so you may need wi-fi to message your family/friends.

    Do your own research and be your own advocate. It might help to speak to others who have been in a similar situation. We can help with that please get in touch.

    Having a hysterectomy is a major operation and we would recommend that you consider counselling prior to and post-surgery.

  • Things to ask your consultant

    If you are having your hysterectomy under the NHS, you will usually be provided with a printout of what to expect after your surgery in the initial 6 to 8-week recovery period.

    Whilst it is important to discuss how long you expect your physical recovery period to take, it is just as important to arm yourself with information regarding your long-term recovery and health following a hysterectomy.

    Your consultant should be considering if and what type of HRT you will need following your hysterectomy. This should include the use of local oestrogen. Many young women who enter surgical menopause due to an oophorectomy (ovaries removed) benefit from both systemic and local oestrogen as well as testosterone hormone replacement. (More about HRT here)

    You may be worrying about the impact of a hysterectomy on your sex life. You are usually advised not to have penetrative sex for around 6 weeks following your surgery but this can vary depending on your own circumstances and type of surgery.

    If you are having a Total Hysterectomy with Bilateral Oophorectomy we advise that you ask your consultant about being referred to a menopause clinic for the long-term management of surgical menopause.

    Unfortunately, it is likely that you’ll be discharged back to your GP following surgery. Regrettably, many GPs are not trained in menopause let alone the more complex issues surrounding hormone insufficiency in younger women brought about through surgery. There are not enough NHS menopause clinics in the UK but it is possible to be referred out of area. We highly recommend that you ask for a referral to a menopause clinic following your hysterectomy, especially if you have had your ovaries removed.

    You can search for your nearest clinic on the British Menopause Society website

  • Plan your recovery

    Useful bits ‘n’ bobs for recovery

    Comfortable and loose nightwear

    Poop stool and stool softener

    Grabber stick

    Support pillow, a V or a long rectangular one can support your body and help make you more comfortable

    Sometimes the most important thing you can do is RELAX

    Now is the time to binge watch Netflix, listen to podcasts, read, crochet – whichever floats your boat.

    Get your home ‘recovery ready'

    Prepare some easy meals that can just be popped in the oven

    Stock up on any household essentials

    Get up to date with cleaning, washing and ironing

    Pop clean bedsheets on, there’s nothing nicer than fresh bedsheets when you return home from hospital!

    Move any items that you use regularly to waist height, bending down can be quite uncomfortable initially. It can be helpful to keep a small table of useful items next to your bedside in the first couple of weeks.

    It’s good to talk

    Talk through a recovery timeline with friends and family to help manage expectations

    Perhaps pop a list together of anything you may need additional support with, it’s okay to ask for help!

    Highlight that the surgery isn’t an instant fix, stress that recovery will take time

    Signpost them to useful information

Recovering from your hysterectomy

Whilst much of the information provided in the NHS hysterectomy booklet is useful, such as the guidance around heavy lifting, it is important to remember that everyone is individual in their recovery. Some women may return to work after 8 weeks and some after 6 months. It is very important that you listen to your body and rest when you need to. Be kind to yourself.

The length of your recovery will be determined by many factors individual to you.  One major factor in your recovery will be the type of surgery you have had:

Abdominal hysterectomy
The womb is removed through a cut in the lower part of your abdomen. This usually leaves a “bikini-line” scar, although occasionally a midline (up and down) cut is necessary.

Vaginal hysterectomy
The womb is removed through the vaginal canal with no visible scars. Your Gynaecologist will discuss whether this method is suitable for your hysterectomy.

Laparoscopically assisted vaginal hysterectomy
Sometimes a hysterectomy is done using a telescope passed through the belly button and the womb is then removed through the vagina

Post-surgery things to consider

Swelly Belly
Swelly belly is caused by trauma to the abdominal tissues, gasses used during surgery and/or fluids collecting in the tissues due to trauma during surgery.
Following an abdominal hysterectomy, women can experience swelly belly for several weeks; however, it is not uncommon for this to last for several months.
It is worsened by doing too much too soon: lifting things that are too heavy, being on your feet too long and just generally overdoing it. It also seems to be worse in the evenings, especially if you have overdone things in the day.
There are support bands available for when you are able to get out for a walk. We recommend you avoid clothes that are tight around your incision area.

Wound care
Depending on your type of surgery, you may also receive information on wound care and after care appointments. We recommend buying some comfortable underwear. You will be more comfortable if the fit of your underwear to your abdominal area is not tight, especially during the initial few weeks of your recovery.

Washing
You can feel extremely sore during the first week or two of your hysterectomy recovery and you are likely to struggle to bend and move like you normally can.
It is important that you take your time when washing yourself and do not put any unnecessary strain on your body. If you have a loved one around to help you to wash, we recommend taking advantage of this.

HRT
It is important to arm yourself with as much information as possible regarding HRT, the different types and doses as well as the benefits and the possible side effects. Further information on this is available here

Sex
You will usually be advised to avoid penetrative sex until 6 weeks after surgery. Do not put pressure on yourself to resume your sex life until you are ready. Speak to your consultant about any concerns you have. Many women worry that they won’t be able to orgasm post hysterectomy. On the contrary, it can be a more pleasurable experience if long-term pain was a factor before your surgery. And remember, intimacy isn’t just about penetration, It can be exciting to explore new ways of giving and receiving pleasure. Most importantly, take your time and listen to your body.

Our top tips

Be kind to yourself and do not allow yourself or anyone else to put any unrealistic recovery expectations on you

Take charge of your own well-being and be your own advocate. Sadly, many GPs are not educated or trained in menopause let alone the complexities of surgical menopause

Arm yourself with as much information about surgical menopause as you can both pre and post-surgery.

Take time to research the psychological and emotional impact of surgical menopause. We recommend receiving some form of counselling as it is a major operation and navigating surgical menopause can be a lifelong commitment.

Reach out, at times surgical menopause can feel lonely but you're not alone. We're right behind you.