Recovery after a minimally invasive hysterectomy

01 Jul Recovery after a minimally invasive hysterectomy

If you have been recommended a hysterectomy, there is no doubt you will be wondering how your body might feel afterwards.

In the immediate post operative period, the pace of recovery greatly depends on the method of surgery, whether it be minimally invasive (laparoscopic/ robotic/ vaginal) or a traditional open procedure. The method of surgery is determined by the reason behind needing a hysterectomy. A hysterectomy for a non-cancerous condition is usually performed under a minimally invasive approach. This allows for a quicker recovery as a result of less pain, less bleeding and a lower infection risk.

Typically, women stay in hospital for 1-2 nights after a laparoscopic, robotic or vaginal hysterectomy. Pain is usually very well tolerated. You can expect to get out of bed, shower, and walk around the day after surgery. A small amount of vaginal bleeding is expected for the next few weeks. A catheter to empty your bladder (inserted during the operation) may be left in for the first night, this is typically removed the next morning. Mild bloating can occur during the first week, this will resolve once you are passing wind and opening your bowels, mobilising as soon as you can will help this.

Regular simple analgesia such as paracetamol or non-steroidal medications in the first week following hysterectomy will help you feel more comfortable, and allow you to move more easily. Take it easy and get family members or friends to help you.

By the second week, most women will be keen to return to their usual activities. Try to avoid doing too much too soon to allow your body time to heal. You will be advised not to drive typically in the first 2 weeks. Women usually return to work after 2-3 weeks depending on how physical their work is. The sutured area at the top of the vagina takes 6-8 weeks to heal. During this time, avoid inserting anything in the vagina and sex.

After the recovery phase and once wounds have healed, most women will find sexual intercourse no different to before their hysterectomy. In women with heavy painful periods or large fibroids, sex will in fact become more enjoyable as there will be no further bleeding or bloating from periods and fibroids. Vaginal length will not change after hysterectomy and, vaginal lubrication will be the same if the ovaries are not removed.

Some women are worried about the risk of prolapse after a hysterectomy. Prolapse of the vault (where uterus and cervix were attached prior to hysterectomy) can occur, as can prolapse of the uterus and cervix in the absence of hysterectomy. There is no clear link between having a hysterectomy and an increased chance of prolapse. The vault is usually incorporated into the supporting ligaments of the pelvis at the time of hysterectomy.

Whether hysterectomy leads to menopause and its associated symptoms such as hot flushes, sweats, insomnia, irritability depends on whether the ovaries (and their hormonal function) are removed at the time of hysterectomy. The ovaries are not removed in the majority of non-cancerous hysterectomies, even in women who are already menopausal. They provide an important supply of hormones for the heart, brain and bones. Hysterectomy is not associated with weight gain.

If your pap tests have previously been normal, a total hysterectomy (including the removal of your cervix) will negate the need for ongoing pap tests in the future. One less thing for you and your GP to keep track of.

As with all surgical procedures, it is important that you have an understanding of the risks and benefits before proceeding. Should you have any questions or concerns about any part of your procedure, do not hesitate to ask your gynaecologist, or get a second opinion. You should feel completely confident in your decision.