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Hysterectomy (cont.)

When to Call a Doctor

After a hysterectomy, call your doctor or go to the emergency room if:

  • You have bright red vaginal bleeding that soaks one or more pads in an hour, or you have large clots.
  • You have foul-smelling discharge from your vagina.
  • You are sick to your stomach or cannot keep fluids down.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • Swollen lymph nodes in your neck, armpits, or groin.
    • A fever.
  • You have pain that does not get better after you take pain medicine.
  • You have loose stitches, or your incision comes open.
  • You have signs of a blood clot, such as:
    • Pain in your calf, back of knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You have trouble passing urine or stool, especially if you have pain or swelling in your lower belly.
  • You have hot flashes, sweating, flushing, or a fast or pounding heartbeat.

Your doctor will give you specific instructions after your hysterectomy. Be sure to follow them. Usually, getting some rest and following those instructions will help postoperative problems diminish over time.

Recovery

Recovering from a hysterectomy takes time. You will stay in the hospital for 1 to 2 days for postsurgery care. Some women stay in the hospital up to 4 days.

Abdominal hysterectomy. As soon as you feel strong enough, get up and around as much as you can. This helps prevent problems after surgery like blood clots, pneumonia, and gas pains. During the first 2 to 3 weeks, it is important to also get plenty of rest. Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.

You will gradually be able to increase your activities. To help you heal well, avoid lifting more than 20 pounds during the first 4 to 6 weeks after surgery. For the same reason, this is also an important time to avoid vaginal intercourse.

As soon as you can move easily without pain or without using narcotic pain medicine, you can drive. Complete recovery usually takes 4 to 8 weeks. Your return to a work routine will depend not only on how quickly you get back your energy and strength but also on how demanding your work is.

Vaginal or laparoscopic hysterectomy. As soon as you feel strong enough, get up and around as much as you can. This helps prevent problems after surgery like blood clots, pneumonia, and gas pains. When you can move easily without pain, you can drive. To help you heal well, avoid lifting more than 20 pounds during the first 4 to 6 weeks after surgery. For the same reason, this is also an important time to avoid vaginal intercourse.

Recovery from a vaginal or laparoscopic hysterectomy takes much less time than from an abdominal surgery. After a routine laparoscopic surgery removing the uterus but not the cervix (laparoscopic supracervical hysterectomy, or LSH), most women are able to return to normal activity in 1 to 2 weeks. About 4 to 6 weeks after the hysterectomy, see your doctor for a follow-up examination.

What are possible long-term problems after hysterectomy?

Pelvic weakness. After a hysterectomy, some women develop other physical problems that are related to weakness of the pelvic muscles and ligaments that support the vagina, bladder, and rectum. Kegel exercises may help strengthen the pelvic muscles and ligaments. But some women need other treatments, including additional surgery.

Vaginal dryness from low estrogen levels may develop if your ovaries were removed (oophorectomy). This can also develop gradually after a hysterectomy. If sexual intercourse is painful because of vaginal dryness:

  • Use a vaginal lubricant, such as K-Y Jelly or Astroglide, or a polyunsaturated vegetable oil that does not contain preservatives. If you are using condoms, use a water-based lubricant, rather than an oil-based lubricant. Oil can weaken the condom so that it breaks. Avoid petroleum jelly (for example, Vaseline) as a lubricant, because it increases the risk of vaginal irritation and infection.
  • Use a low-dose vaginal estrogen cream, ring, or tablet, which will reverse vaginal dryness and irritation by affecting only the vaginal area. If you are having other menopausal symptoms, talk to your doctor about systemic estrogen replacement therapy (ERT) and other treatment options. For more treatment information, see the topic Menopause and Perimenopause.
Click here to view a Decision Point.Hysterectomy and Oophorectomy: Should I Use Estrogen Replacement Therapy (ERT)?

Pain during intercourse may occur if your vagina was shortened during your hysterectomy. Changing positions may help make intercourse less painful. Talk with your doctor if you have any difficulty during intercourse after a hysterectomy.

How will I feel emotionally after my hysterectomy?

It is normal to have various concerns when faced with the possibility of having a hysterectomy. A woman's emotions are often based on her beliefs about the importance of her uterus, her fears about her health or personal relationships after a hysterectomy, and concerns about her enjoyment of sexual activities after surgery. If you are considering a hysterectomy, talk with your doctor about your specific fears and anxieties concerning the surgery.

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