Menstrual symptoms or myoma’s may require the removal of the uterus. In addition, the reason for the hysterectomy, the size of the uterus, or previous surgeries in the past may determine how the surgery is performed. This brochure provides information about abdominal hysterectomies.

Before surgery

Usually, you will be admitted to the gynecology department G6N, location AMC, the day before surgery. Sometimes you can also come the day of surgery itself. The anesthesiologist will discuss with you when you should and should not eat or drink. The operation is performed under general anesthesia.

Operation

You will be given antibiotics during the operation. If you are hypersensitive to certain antibiotics, you should mention this before the operation. To remove the uterus, a horizontal (bikini) cut or a vertical cut is made, depending on the size of the uterus, among other things. Then, the uterus is removed with the cervix and both fallopian tubes. The ovaries are left in women who are not yet menopausal and when the ovaries look normal.

After the surgery

When you wake up, you will have a catheter in your bladder. This is usually removed the next day. A test will then be done to make sure you can pass urine properly. While you are in hospital, you will be given injections to reduce the risk of thrombosis (blood clots in the blood vessels) after surgery. It is normal to have some bloody or brownish vaginal discharge for several weeks after surgery. This is because the stitches in the top of the vagina dissolve on their own over time.

Back home

Here is some general advice.

  • Walking: may be done immediately after surgery.
  • Showering: may be done immediately after surgery.
  • Bathing: after 2 weeks, provided there is no more blood loss.
  • Driving: after 2 weeks, provided you feel confident enough and can move your legs well.
  • Light housework: after 2 weeks
  • Cycling: after 3 weeks.
  • Lifting: gradually build up after 2 weeks after surgery, unlimited after 6 weeks.
  • Heavy housework: gradually build up after 4 weeks after surgery.
  • Caring for small children: after 4 weeks.
  • Sports: gradually build up after 6 weeks after surgery, depending on type of sport.
  • Community/free time: after 6 weeks or after the follow-up check at the outpatient clinic. This is to allow the scar at the top of the vagina to heal properly.
  • Work: resume gradually after 3 weeks after surgery, build up the number of hours.

Complications

Complications can occur with any surgery:

  • Bleeding: after a hysterectomy, bleeding can occur in the top of the vulva. Usually, the body resolves this itself, but recovery takes longer. Re-bleeding requiring a 2nd surgery occurs in less than 5% of women.
  • Postoperative infection: Although the work is done in a sterile manner, there is a small risk of infection of the scar in the vagina or pelvis. Symptoms may include pain in the scar or purulent discharge from the wound. In addition, vaginal infections may include an unpleasant smell of discharge, fever, and pain in the lower abdomen. If you have these symptoms, please get in touch with your gynecologist.
  • Bladder infections: about 6% of women have bladder infections after surgery. Symptoms include a burning and painful sensation when urinating, more frequent urination, and sometimes blood in the urine. If necessary, you will be given an antibiotic.

The following complications are somewhat more common with a hysterectomy:

  • Difficulty urinating after catheter removal occurs in 10-15% of abdominal surgeries. Sometimes a temporary catheter is needed. Usually, after a few days, urination succeeds.
  • Constipation is common but is a short-term problem. When symptoms occur, you will be given a prescription of Movicolon to help keep stools flexible.
  • Some women may experience pain or discomfort during intercourse, or the sexual experience may change. Other women may experience fewer symptoms after surgery. Do not hesitate to discuss this with your gynecologist.
  • Emotional aspects: some women feel "less of a woman" after a hysterectomy. This may involve a grieving process.