By Paul MacKoul, MD – Laparoscopic GYN Surgeon and Co-Founder of CIGC.
Hysterectomy Recovery – What to Expect
Hysterectomy is a GYN procedure that surgically removes the uterus and sometimes the ovaries and fallopian tubes. Like many other major surgeries, it requires recovery time.
Everyone experiences hysterectomy recovery differently, but here is what you can expect:
- Most patients who have a hysterectomy procedure with CIGC’s specialists, who use the advanced DualPortGYN® technique, are back to their routine in about a week. Recovery from hysterectomy procedures using other methods can take from three to eight weeks.
- There are common side effects that you will likely encounter, including pain, bruising and swelling. These effects are typically mild and will subside as your recovery progresses.
- If your ovaries are removed during your hysterectomy procedure you will begin menopause. Your doctor can advise you on estrogen-only hormone replacement therapy to relieve any symptoms you may develop.
- If your ovaries are not removed during your hysterectomy procedure, you will not begin menopause and will not require estrogen only hormone therapy.
- DualportGYN procedures small incisions and overall approach to surgery allow for very rapid return to normal activities as compared to other hysterectomy types.
- Mobilization and walking are highly encouraged, and reasonable exercise regimens can be started relatively quickly.
- Swimming is allowed within the first week.
- Intercourse can start with a supracervical hysterectomy in two weeks. As this type of hysterectomy retains the cervix there is no defect in the vagina that requires healing. Partial and complete hysterectomy will require refraining from intercourse for 8 weeks to allow the vagina to heal.
Be sure to follow CIGC’s pre- and post-surgery instructions. Read more to learn strategies for a safe and healthy recovery.
Side Effects During Recovery
Physical Side Effects
After undergoing a hysterectomy, other possible side effects to expect include:
- Bleeding or discharge from the vagina
- Abdominal swelling
Emotional Side Effects
- Resolution of Pain and Bleeding. Many women have reported feelings of happiness after undergoing a hysterectomy due to the end of significant pain and bleeding associated with the menstrual cycle. Many patients with adenomyosis have suffered through many years of undiagnosed intolerable pain and bleeding, and for these patients the rapid recovery and complete elimination of these symptoms is a life changing positive experience.
- Increased Energy. Almost all patients who have had heavy bleeding and anemia note increased energy and a high rate of metabolism allowing many to lose weight. Patients have a new outlook on life with renewed energy and functionality.
- Reduction of Abdominal Girth (Distension). Patients with very large uterus will have complete resolution of long-standing abdominal distension, often appearing as if they are pregnant. With their abdomen now a normal size, they can buy new clothes, can exercise and function easier, and are able to normally cope with daily requirements at home and at work.
While some women may also feel relief now that they no longer have to worry about birth control and pregnancy, in some cases, feelings of sadness can surround the loss of fertility. Be sure to fully discuss these concerns with your CIGC surgeon prior to performing the procedure, to ensure that all questions are answered and you fully understand options available to you.
Your physician may prescribe medications to address several aspects of your recovery. Make sure you have discussed any potential interactions between these and your current medications.
You will be given pain medication intravenously prior to waking up from surgery. Once home, you may only need Tylenol (acetaminophen) or a nonsteroidal anti-inflammatory (NSAID) such as ibuprofen. If you were given a prescription drug for pain as part of your recovery plan, take it sparingly: Prescription drugs, such as opioids, can cause constipation, which can add to your discomfort. Consider these pain control tips:
- Stay ahead of pain — take your medication before pain becomes acute and requires a narcotic.
- Take pain medication a half hour before an activity you know will increase your discomfort.
- If you must take a narcotic, consider alternating with an NSAID.
Caring for Your Incision
The ¼-inch incisions used with CIGC’s laparoscopic procedures involve regular or dissolvable stitches, surgical glue and/or surgical tape called Steri-Strips™.
Bruising at the incision sites is generally present with the removal of a very large uterus with fibroids. Usually, it does not present a major problem in the vast majority of patients. Bleeding near the incisions from small “perforating” vessels leads to the bruising, which resolves in several weeks. You will be given instructions on caring for your incisions.
Call your doctor if you notice any signs of infection, including fever.
Returning to Activities
Going back to work. Most patients are ready to go back to work in about seven days after a typical DualPortGYN hysterectomy. CIGC surgeons do not perform open, robotic, standard laparoscopic, or vaginal procedures. Generally, non DualportGYN procedures can take weeks or months longer to recover.
Sex. Patients undergoing supracervical hysterectomy procedures can resume intercourse in two weeks. All other patients in which the cervix is removed will require 8 weeks before intercourse can resume. This is necessary to allow for complete healing of the top of the vagina, where sutures are placed to close the opening.
Driving. After a DualPortGYN hysterectomy, do not drive until at least two days have passed since you last took any narcotics and you feel strong enough to stop the vehicle in case of an emergency.
Exercise. Rest is important, but so is getting up and moving around a bit as soon as you feel ready. Walking is an ideal way to ease back into fitness and will help you heal more quickly.
When starting an exercise routine after surgery, use caution and start out slowly, gradually increasing time, distance and speed. All patients have different levels of fitness and exercise tolerance. Resuming an exercise program depends more on how you feel. Some patients can start a gradual regimen several days after surgery, whereas some will require longer. Swimming is allowed during the first week of the surgery if you feel comfortable doing so.
Taking a bath. Generally, taking a bath can resume once you are able to move in and out of the bathtub safely.
Eating a healthy diet with vegetables, fruits and whole grains is helpful to recovery.
Fiber-rich foods — such as fruits and vegetables — along with eight to 10 glasses of water a day will guard against constipation.
When to Call Your Healthcare Provider
- Lightheadedness, dizziness, or feeling faint. Call your doctor immediately to discuss.
- Urinary retention. Anesthesia can cause blunting of nerves that supply the bladder for urination. Prolonged bladder distension (the inability to pee) will cause pain and will require placement of a foley catheter to drain the bladder and avoid injury. Usually, the catheter will stay in place for at least 5 days.
- An increasing amount of pain in your pelvic region, abdomen or chest
- Sudden, bright red and heavier bleeding from the vagina that does not stop
- Watery discharge from the vagina
- Pressure in your vagina
- Vomiting or extreme nausea
- A fever over 100.5 degrees Fahrenheit
- Trouble urinating, a burning sensation when urinating or the need to urinate often
- Growing redness and swelling and/or increasing discharge from your incision