Vaginal Hysterectomy: A Minimally Invasive Procedure for Uterine Conditions
If you have been diagnosed with a benign uterine condition, such as fibroids, endometriosis, adenomyosis, or uterine prolapse, you may be considering a hysterectomy. A hysterectomy is a surgical procedure that removes the uterus, and sometimes the cervix and other reproductive organs. There are different types of hysterectomy, depending on how the surgery is performed and what organs are removed.
One of the most common and preferred types of hysterectomy is the vaginal hysterectomy. This is a minimally invasive procedure that removes the uterus through an incision inside the vagina. There are no incisions on your abdomen, which means less pain, less scarring, and faster recovery. Studies have shown that vaginal hysterectomy is associated with a fast return to normal activities and improved quality of life .
Let’s explore what to expect before, during, and after a vaginal hysterectomy, as well as the benefits and risks of this procedure.
Before the Surgery
Before you undergo a vaginal hysterectomy, your doctor will perform a physical exam and review your medical history. You may also need some tests, such as blood tests, urine tests, pelvic ultrasound, or pap smear. Your doctor will explain the procedure in detail and answer any questions you may have. You will also need to sign a consent form that states you understand the risks and benefits of the surgery.
You will be asked to stop taking certain medications, such as aspirin or blood thinners, a few days before the surgery. You will also need to avoid eating or drinking anything after midnight the night before the surgery. You may need to take antibiotics to prevent infection or laxatives to empty your bowels.
You will need to arrange for someone to drive you home after the surgery and stay with you for a few days. You will also need to prepare your home for your recovery by having comfortable clothes, pillows, sanitary pads, ice packs, and painkillers ready.
During the Surgery
A vaginal hysterectomy is usually done under general anaesthesia, which means you will be asleep and not feel any pain during the surgery. The surgery takes about one to two hours.
To perform the hysterectomy:
- Your surgeon makes an incision inside your vagina to get to the uterus
- Using long instruments, your surgeon clamps the uterine blood vessels and separates your uterus from the connective tissue that supports it
- Your uterus is removed through the vaginal opening, and absorbable stitches are used to close the incision
- If your cervix is also removed, it is called a total vaginal hysterectomy
- If your ovaries and fallopian tubes are also removed, it is called a total vaginal hysterectomy with salpingo-oophorectomy
After the Surgery
After the surgery, you will be taken to a recovery room where you will be monitored for any complications. You may have some pain, bleeding, or swelling in your vagina. You may also have some nausea or vomiting from the anaesthesia. You will be given painkillers and antibiotics to help you feel more comfortable.
You will be able to go home within 24 hours of the surgery, but you will need to rest for at least two weeks. You will need to avoid lifting heavy objects, driving, or having sex for six weeks. You will also need to avoid using tampons or douching until your doctor says it is safe.
You will have some vaginal discharge for several weeks after the surgery. This is normal and part of the healing process. The discharge may be bloody at first, then change to brown or yellow. You will need to wear sanitary pads to protect your clothing.
You will need to see your doctor for a follow-up visit about six weeks after the surgery. Your doctor will check your incision and your healing progress. You will also need to have regular pelvic exams and pap smears in the future.
Benefits of Vaginal Hysterectomy
Vaginal hysterectomy has many benefits compared to other types of hysterectomy, such as:
- Less pain
- Less blood loss
- Less risk of infection
- Less scarring
- Faster recovery
- Lower cost
- Improved quality of life
Vaginal hysterectomy can also treat your uterine condition and relieve symptoms such as:
- Heavy or irregular bleeding
- Pelvic pain or pressure
- Pain during intercourse
- Urinary or bowel problems
Risks of Vaginal Hysterectomy
As with any surgery, vaginal hysterectomy has some risks, such as:
- Bleeding
- Infection
- Injury to nearby organs, such as bladder or bowel
- Blood clots
- Anaesthesia complications
- Vaginal shortening or narrowing
- Pelvic organ prolapse (when the bladder, bowel, or rectum bulge into the vagina)
- Sexual dysfunction
- Early menopause (if ovaries are removed)
You should call your doctor right away if you have any of the following signs of complications after the surgery:
- Fever or chills
- Severe pain or swelling in your abdomen or pelvis
- Heavy bleeding or foul-smelling discharge from your vagina
- Difficulty urinating or having bowel movements
- Chest pain or shortness of breath
- Leg pain or swelling
Conclusion
Vaginal hysterectomy is a minimally invasive procedure that removes the uterus through the vagina. It is a common and preferred option for women with benign uterine conditions, such as fibroids, endometriosis, adenomyosis, or uterine prolapse. It has many benefits, such as less pain, less scarring, and faster recovery. It can also treat your symptoms and improve your quality of life. However, it also has some risks, such as bleeding, infection, or injury to nearby organs. You should discuss with your doctor if vaginal hysterectomy is right for you and what to expect before, during, and after the surgery.
Sources
- Debbo Africa: https://debbo.africa
- Women’s Wellness: The hysterectomy decision - Mayo Clinic News Network. (2017): https://newsnetwork.mayoclinic.org/discussion/womens-wellness-the-hysterectomy-decision/
- Vaginal hysterectomy recovery: Timescales, tips, and what to expect. (2018): https://www.medicalnewstoday.com/articles/321366