A hysterectomy is a surgical operation to remove the uterus, the organ located in the female pelvis.
Attached to the uterus on each side is a single fallopian tube and one ovary.
During pregnancy, a fertilized egg implants itself in the lining of the uterus where the developing fetus is nourished prior to birth.
The uterus, or womb, is crucial for reproduction. After undergoing hysterectomy, a woman will no longer menstruate and she cannot become pregnant.
Hysterectomy Surgery and Recovery: Factors to Consider
As with any surgery, recovery varies from person to person. Some women recover more quickly and resume their everyday activities fairly quickly, while others need a bit more time.
But in the case of hysterectomy, the surgical method used to remove the uterus will determine the type of recovery to expect.
Methods Matter: What to Know About Hysterectomy Side Effects, Scarring, and Long-Term Healing
The way in which a hysterectomy is performed can play a major role in your recovery.
If you have an abdominal hysterectomy, you will have a 5- to 7-inch incision that needs to heal. This incision is usually closed with stitches — commonly the dissolvable kind — or surgical staples. If staples or nondissolvable stitches are used, they will have to be removed by your doctor. (1)
If you have a vaginal hysterectomy without the assistance of a laparoscope, you will have no visible scarring from the small incision in the vagina made by the surgeon. The internal stitches used will likely dissolve on their own. (2)
If you’ve had a vaginal hysterectomy and your surgeon inserted a laparoscope or other instruments into your abdomen, expect to have about two to four incisions, each less than 1 inch long covered with Steri-strips that will most likely fall off within a week. (2)
How Long Do Women Need to Stay in the Hospital After Hysterectomy?
The length of a postoperative stay depends on how the surgery was performed. Women who’ve had an abdominal hysterectomy may stay in the hospital for one to two days.
Vaginal, laparoscopic-assisted vaginal, or robotic-assisted procedures are usually done on an outpatient basis. In most cases, a woman who has these less invasive procedures will either go home the same day after the procedure or stay overnight in the hospital, according to one report.
Be sure to discuss with your doctor in advance the various scenarios you may expect after surgery.
Can Women Eat Immediately After Undergoing Hysterectomy?
In most cases, according to one study, you will be able to eat and drink within the first 24 hours after an abdominal hysterectomy. However, it might take two to four more days before you have your first post-op bowel movement. That’s because the anesthesia, along with the manipulation of your organs that happens during the procedure, can cause the bowels to temporarily slow down. By the time you’ve been discharged, you should be passing gas. (3)
Does Hysterectomy Cause a Lot of Postoperative Pain?
If you undergo an abdominal hysterectomy your postoperative pain is generally greater than the pain after a laparoscopic or vaginal hysterectomy.
But this pain generally responds to narcotics that are given during the first 24 hours and perhaps for a bit longer if needed. By the second day, you may find that nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil or Motrin), are enough to alleviate the pain.
Some women may not need any pain medication at all. But if they do, it can be controlled.
How Long Does It Take to Fully Recover From Hysterectomy?
If you have abdominal surgery, complete recovery can take six to eight weeks, so you must be patient and allow your body to heal. For at least six weeks, avoid any heavy lifting (meaning items over 20 pounds). Do not do any housework, such as vacuuming, until you’ve discussed it with your doctor. You must also abstain from sexual intercourse for at least six weeks. And do not put anything, including tampons, into your vagina.
If you have a vaginal hysterectomy or a laparoscopic-assisted vaginal hysterectomy recovery can be as short as two weeks. Pain is generally minimal. You may feel some achiness and tenderness at the incision sites (if the surgery was performed laparoscopically). Most women will be advised to avoid heavy lifting and abstain from sex for at least six weeks.
Risks Related to Hysterectomy or Surgical Removal of the Uterus
Complications are usually rare; call your doctor if you experience any of the following:
- Fever or chills
- Heavy bleeding or unusual vaginal mucus or discharge
- Severe pain
- Redness or discharge from incisions
- Problems with urinating or having a bowel movement
- Shortness of breath or chest pain
Hysterectomy and Short-Term Side Effects
You may experience some light vaginal bleeding that comes and goes during the first few weeks following surgery. Typically this will decrease over time.
Getting Back Into Daily Life, Returning to Work After Hysterectomy
Although you need plenty of rest following surgery, it’s important to get up and move around as soon as possible. Pace yourself and listen to your body. It’s completely normal to feel some fatigue.
You may need to take anywhere from two to six weeks off of work depending on the type of procedure.
Exercise and Physical Activity After Hysterectomy
You can resume normal exercise about six to eight weeks following an abdominal hysterectomy. If the procedure is laparoscopic, you might be able to resume low-intensity exercise in two to four weeks.
The Emotional Impact After the Uterus Is Removed
“Women have a wide range of emotions when it comes to having hysterectomy,” says Leena Nathan, MD, assistant clinical professor at UCLA Health Obstetrics and Gynecology in Westlake Village, California. “For women who are perimenopausal and suffering from fibroids or bleeding issues, there is a sense of relief when they have a permanent solution to their problems.”
“For women of childbearing age who have a hysterectomy for cancer or precancer, there can be a profound sense of loss, disappointment, and guilt,” adds Dr. Nathan.
Hysterectomy and Potential Long-Term Effects
Long-term effects vary from woman to woman depending on age, health, which organs were removed, and other factors.
Hysterectomy and Surgical or Induced Menopause: What to Expect
If you have your ovaries removed at the time of your hysterectomy and you haven’t reached menopause prior to the surgery, you will immediately go into what is called surgical, or induced, menopause. You may start experiencing symptoms such as hot flashes, mood swings, and vaginal dryness, although not everyone will have these symptoms.
During the natural lead-up to menopause, estrogen levels lower gradually, but surgical removal of the ovaries may cause estrogen levels to plummet. Your doctor may suggest hormone replacement therapy to alleviate some of the more severe symptoms of menopause.
Long-Term Health Effects Related to Hysterectomy
Some women develop pelvic floor weakness following a hysterectomy, which can lead to bladder or bowel problems, including urinary incontinence. Sometimes corrective surgery is needed.
Oophorectomy: When Ovaries Are Removed During Hysterectomy
Oophorectomy is the medical term for removing a woman’s ovaries.
For many years, research has indicated that whenever possible, it’s best not to remove the ovaries with hysterectomy because the organs will continue to produce estrogen that is essential for bone health and can help protect you from heart disease.
However, some recent research seems to indicate that some of these problems occur even when the ovaries are preserved or not removed. “Several recent studies have also shown long-term risks, including coronary artery disease and congestive heart failure,” says Shannon Laughlin-Tommasso, MD, obstetrician and gynecologist, as well as research consultant, at the Mayo Clinic in Rochester, Minnesota. Dr. Laughlin-Tommasso authored one such study. (4)