A vaginal hysterectomy is an operation to remove the womb (uterus) through the vagina.
At Kingsbridge Private Hospital Belfast, you will meet with one of our Consultant gynaecologists in Five Star facilities. We endeavour to provide patients with a comforting and reassuring experience.
Why would I have a hysterectomy?
You may have a hysterectomy if your uterus is causing health problems that cannot be treated by other means.
Possible reasons include the following:
- Heavy or very painful periods. In some women, day-to-day life is made difficult because of heavy periods. Sometimes the heavy bleeding can cause anaemia. There are various other treatment options for heavy periods, including tablets and an intrauterine system (Mirena® coil). If they do not help to improve the problem, hysterectomy is an option for treatment. See separate leaflet called 'Heavy Periods (Menorrhagia)' for further information.
- Fibroids. These are swellings of abnormal muscle that grow in the womb. Fibroids are common and often do not cause any symptoms. However, in some women they can cause heavy or painful periods. Some fibroids are quite large and can press on the bladder to cause urinary symptoms.
- Prolapse. This is where the uterus or parts of the vaginal wall drop down. This may happen after the menopause when the tissues which support the uterus tend to become thinner and weaker.
- Endometriosis. This is a condition where the cells which line the uterus are found outside the uterus in the pelvis. This can cause scarring around the uterus, and may cause the bladder or rectum to stick to the uterus or Fallopian tubes. Endometriosis may cause only mild symptoms, but some women develop painful periods, abdominal pain or have pain during sex.
- Cancer. Hysterectomy may be advised if you develop cancer of the cervix, uterus, Fallopian tubes or ovaries.
What are the alternatives to a vaginal hysterectomy?
Hysterectomy surgery will usually only be recommended if other treatments, such as medicines or other surgery, are unsuitable or haven't worked.
Alternative surgical techniques to a vaginal hysterectomy are as follows.
- Keyhole hysterectomy. This procedure is done through small cuts in your abdomen. This may be used to help with vaginal hysterectomy.
- Vaginal repair surgery that doesn't involve removing your womb.
- Abdominal hysterectomy. This involves removing your womb through a cut in your abdomen (tummy).
Ask your gynaecologist for advice about which surgery will be most suitable for you.
Please lick on the links above to find out more about these procedures.
Preparing for a vaginal hysterectomy
Your gynaecologist at Kingsbridge Private Hospital will explain how to prepare for your operation. If you smoke, you will be asked to stop, as smoking can increase your risk of getting a chest and wound infection This can slow your recovery.
The procedure may be done under a general anaesthetic which means you may be given fasting instructions. This means not eating or drinking, typically for about six hours beforehand.
You may also be able to have the procedure done under epidural anaesthesia. This is an injection that is given into the space that surrounds your spinal cord and completely blocks pain from your waist down.
Your gynaecologist at Kingsbridge Private Hospital will discuss with you what will happen before, during and after your procedure, and any pain you might have.
What happens during a vaginal hysterectomy?
The operation usually takes about one to one and a half hours.
Your gynaecologist will make a cut in the top of your vagina and remove your cervix and womb. He or she will then close the top of your vagina using dissolvable stitches and may place a tampon-shaped dressing (known as a pack) in your vagina.
What to expect after the procedure
After surgery you will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort.
Your nurse will give you advice about getting out of bed, bathing and your diet. An appointment with our physiotherapists after surgery can help show you exercises that you can do to help your recovery. This will include exercises to strengthen your pelvic floor muscles.
You will need to stay in hospital for one to two days depending on how well you recover. Before you go home, your nurse at Kingsbridge Private Hospital will give you advice about managing at home over the first few days and may arrange a date for a follow-up appointment.
Recovering from a vaginal hysterectomy
The length of time it takes to recover after a vaginal hysterectomy at Kingsbridge Private Hospital will be different for every woman, and it can take up to a couple of months to get back to full health. Most women find they are able to return to work between two and six weeks after the operation.
It is common that you may have some pain in your lower abdomen after the procedure. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.
When you get home it is recommended that you take it easy for a few days. You will likely feel more tired than usual. If you have been given exercises to do, try to do these regularly.
Keep lifting to a minimum. You can lift light items, such as a kettle, but don't lift anything heavy for about four weeks after your surgery. It is recommended that you have a friend or relative to stay with you for the first few days while you recover.
It's usual to have some bleeding for about one to two weeks after the procedure.
You will need to wait until your scar has healed before you start to have sex again. This will take between four and six weeks. How comfortable you feel about sex after a hysterectomy and when you feel ready will vary for every woman. You may feel more sexual pleasure because the problem that meant you had to have a hysterectomy has now gone. However, some women feel a sense of loss after a hysterectomy and may find their libido (sex drive) is reduced. Your consultant at Kingsbridge Private Hospital will talk to you about these issues and any concerns you may have before you have the procedure.
What are the risks?
As with every procedure, there are some risks associated with a vaginal hysterectomy. Risks are specific to you and differ for every person. Individual risks will be discussed at you consultation.
Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. Side-effects of a vaginal hysterectomy include:
- abdominal pain
- vaginal bleeding
If your ovaries have been removed during the procedure, you will have menopausal symptoms such as hot flushes and vaginal dryness.
Complications are very rare but possible complications of any operation include an unexpected reaction to the anaesthetic or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
Specific complications of a vaginal hysterectomy can include the following.
- Blood loss.
- Damage to other organs and tissues in your abdomen, particularly your bowel, bladder or ureters (tubes that carry urine from your kidneys to your bladder). This can cause incontinence or a need to urinate frequently.
- A wound or urinary infection. You may need antibiotics to treat this.
- Premature ovarian failure. There is a risk that if your ovaries aren’t removed, they may not work properly because they receive some of their blood supply through your womb.
- Prolapse of the vagina where it was cut.
- Nerve damage.
At Kingsbridge Private Hospital Belfast we endeavour to provide patients with a Five Star service and state-of-the-art facilities. We ensure you are in the best hands available.