HYSTERECTOMY (VAGINAL)

General Information

DEFINITION--Removal of the uterus, cervix, fallopian tubes and ovaries through an incision in the deepest recesses of the vagina. This surgery is frequently accompanied by colporrhaphy, a plastic surgery to repair weakened bladder and rectal muscles.

BODY PARTS INVOLVED--Bladder muscles; rectal muscles; uterus; cervix; fallopian tubes; ovaries; vagina.

REASONS FOR SURGERY--Strengthening of the bladder muscles, rectal muscles and pelvic ligaments.

SURGICAL RISK INCREASES WITH

• Obesity.
• Smoking.
• Iron-deficiency anemia; heart or lung disease; or diabetes mellitus.
• Use of drugs, such as: cortisone; antihypertensives; diuretics; or beta-adrenergic blockers.
• Use of mind-altering drugs.

What To Expect

WHO OPERATES--General surgeon or obstetrician-gynecologist.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of abdomen and kidneys; dilatation and curettage of the uterus (D & C).
• After surgery: Blood studies.

ANESTHESIA

• Spinal anesthesia by injection.
• General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• The vaginal walls are separated from the bladder muscles and rectal muscles.
• The deepest recesses of the vagina are opened. The cervix, uterus, fallopian tubes and ovaries are cut free and removed. The rear part of the vagina is closed with sutures.
• The bladder muscles and rectal muscles are sewn back in place. Supporting tissue is repaired.
• A small catheter is left in the bladder for 7 to 10 days.
• The procedure may also be performed by laparoscopy (see in Surgery section).

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Muscles supporting bladder and rectum may require a second repair.
• Inadvertent damage to bladder, rectum or ureters.
• Urinary retention.

AVERAGE HOSPITAL STAY--5 to 7 days.

PROBABLE OUTCOME--The vagina will be shortened slightly. This should cause no lasting problem. Expect permanent sterility. Allow about 6 weeks for recovery from surgery.

Postoperative Care

† Use sanitary napkins--not tampons---to absorb blood.

MEDICATION---

Your doctor may prescribe:

• Pain relievers. > Vaginal creams or medicated douches if vaginal discharge develops an unpleasant odor. > Hormonal supplements.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Resume driving 2 weeks after returning home. > Resume sexual relations as soon as able.

DIET--Clear liquid diet until the gastrointestinal tract functions again. Then eat a well--balanced diet to promote healing.

Call Your Doctor If

Any of the following occurs:

• Vaginal bleeding that soaks more than 1 pad per hour.
• Frequent urge to urinate or excessive vaginal discharge that persists longer than 1 month.
• Increased pain or swelling in the surgical area.
• Signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• Abdominal swelling or pain.