What to expect up to four months after your hysterectomy

Posted in hysterectomy; Tagged Hysterectomy; Comments 19 ; Posted 2 years ago by Andreas Obermair

Recovery after surgery may differ individually but also depending on if you had a laparoscopic or abdominal (open) surgery. For laparoscopic procedures a follow-up appointment should be booked 1-2 weeks after surgery, to make sure you are healing correctly. If the surgery was open, a follow-up appointment is scheduled for 4 to 6 weeks.

This is a guide on what to expect after surgery, keeping in mind each person is slightly different.

24 hours after hysterectomy

• Most anaesthetics wear off quickly, however you may feel sleepier than usual.
• After surgery, discomfort and mild to moderate pain are common. In hospital pain medication will be administered to keep pain levels low.
• The incision sites may be red, bruised, swollen, itchy, or have a burning sensation. Your tummy may feel bloated.
• You should be able to shower the day after your procedure. During this time, you can allow the water to run over your incisions that are covered by glue. 
• A normal diet can resume after surgery. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, or toast.
• For laparoscopic surgery, patients generally go home the next day; open surgery patients go home after 3-4 days in hospital.
• When you leave the hospital, you’ll be given instructions about wound care, including information on bathing and showering, return to activities and how and when to take your medications.

1-2 weeks after hysterectomy

Caring for your surgical wound:

• I use sutures which do not need to be removed. However, these sutures could slightly stick out of the skin for a couple of weeks; these sutures will become loose and finally fall off by themselves.
• Check the area of your incision each day. If there is redness, swelling, drainage or wound opening, inform your doctor immediately. These can be signs of a starting infection.
• Keep clean and dry. Clean water is good for the surgical wound and does not cause harm. I recommend not using soaps or creams into the wound as this could cause an infection.
• Wear loose fitting clothing that will not rub or irritate the incision area.

Take medications:

• Take prescribed pain medications regularly (by the clock) for at least one week after discharge from hospital as it is much easier to maintain a pain-free state than to fight pain.
• If your doctor prescribed antibiotics, take them as directed.

Symptoms:

• After a hysterectomy, the top of the vagina has been sewn with stitches. A slight vaginal discharge is normal for up to 6 weeks and can even be blood-stained. You'll likely need to wear a pad during recovery for vaginal bleeding and discharge (no tampons).
• Patients may experience menopausal symptoms like hot flashes, night sweats, and mood swings if you were pre-menopausal prior to a total hysterectomy (which removes the ovaries). If severe, treatments such as hormone replacement therapy can relieve symptoms.
• You may feel temporarily numb near the incision or down your leg.

Diet and bowel movements:

• Bowel movements may take 4-5 days to get back to normal. Your first bowel movement should occur 4-5 days after surgery.
• For weeks (which can sometimes persist for months) bowel function could be impaired because of surgery and pain medication. Try natural fibres (such as beans, lentils, or pear and prune juices) and natural yoghurt first; laxatives may be required and/or prescribed prior to discharge.

Activities:

• Take it easy for the first 2 weeks. Avoid household activities that are strenuous or involve heavy lifting. While rest is important, still get up and move around the house, as gentle walking will help with recovery. Then you rest again.
• After 2 weeks, gentle exercise can resume if the surgery was laparoscopic. If laparotomy (open) surgery was performed, wait 6 weeks. 
• When you feel capable and no longer require pain medications, it’s ok to drive again.
• Resist any straining for up to 8 weeks post-surgery as it could cause discomfort or pain in the lower pelvic areas. Straining can originate from wanting to move your bowels, emptying your bladder or performing strenuous physical exercise.

6 weeks after hysterectomy

The surgical wound:

• The incision site should now be completely healed. 

Symptoms:

• It’s not unusual to feel weak or tired, and have less energy.
• Although periods stop after hysterectomy, you may still feel bloated and have other symptoms like those you had when you were menstruating.
• Any light vaginal bleeding or dark brown discharge should stop by the 6 week mark.

Overall, most women will start to feel much better at the 6 week mark.

Activities:

• Patients can resume having baths.
• Patients can resume sexual intercourse.
• Patients can use creams on the wound if it’s healed completely.
• Most women can return to work. Patients and their doctor will ultimately decide when their ready to go back to work.

You can gradually begin to increase the intensity of exercise as you recover. 

At approximately six weeks all patients will receive a questionnaire which I ask all my patients to complete if possible. This helps me to continually check that I am doing the very best for my patients at all times.

4 months after hysterectomy

By this time patients should be fully recovered and back to their usual activities, although it is not unusual to still be feeling fatigued or emotional.

Research has shown that fatigue is the most common and longest-lasting symptom that women have after a hysterectomy. On average, women experience fatigue for three months after surgery, but some women have reported feeling tired for up to six months after the operation.

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