Patient information

Leaving hospital following a hysterectomy This leaflet aims to help you during your recovery from surgery by providing some useful information and advice. If there is anything you don’t understand or you need further advice or reassurance on, then please feel free to contact Sonning Ward on 0118 322 8204 / 8458.

Do I need to come back to the hospital again following surgery? If your consultant needs to see you again, then your nurse will give you an appointment to return to the Outpatients Department, usually within six to eight weeks following surgery. Your consultant will check that you are recovering well; he may want to check any wounds you have and give you the results of any biopsies that may have been taken at the time of surgery. If you don’t need to come back to the hospital, you will need to arrange to see your GP around six to eight weeks following your surgery to check you are recovering well. The nurses will tell you whether you will have an outpatient appointment or if you need to make an appointment with your GP.

What about my stitches? There are two types of stitches that are currently used; these are soluble and non-soluble. If you have soluble stitches then these should dissolve in about three to four weeks. If you have non-soluble stitches then you will need to arrange an appointment with the practice nurse at your GP surgery to have them removed on day 5 after surgery. Your nurse will advise you on which kind of stitches you have. If the stitches become red or inflamed then please contact your GP. Following a vaginal hysterectomy, any stitches in your vagina will not need to be removed as they are dissolvable. You may notice a stitch or part of a stitch coming away after a few days or weeks this is not unusual and nothing to worry about. It usually occurs with the stitches on the surface of your skin.

How do I look after my wound? The wound dressing should stay in place for five days and will only need changing in this time period if your wound is oozing. Once the dressing has been removed you will need to keep your wound clean and dry. Shower or bathe daily but do not use scented soaps, talc or lotions over the wound. Once the wound has started to heal and begins to scar, then you can start using scented soaps and lotions. Your wound may look swollen for up to six weeks but will eventually settle down and you will be left with 4-6 inch silver-looking scar. The incision is

Leaving hospital following a hysterectomy, June 2015

Patient information – Leaving hospital following a hysterectomy

usually made in the top of your pubic hairline but sometimes may run up and down your tummy-button to your pubic hairline instead.

Is it better to have a bath or shower? It doesn’t really matter. However, if you prefer to have a bath, do not have a ‘long soak’ for the first one to two weeks, as this can increase the risk of infection. Alternatively, a sponge bath may be better. Also avoid using scented soaps and bubble baths until your wound has healed completely. You need to wash the area daily with warm water, just patting the wound with a towel, not rubbing it. It is advisable to leave your underwear off for a few hours each day and to avoid close fitting trousers and tights, until the wound begins to heal. Keeping scars clean and dry will help with healing

Will I have vaginal discharge or bleeding after surgery? It is quite normal to have vaginal discharge and this can vary from dark red/brown to pale and whitish. It can last two to three weeks. Avoid using tampons during this time as they could introduce infection into the vagina. If the bleeding becomes heavy, bright red or if the discharge is smelly, then contact your GP as soon as possible as this could be a sign of infection.

When can I restart a sexual relationship? You can resume sexual intercourse at around six weeks following your surgery if you feel comfortable. Removing your uterus should not stop you having a good sex life after the operation. In fact many women report an improvement in their sexual pleasure after having a hysterectomy. This may be because the reason for having a hysterectomy (pain, prolonged heavy bleeding etc) is removed.

Will I have pain? You may feel some mild discomfort in your abdomen. You may take painkillers such as paracetomol and/or ibuprofen which you can purchase from any pharmacy, following the instructions on the packet. Taking painkillers to reduce your pain will enable you to stand up straight and move around – all of which will speed up your recovery and help to prevent the formation of blood clots in your legs and lungs.

When will my bowels return to normal? You may have trouble opening your bowels, feel bloated or have some discomfort due to wind for the first few days after the operation – this is because you are less mobile, may not be eating your usual diet and may be taking certain pain killing medication which can cause constipation. Your bowel habits should return to normal in time but eating fresh fruit, vegetables, fibre, drinking plenty of fluids and becoming more mobile as the days go on will help. If you have not opened your bowels within a week of surgery then your local chemist can recommend a mild laxative to help. Leaving hospital following a hysterectomy, June 2015

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Patient information – Leaving hospital following a hysterectomy

I’ve had a hysterectomy but still have my ovaries – how will this affect me? Your ovaries will continue to function but you may stop ovulating (producing eggs) slightly earlier than expected – a quarter of women will start to have menopausal symptoms within two years of the operation.

What happens to the eggs my ovaries produce? Your body absorbs the eggs produced by your ovaries; this will not affect you in any way.

My ovaries have been removed how does this affect me? Will I need HRT? If you have had a total hysterectomy then your ovaries will have been removed along with your tubes and uterus. If this is the case, you may need to go on Hormone Replacement Therapy (HRT) to replace the hormones that your body is not producing. Your consultant will discuss with you whether this is necessary. You will need to arrange an appointment with your GP to discuss the best HRT options for you.

Will there be an empty space where my womb was? No. Your internal organs will settle in to fill any space left after the operation.

Will I still need to have a cervical smear test? If you have had a total or vaginal hysterectomy your cervix will have been removed so you will not need to have a cervical smear test. If you had a laparoscopically assisted subtotal hysterectomy, your cervix will have been left in place, so it is important that you keep up with regular smears. Your consultant or nurse can advise you on which procedure you have had and whether you will need to continue to have smear tests.

I feel tearful – is this normal? You may experience some ‘blue’ days after major surgery. Wanting to do more than your body will allow may leave you feeling low and frustrated. This is normal and will settle down in time. If not then do make an appointment to see your GP.

When can I go back to work? You will normally need between four to eight weeks off work, depending on how physically demanding it is. If your job is particularly physical then you may need up to 12 weeks off. Returning to work can help your recovery by getting you back into your normal routine again. Some women who are not at work for longer periods start to feel isolated and depressed. You do not have to be symptom-free before you go back to work. It is normal to have some discomfort as you are adjusting to working life. It might be possible for you to return to work by doing shorter hours or lighter duties and building up gradually over a period of time. Only go back to work when you are sure you are fit enough. Leaving hospital following a hysterectomy, June 2015

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Patient information – Leaving hospital following a hysterectomy

Your nurse can organise a sick certificate for you for the first two weeks. After that, you will need to see your GP for further certificates.

Driving You should be able to start driving again around six weeks after your operation. Each insurance company will have its own conditions for when you are insured to start driving again. Before you drive you should be:  Able to sit in the car comfortably and work the controls  Able to wear the seatbelt comfortably  Able to make an emergency stop  Able to comfortably look over your shoulder to manoeuvre.

Stop smoking Stopping smoking will benefit your health in all sorts of ways such as lessening the risk of infection, a wound infection or chest problems. By not smoking – even if it’s just while you are recovering – you will bring immediate benefits to your health.

Formation of blood clots – how to reduce the risk There is a small risk of blood clots forming in the veins in your legs and pelvis (deep vein thrombosis) after any operation. These clots can travel to the lungs (pulmonary embolism) which could be serious. You can reduce the risk of clots by:  Being as mobile as you can as early as you can  Doing exercises when you are resting, eg:  Pump each foot up and down briskly for 30 seconds by moving your ankle.  Move each foot in a circular motion for 30 seconds  Bend and straighten your legs – one at a time, three times for each leg.

A pelvic-floor exercise programme Your pelvic floor muscles span the base of your pelvis. They work to keep your pelvic organs in the correct position (prevent prolapse), tightly close your bladder and bowel (stop urinary or faecal incontinence) and improve sexual satisfaction. It is important for you to get these muscles working properly after the operation, even if you have stitches. To identify your pelvic floor muscles, imagine you are trying to stop yourself from passing wind or you could think of yourself squeezing tightly inside your vagina. When you do this you should feel your muscles lift and squeeze. It is important to breathe normally while you are doing pelvic floor muscle exercises. You may also feel some gentle tightening in your lower abdominal muscles. This is normal. Women used to be told to practice their pelvic floor muscles exercises by stopping the flow of urine midstream. This is no longer recommended as this could affect the bladder in the longer term.

Leaving hospital following a hysterectomy, June 2015

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Patient information – Leaving hospital following a hysterectomy

You should do pelvic floor muscle exercises at least three times a day. Do about 10 repetitions and hold each tightening for 5-10 seconds. At first you may find it easier to do them when you are lying or sitting. As your muscles improve, aim to do your exercises when you are standing up. It is important to tighten your pelvic floor muscles before you do anything that may put them under pressure, such as lifting, coughing or sneezing. We recommend that all women do pelvic floor exercises throughout their life.

How much can I do around the house? Weeks 1-2: When you first get home you may feel very tired and the simplest task may exhaust you. Concentrate on taking it easy. Making drinks and light snacks is fine but remember to have lots of rest periods. Weeks 2-3: You may continue to feel tired. Plan ahead and do things in stages. You should feel up to making light meals, going to the shops, visiting friends and doing some light exercise. Weeks 3-4: Start some light housework and you can begin to do more light exercise. Weeks 4-6: You can return to sport, swimming, normal housework (such as vacuuming) and going back to work as long as your job is not extremely physical. You can start back lifting heavier objects (such as shopping bags). You should be able to return to driving. In a stationary vehicle, try testing your ability to use the controls, especially the brakes. Go with another driver the first time out if you do not feel confident. You will also need to check with your motor insurance company that you are covered to drive. You can also resume sexual intercourse if you feel comfortable. Some women will take longer than others to recover, both physically and mentally, but this does not automatically mean anything is wrong. Just remember to pace your recovery and look forward to returning to normal life. Remember, every woman’s experience is different.

This document can be made available in other languages and large print upon request. Author: Rebecca Greenhalf, August 2010 Reviewed: June 2015 Review due: June 2017

Leaving hospital following a hysterectomy, June 2015

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