Following a hysterectomy it is likely that you will wake up feeling tired and in some pain. This is normal after this type of surgery. You will be given painkillers to help reduce any discomfort. If you feel sick after the anaesthetic, your nurse can give you medicine to help relieve this.
You may have a drip in your arm and a catheter (a small tube to drain urine from your bladder, which passes into a collection bag). If you had an abdominal hysterectomy you may also have a drainage tube in your abdomen to take away any blood from beneath your wound. These tubes usually stay in place for one to two days.
There will be a dressing covering any wounds from your operation. If you have had a vaginal hysterectomy you may have a gauze pack inserted into your vagina. This is to minimise the risk of any bleeding after the operation. It usually stays in place for 24 hours. It can be uncomfortable and make you feel like you need to empty your bowels.
The day after the operation you will be encouraged to take a short walk. This encourages your blood to flow normally, which will reduce the risk of complications such as blood clots in your legs (deep vein thrombosis).
Once your catheter has been removed you should be able to pass urine normally. Any stitches that need removing will be taken out between five and seven days after the operation.
Recovery time
How long it takes before you are well enough to leave hospital will depend on your age and general health.
Generally, women who have had a vaginal hysterectomy can leave after one to four days. Women who have had an abdominal hysterectomy can usually leave after two to five days.
A laparoscopic hysterectomy is a less invasive operation. You will usually be in hospital for less time after a laparoscopic hysterectomy than you would be after a vaginal or abdominal hysterectomy, providing there are no complications.
A follow-up appointment may be arranged 6 to 12 weeks after your operation to check your progress. Increasingly, a follow-up with your surgeon does not occur and your care will be taken over by your GP after you are discharged from hospital.
It takes about six to eight weeks to recover fully from a hysterectomy operation. During this time you should rest as much as possible and not lift anything heavy, such as bags of shopping. You need time for your abdominal muscles and tissues to heal.
If you live by yourself, help may be available from your local authority while you are getting better. Hospital staff should be able to advise you about this.
Side effects
Bowel and bladder disturbances
After your operation you may experience some changes in your bowel and bladder functions when going to the toilet. Some women get urine infections or find they get constipation, both of which can easily be treated. It is recommended that you drink one to two litres of fluid a day and increase the fruit and fibre in your diet to help with your bowel or bladder movements.
Vaginal discharge
After a hysterectomy you will experience some bleeding and discharge. This is less than a period but may last up to six weeks. If bleeding is heavy, you start passing blood clots or you have an offensive discharge, you should inform your GP.
Menopausal symptoms
If you have your ovaries removed, you are likely to feel severe menopausal symptoms after your operation. These include hot flushes, anxiety, confusion, weepiness and sweating. You may be given hormone replacement therapy (HRT) after the operation. This can be given in the form of an implant, injections or tablets. It usually takes around a week before this takes effect.
Emotional effects
It is common to feel a sense of loss and sadness after a hysterectomy. This is especially the case among women with advanced cancer who had no other treatment option.
Some women who have not gone through the menopause may feel a loss as they can no longer have children. Others might have a sense that they are less 'womanly' than before. In some cases, having a hysterectomy can be a trigger for depression.
You may find that talking to other women who have had a hysterectomy can provide emotional support and reassurance. Your GP or the hospital staff may be able to recommend a local support group. Charities such as The Hysterectomy Association can put you in touch with other women through online forums.
If feelings of depression persist, you should see your GP, who will be able to advise you on available treatment options.
Getting back to normal
Returning to work
How long it will take for you to return to work will depend on how you feel and what sort of work you do. If your job does not involve manual work or heavy lifting, it may be possible to return after four to eight weeks.
Driving a car
You should not drive a car until you are comfortable wearing a seatbelt and can perform an emergency stop. This can be anything from three to eight weeks after the operation. You may want to check with your GP that you are fit to drive before you start. Some car insurance companies require a certificate from a GP stating that you are fit to drive. You should check this with your car insurance company.
Exercise and lifting
You should be given some information after your operation on suitable forms of exercise during your recovery period. Walking is always recommended and you can swim after your wounds have healed. You should not try to do too much as you will probably feel more tired than normal.
You should not lift any heavy objects during your recovery. If you lift light objects you should make sure that your knees are bent and your back is straight.
Sex
It is generally recommended that you do not have sex until your vaginal discharge has stopped and you feel comfortable and relaxed, or after a minimum of six weeks have passed.
You may experience some vaginal dryness, especially if you have had your ovaries removed and you are not taking HRT. Many women also experience an initial loss of sexual desire (libido) after the operation, but this normally returns once they have fully recovered.
Studies show that pain during intercourse is reduced, and orgasm, strength of orgasm, libido (desire for sex) and sexual activity all improve following a hysterectomy.
Contraception
Contraception to prevent pregnancy is no longer required after you have had a hysterectomy. You will still need to use condoms to protect yourself against sexually transmitted infections.
