This leaflet has been designed to help you prepare for your operation. It does not contain all the known facts about your operation or complaint. Some of the risks associated with your operation will depend on your medical condition and, as any operation can be life threatening, these risks will vary from person to person. Your doctor will be available to discuss these with you.
What is a pelvic floor repair with a vaginal hysterectomy?
This is an operation to repair a prolapse. A prolapse is a weakening of the pelvic floor muscles which support the uterus (womb), bladder and the rectum ( back passage). This can cause the uterus, bladder or rectum to "drop" into the vagina. A vaginal hysterectomy may also be needed to help correct the prolapse. You will be in hospital between 5 -7 days.
Why do I need the operation?
What are the benefits of the operation?
- Prolapse of the uterus and/or vagina
- Feeling of pressure or heaviness in your vaginal area
- Feeling a lump/bulge in your vagina which can cause problems with your bowels or passing urine
Benefits of the operation
No operation is without risk. Those associated with this operation include
- No incision (cut) on the abdomen
- No sutures (stitches) to remove
- Symptoms directly related to the prolapse should improve
- Risks associated with the operation
- Damage to nearby organs
- Haemorrhage (difficulty in controlling bleeding)
- Difficulty passing urine
- A repair of a large prolapse may unmask stress leakage of urine
- There is a possibility that your vagina may become narrower after your operation and this can make sexual intercourse difficult. The doctor will discuss this with you before your operation
- Prolapse can recur.
If any of the above occurs further surgery or treatment may be needed to repair or investigate the problem.
A general anaesthetic (you will be asleep) also carries a small risk. These risks are greater for women who smoke or are overweight. It is advisable, if either of these apply, to reduce or stop smoking and try to lose some weight. In addition there may be special risks for women with certain medical problems such as heart or lung disease.
You will be able to discuss any concerns you may have with your anaesthetist before your operation.
What happens before your operation?
- You will be admitted to the ward either the day before, or, on the same day as your operation.
- If you have not attended a pre operative assessment clinic you will need to have some investigations performed e.g blood tests, E.C.G. (heart tracing). These will be done on the day of admission.
- It may be necessary to wear special stockings and/or have a series of small injections which help lower the risk of blood clots developing.
- You will have the opportunity to ask any questions concerning your operation or your anaesthetic.
- You may be seen by the physiotherapist.
What happens during your operation?
The operation is normally done under general anaesthetic and takes between one - one and a half hours. You will be away from the ward for approximately two - three hours depending on your recovery time.
- Your operation is done through the vagina so there will be no incision on your abdomen. There will, however, be sutures inside the vagina which will slowly dissolve.
- There will be a catheter (a narrow, hollow tube) in your bladder to drain your urine. This is normally removed after 24 - 48 hrs providing everything is satisfactory.
- You may have a drip (intra venous infusion, I.V.) usually in the back of the hand. This will help to give you fluids and/or drugs until you start to eat and drink.
- There is a possibility that you will have a gauze dressing put into the vagina. This will also be removed after 24 - 48 hours depending on the doctors1 decision.
Will I have any pain?
Any operation can produce pain. This can be mild in some patients and more severe in others. Always tell a member of staff if you are in pain, there is no need to suffer!
There are several methods of pain relief (analgesia) available. Before your operation the anaesthetist will discuss and explain to you which is the best method of analgesia for you. Some of these methods can include:
- Epidural analgesia - an infusion (drip) around the spinal cord which numbs the nerves and helps to prevent pain
- Patient Controlled Analgesia (PCA) - you control how much pain relief you need by pressing a hand held button attached to a pump (similar to a drip).
- Intra muscular analgesia - a pain killing injection usually given into the muscle of either your bottom or thigh.
- Suppository - this is for pain relief. It is given, with your permission, into your back passage (rectum).
- Tablets - taken by mouth when you feel able to drink.
It may be necessary to take some form of analgesia when you go home.
Will I feel sick?
Some patients may feel sick from the effects of the anaesthetic or operation. Some of the drugs used for pain relief can also cause nausea and sickness. An anti sickness preparation can be given to help control this.
WHAT WILL HAPPEN AFTER THE OPERATION?
On your return to the ward:
- The nurse will check your blood pressure, pulse and wound at regular intervals. The amount of urine you pass through the catheter will also be monitored.
- On the first day after your operation you will be given help with your personal hygiene and encouraged to sit out of bed for short periods.
- If you feel well enough on your second day you will have a bath or shower, with help if needed. Providing you are eating and drinking your drip will be removed.
- If you have a gauze dressing in your vagina and everything is satisfactory this will be removed after 24 hours, depending on the doctors' decision.
- By day three, if everything is satisfactory, your catheter will have been removed and the nurses will be monitoring how much and how often you are passing urine. You will be encouraged to move around more and be able to bath and shower without assistance.
Please remember not to compare your recovery rate with other patients - not everyone will have had the same operation, and all patients are different.
Please remember not to do any lifting for approximately 10 weeks as there is a possibility that your prolapse may recur.
You will probably be tired when you go home. It is be advisable, if possible, to arrange for someone to stay with you for your first few days at home.
- Rest whenever you feel tired
- Drink plenty of fluids and empty your bladder regularly
- It is advisable to bath each day but avoid bubble bath and other perfumed bath products
- You may still have some bleeding or discharge from your vagina. This should be decreasing. To help prevent any infection please use sanitary towels, not tampons.
- After about 10-14 days you may find small pieces of stitch material on your pad. Do not worry about this, the internal sutures are beginning to dissolve. When this occurs, bleeding from the vagina may increase slightly. If this becomes heavy or you are passing clots then you need to contact your doctor and rest.
- Continue to rest whenever you feel tired but remember to do some form of gentle exercise each day.
- Gradually increase your activities. After about six weeks you should be able to do most of the things you were doing before your operation except for any heavy housework or lifting.
Some advice and questions you might like to have answered -
The best advice you can have is to listen to your body. If you feel tired
Will I be depressed?
It is normal to feel low and tearful after any major operation, not just a hysterectomy. However, if these feelings continue then see your doctor Please remember that having any type of hysterectomy does not mean you will be any less of a woman. Your femininity will stay the same.
Will I put on weight?
The operation itself will not cause you to put on weight - unless you eat more and exercise less. Your movement is limited after your operation so it is important that you continue with the exercises that you have been shown and eat a sensible diet.
How soon can I resume driving?
It is advisable to wait at least six weeks after your operation or until after your follow up appointment. You need to be able to do an emergency stop and you may not have the strength to do this. It can also be painful. Please check this situation with your insurance company.
What about sex?
Sexual activity can normally be started after your check up which is usually about six weeks. After your operation please be sure that both mentally and physically you feel ready to start having sexual intercourse
When can i start sporting activities?
Check with your doctor at your follow up appointment
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