Hysterectomy – Abdominal

SALPINGO-OOPHORECTOMY

Removal of the uterus, cervix, and often the fallopian tubes and ovaries through an incision in the abdomen. Be sure you understand all aspects of this surgical procedure, its risks and benefits and any possible alternative therapies. With removal of the ovaries, sudden surgical menopause occurs.

REASONS FOR PROCEDURE

  • Uterus: Cancer or suspected cancer; fibroid tumors; chronic bleeding; prolapsed (dropped) uterus; endometriosis; chronic pelvic infection; severe menstrual pain; ;or voluntary sterilization.
  • Fallopian tubes and ovaries: Cancer or suspected cancer of the ovaries; precancerous or twisted ovarian cysts; ovarian pregnancy; ovarian abscess; damage to the ovaries from severe endometriosis.

RISK INCREASES WITH

  • Obesity.
  • Smoking.
  • Conditions resulting in excessive estrogen exposure, such as estrogen drugs, delayed childbirth, chronic anovulation (failure to release eggs from the ovary each month).
  • 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.

DESCRIPTION OF PROCEDURE

  • Antibiotic to prevent postsurgical infection may be prescribed in certain cases.
  • A general or regional anesthetic will be administered.
  • A urinary catheter is placed.
  • An incision is made in the abdomen (horizontal or vertical depending on the condition).
  • The abdominal organs are examined.
  • In a simple hysterectomy, the uterus and cervix only are removed. In a total hysterectomy, the fallopian tubes and ovaries are cut free and removed as well (salpingo-oophorectomy).
  • The vagina is often closed with sutures at its deeper end.
  • The surgical wound is closed in layers.
  • A catheter may remain in the bladder for hours to days.

EXPECTED OUTCOME

  • Relief from symptoms caused by benign uterine conditions. Symptom relief is associated with improvement of quality of life.
  • The vagina will be shortened slightly. This could cause no lasting problem. Expert permanent sterility. Allow about 6 weeks for recovery from surgery.

POSSIBLE COMPLICATIONS

  • Excessive bleeding.
  • Surgical wound infection.
  • Inadvertent injury to the bowel, bladder or ureters (the tubes going from the kidneys to the bladder).
  • Anesthetic complications (depending on method used).
  • Urinary tract infection.
  • Respiratory infection, particularly pneumonia.

POSTPROCEDURE CARE
GENERAL MEASURES

  • Hospital stay may be 2 to 5 days.
  • To keep lungs clear, cough frequently while using appropriate support. Deep breathing aids are frequently available.
  • Once home, someone should be available to help care for you for the first few days.
  • Use an electric heating pad, a heat lamp or a warm compress to relieve incisional pain or gas pains.
  • Shower as usual. You may wash the incision gently with mild unscented soap.
  • Use sanitary napkins-not-tampons to absorb blood or drainage (discharge is normal, but has an unpleasant odor).
  • Aftereffects of surgery may include constipation, urinary symptoms, fatigue and weight gain.
  • The psychological aftermath of a hysterectomy will depend on the individual. Some women feel only relief, others experience frequent and unexpected crying episodes (may be due to hormonal changes), and a few suffer from depression. Seek help and support from family and friends.

MEDICATION

  • After surgery, medicines for pain, gas, nausea or constipation may be prescribed.
  • Antibiotics if infection develops.
  • Supplementary hormones are recommended unless there are reasons why they should not be taken.

ACTIVITY

  • To help recovery and aid your well-being, resume daily activities, including work, as soon as you are able. Recovery at home may take 1 to 3 weeks, with full activities resumed in 6 to 8 weeks.
  • Resume driving 2 weeks after returning home.
  •  Sexual relations may be resumed in 4 to 6 weeks (or when advised). Most women experience no change in sexual functions; some report improvement, while others have a worsening sexual functions, specifically, loss of libido (sexual desire).

DIET

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