A vaginal hysterectomy is a surgery to remove the uterus (womb) and sometimes the cervix through the vagina. It is less invasive than abdominal surgery, with no external incisions, resulting in less scarring and a faster recovery.
Why is it Performed?
Your gynaecologist may recommend this procedure for:
- Uterine prolapse (when the uterus slips into the vaginal canal).
- Heavy or irregular bleeding unresponsive to treatment.
- Fibroids, endometriosis, or adenomyosis.
- Precancerous conditions (e.g., complex hyperplasia).
Before Surgery
- Pre-operative consultation:
- Discuss medical history, allergies, and medications (e.g., blood thinners).
- Tests: Pelvic exam, ultrasound, or blood tests.
- Preparation:
- Fasting: No food/drink for 6–12 hours before surgery.
- Bowel prep: Rarely required (your gynaecologist will advise).
- Hygiene: Shower with antibacterial soap; avoid lotions/perfumes.
- Arrange support: Plan for someone to drive you home and assist for 1–3 days.
During the Procedure
- Anaesthesia: General or spinal/epidural (you’ll be asleep or numb).
- Surgery:
- The uterus is detached and removed through the vagina.
- Laparoscopic tools may be used to assist if needed.
- Dissolvable stitches close internal incisions.
- Duration: 1–2 hours.
Risks and Complications
- Common (temporary):
- Vaginal bleeding/discharge (up to 6 weeks).
- Mild pain, urinary discomfort, or fatigue.
- Rare but serious:
- Infection, bleeding, or injury to nearby organs (bladder, bowel).
- Blood clots, anaesthesia reactions, or vaginal prolapse later in life.
- Early menopause (if ovaries removed).
Recovery
In the hospital:
- Stay for 1–2 days (most go home the same day).
- Pain relief and guidance on wound care.
At home:
- Rest: Avoid lifting >5kg, driving, or sex for 6 weeks.
- Hygiene: Use sanitary pads (no tampons); keep the vaginal area clean.
- Activity:
- Gentle walks encouraged; avoid strenuous exercise.
- Gradually resume normal tasks over 2–6 weeks.
- Follow-up: Stitch check at 2 weeks; discuss results/biopsies.
Return to work: Typically, 4–6 weeks (adjust based on job demands).
Long-term effects
- Menopause: Occurs immediately if ovaries are removed (hormone replacement therapy may be offered).
- No periods: Permanent end to menstrual bleeding.
- Sexual health: Most resume normal activity after healing; discuss concerns with your gynaecologist.
eGynaecologist Advice
- Vaginal hysterectomy may not be suitable for very large uteruses or certain cancers and should discuss your suitability if you are considering hysterectomy.
- You should seek gynaecological help if you have severe pain, fever, or chills after hysterectomy procedure or notice heavy bleeding or foul-smelling discharge from incisions
- You must seek urgent gynaecological review if you develop chest pain, shortness of breath, or calf swelling after while you are recovering from surgical procedure
- Hysterectomy procedure stops menstrual periods permanently and if ovaries are removed, menopause begins immediately. You should consult your gynaecologist if you need hormone replacement after hysterectomy
Frequently Asked Questions
Will there be visible scars?
No external scars—incisions are internal.
Can the surgery affect bladder function?
Temporary urinary changes are possible but rare.
When can I travel?
Avoid long trips for 2–3 weeks to reduce clot risk.
Will sex feel different?
Most report no change; some note improved comfort if prolapse was repaired.
