Vaginal Hysterectomy: Treatment & Procedure

In what cases vaginal hysterectomy surgery is performed?

A vaginal hysterectomy is performed for the following reasons:

• Removal of a suspected cancerous tumor within the uterus
• Fibroid tumor
• Chronic and excessive bleeding
• Uterine prolapse
• Endometriosis
• Chronic pelvic pain
• Severe pain associated with menopause

How do I prepare for vaginal hysterectomy surgery?

Before vaginal hysterectomy surgery, a healthcare provider will evaluate the patient’s medical history to gain a comprehensive knowledge of the patient’s overall health status, including information related to the medications that she is currently taking. Some medications may potentially increase the risk of bleeding, and the doctor may suggest discontinuing them for a period of time before the procedure is performed. Blood tests may be performed to determine if there is a bleeding tendency or other medical conditions that may prevent the person from undergoing the procedure.

A blood test also helps in identifying the number of leukocytes and other blood cells. If you are allergic to anesthesia, such as lidocaine, then do inform your doctor, as it can increase the risk of anesthesia-related complications. Avoid applying any cosmetic, deodorant, or topical medicine on or around the vaginal, prior to the procedure. Avoid smoking and using any nicotine-based products for a while before the surgery. Avoid the consumption of alcoholic drinks for a period of time as instructed. You must avoid eating or drinking at least 8 hours prior to the surgical procedure. If you are diabetic, it is important to maintain blood sugar within the normal range.

Questions to ask your gynecologist before vaginal hysterectomy

Some of the basic questions that you should ask your gynecologist before surgery are as follows:

• What is a vaginal hysterectomy procedure?
• Why is this procedure necessary?  How will it help?
• How soon should I get it done? Is there an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed? 
• What are the risks while performing the procedure?
• What are the complications that might take place during recovery?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any follow-up tests or periodic visits to the healthcare facility required after the procedure?
• What are the costs involved?

What common factors can increase the risks and complications during the vaginal hysterectomy surgical procedure?

Some factors that increase the risk of complications during vaginal hysterectomy surgery are as follows:

• The risk of surgery increases with the degree of obesity
• Smoking increases the chances of complications during surgery. The longer the smoking history, the greater the surgical risk
• Advancing age
• Uncontrolled diabetes, as shown by a high hemoglobin A1c and a high fasting glucose
• Hypertension, if it is poorly controlled
• Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
• History of bleeding disorders
• Poor immune system due to a variety of issues

What post-operative care is needed after the vaginal hysterectomy surgical procedure?

At home, the following post-operative care is recommended after a Vaginal Hysterectomy procedure:

• Resume your daily activities gradually (under the physician’s advice). This facilitates a quicker recovery.
• To alleviate discomfort from the incision, apply a heating pad or warm compress.
• People are encouraged to follow a clear, liquid diet right after surgery. The diet is gradually advanced to solid food.
• Continue taking showers and keep the wound dry and clean. Gently wash the surgical wound with organic soap.
• You may be required to use sanitary napkins (for bleeding) for about a week or more.
• Complete the course of prescribed medication as advised by your physician.
• Take supplemental female hormonal medications under the supervision of the physician.
• Resume driving 2 weeks after the hysterectomy surgical procedure or when advised by your physician.
• Avoid sex till complete healing has taken place (generally 6-8 weeks, or follow the physician’s advice).

What are the possible risks and complications after the vaginal hysterectomy procedure?

The following complications may arise post-vaginal hysterectomy:  –

• Chronic pain
• Vaginal prolapse
• Vesico-vaginal fistula- An abnormal connection between the urinary bladder and the vagina
• Urinary incontinence
• Obstruction of the urinary system or bowel
• Urinary tract infection
• Infection in the surgical wound
• Excessive bleeding