A vaginal hysterectomy is surgery to remove the uterus through the vagina. It is a way to take the uterus out through the vagina rather than through a cut in your belly.
The uterus is the muscular organ at the top of the vagina. Babies grow in the uterus, and menstrual blood comes from the uterus.
Sometimes the uterus loses support and falls down through the vagina. The uterus may fall far enough to cause a lot of discomfort and may cause other problems. This problem is called uterine prolapse, or fallen uterus. If your vaginal walls are also dropping or sagging, your healthcare provider may repair them during the surgery. If the bladder is also dropped, then your provider may also repair your dropped bladder during the surgery.
Examples of alternatives are:
You should ask your healthcare provider about these choices.
Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Find someone to drive you home after the surgery. Allow for time to rest. Try to find other people to help you with your day-to-day duties.
Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For these reasons, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.
If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your healthcare provider if you need to stop taking it before your surgery. Be sure to tell your provider what medicines you are taking, including nonprescription drugs and herbal remedies.
Follow any other instructions your healthcare provider gives you. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.
You will be given a regional or general anesthetic. A regional anesthetic numbs the lower part of your body while you stay awake. It should keep you from feeling pain during the operation. A general anesthetic relaxes your muscles and causes a deep sleep. It will keep you from feeling pain during the procedure.
You will have an IV in your arm to give you fluids and medicines.
Your healthcare provider will cut through the vaginal wall to reach the ligaments and blood vessels that surround and support the uterus. Your provider will separate ligaments and blood vessels from the uterus and tie the blood vessels so they will heal and not bleed. Your provider will then cut the uterus off at the top of the vagina and remove it through the vagina.
Your healthcare provider will attach the uterine ligaments to the vagina to hold the vagina in place. If ligaments and other tissue around the vagina have stretched from aging or childbearing, your provider may repair the walls of the vagina by sewing the ligaments together. The vagina is then attached to the repaired ligaments and the top of the vagina is sewn closed.
You may stay in the hospital for 2 to 5 days. If the walls of your vagina were repaired, you may stay in the hospital longer while the bladder heals and starts working again. You may go home with a catheter in your bladder, which is a tube used to drain urine from the bladder until the bladder is working normally again. Your healthcare provider will check how your bladder is working at a follow-up visit.
After you go home, get plenty of rest. Do not do any heavy lifting or strain the stomach muscles in any other way for 4 to 6 weeks. Follow your healthcare provider's instructions for activity, pain relief, and preventing constipation. Ask your provider what other steps you should take and when you should come back for a checkup.
If you were having menstrual periods before the surgery, you will no longer have them after the operation. Without your uterus you will not be able to get pregnant. If you have concerns about this, discuss them with your healthcare provider before the surgery.
Your healthcare provider may give you medicine to help with these problems. Ask your provider how these risks apply to you.
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