Abdominal Hysterectomy
Open Myomectomy

Pre-op

  • Please follow the pre-operative checklist page for more details.
  • Have your pre-op blood test 1 week before your surgery. If ECG is requested, please do the test.
  • Avoid constipation in the days leading up to your operation. If needed take a stool softener/laxative eg. Movicol, Fybogel, Metamucil.
  • If the surgery is anticipated to be complex you may require special bowel preparation. Dr Zachariah will inform you if this is required.
  • Prepare for your post op recovery by stocking up your pantry and your freezer with some cooked meals since recovery may take several weeks

Post-op

  • After your surgery, you will typically stay in hospital 1-2 nights, depending on your recovery. Before you go home, ideally you should be able to walk around slowly by yourself, tolerate normal drinking and eating, has passed urine and passed wind.
  • WOUND: You will have a suture line with stitches. Generally dissolving stitches under the skin surface is used which do not need removal. Glue or the dressing used will be waterproof and you are allowed to have a shower. Pat dry the wound area with a clean towel. Aim to keep your dressing on intact, for 5-7 days. The dressing need not be changed unless water has soaked through the dressing. If you have any concerns regarding your wounds such as redness of the skin next to the wound, increasing pain or other concerns, or problems with your dressings you can either contact our rooms or see your local GP.
  • Make sure you have someone organised to stay with you to help you especially in the first 1-week post-surgery.
  • Continue your painkillers provided by the hospital regularly to keep your pain well controlled.
  • Bring your TED stockings home which are provided by the hospital and continue to wear them. They may need to be worn for up to two weeks until you are fully mobile again.
  • When sitting or lying down, exercise your feet and legs each hour when awake.
  • Keep your fluid intake up (especially water) and eat small amounts of diet until your appetite returns. Avoid constipation and straining. It is best to take a stool softener/laxative eg. Movicol, Fybogel until your bowel functions and regular.
  • Avoid excessive bending, lifting, Gym and heavy housework/strenuous activities for 6 weeks.
  • You will require 4-6 weeks leave from work. Gradually increase your usual level of activity as your body permits. It is perfectly safe to resume normal daily living activities – listen to your body.
  • After hysterectomy, avoid intercourse for 8 weeks to allow complete healing of the incision at the top of the vagina (vaginal vault). Avoid swimming in a public pool for 2-4 weeks to reduce the risk of infections. Swimming in your own pool or ocean is acceptable once the wound is healed well.
  • Driving should be avoided for 3 weeks. Please check with your motor vehicle insurance provider prior to driving.

What to expect

Many gynaecological procedures are followed by some pain or discomfort. This should improve over time and can be managed with pain medications such as simple analgesia (eg: Panadol / Nurofen) for the initial 5-7 days. You will be given pain control medication in the hospital and to go home with. Most women will need the stronger pain medication from the hospital for the first 3-5 days after the operation. It is important that you take enough pain medication to allow you to take deep breaths, cough, and walk around slowly. Severe pain is unusual and should be reported to our rooms.
You may have a blood-stained vaginal discharge which is similar to a light period. This will gradually reduce to nil over the next two to four weeks as your internal wound heals. A pad may be used, but tampons should be avoided.
No. Generally dissolving stitches are used which do not need removal. Glue or the dressing used will be waterproof and you are allowed to have a shower.
You may eat and drink normally. You may have a decreased appetite for the first few days after surgery; you may prefer to eat small, frequent meals. A high fibre diet may help to prevent constipation. However, if you are not able to eat or drink anything or if vomiting develops, call the hospital or the rooms.
Constipation is common after pelvic surgery and usually resolves with time and/or treatment. It is best to avoid constipation and straining by regular use of stool softeners or laxatives (eg: Coloxyl, Movicol etc) during the initial 1-2 weeks. If you do develop diarrhoea with the regular use of the laxatives, cease using them.
You may feel a pulling sensation during urination due to the catheter used. It can be normal to urinate frequently after surgery. However, if you are bothered by any urinary symptoms or do have a temperature, please call the rooms or the hospital.
Showers are permitted. Avoid using a public pool for a month in order to reduce the risk of infections. You may use your own bathtub or pool after 2 weeks.
Lifting heavy objects can increase stress on the healing tissues. For the first 4-6 weeks lift nothing greater than two kilograms. Increase gently as tolerated over six to eight weeks. It is best to avoid lifting heavy objects from the floor; if the object cannot be lifted with one hand, you should ask for help. You should also avoid squatting.
It is normal to feel tired for a few weeks after a major surgery. Taking a few short naps during the day or resting when you are tired may help. While rest is important, it is also important to walk around several times a day, starting on the day following surgery and build up gradually as able. When resting make sure to do feet/calf exercises and it is important to continue to wear the TED stockings for 1-2 weeks post operatively. These activities will help prevent complications, such as blood clots (DVT/Pulmonary embolism) and pneumonia. It is okay to do simple housework and climb stairs. You should avoid playing sports and doing heavy exercises in a gym environment for 6-8 weeks.
You should not drive a car for three weeks post operatively. You may ride in a car; as always, wear a seat belt. We do recommend avoiding long trips by car, train, or airplane during the first two weeks after major gynaecological surgery. Long-haul flights are to be avoided for 6 weeks to reduce the risk of thrombosis (DVT/ Pulmonary embolism).
After most types of gynaecological surgery, you should not put anything in your vagina until the tissues are completely healed. Otherwise, you may develop an infection or interfere with healing. This includes tampons, douches, fingers, and all types of sexual activity that involve the vagina. These activities should be avoided for 8 weeks after hysterectomy.
You may feel fatigued. You will require up to 4-6 weeks off work to allow appropriate recovery. Time off work also depends upon your daily activities at work; a person who sits at work may be able to return to work sooner than someone whose job requires them to stand, walk, or lift. You should have returned to normal activity within two to three months, although full recovery may take longer rarely.
You will no longer have periods after a hysterectomy; however, this doesn’t mean that you have gone into menopause. If your ovaries are conserved at surgery a hysterectomy will not cause menopause and hence you will not automatically require menopausal hormone therapy. If you were prescribed Vagifem pessaries to use pre-operatively you should recommence them approximately 2 weeks after surgery. Speak to the Nurse if you are unsure.
For most of the women hysterectomy surgery does not have a negative effect on sexual function.

What post-operative follow up will I have?

  1. Dr Zachariah will visit you in the hospital on post-operative Day 1. A discharge plan will be made. Please remember, the least number of days in the hospital is the best for you.
  2. You will receive a call from Dr Zachariah’s rooms 5 -7 days after surgery to check on your condition. Carolyn, Dr Zachariah’s Nurse will discuss the pathology report if available. If you have any concerns, you may discuss with Carolyn.
  3. You will have a follow up appointment with Dr Zachariah in person 6 weeks after surgery. In the meantime, if you have any concerns, you may call or email the rooms. We will make every effort to resolve your concerns.

Potential Complications after discharge

  • Your wound becomes red or inflamed, painful.
  • You have heavy vaginal bleeding – heavier than a normal period.
  • You have offensive or abnormal vaginal discharge.
  • You develop a fever i.e., temperature >380 C, or you are feeling unwell.
  • You have pain that is not relieved by simple analgesia.
  • Nausea and vomiting that is difficult to manage.
  • You are having difficulty passing urine or opening your bowels.
  • Swelling in an extremity (leg or arm) that is much greater on one side than the other.
  • Shortness of breath or chest pain.

Contact

  • For post-operative complications as listed above please contact Dr Zachariah’s rooms on: 08 9389 5000.
  • During out of hours or weekends please call Hollywood Hospital Switch board on 08 9346 6000 and ask to speak with the Nurse Co-ordinator who will liaise with Dr Zachariah.
  • For non-urgent matters, please contact your GP.
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