Hysterectomy is a gynecologic surgery in which the surgeon removes the uterus (womb). About 300,000 women undergo this procedure each year in the US. Your doctor may recommend a hysterectomy to treat pelvic pain, painful periods, or abnormal heavy vaginal bleeding that does not respond to other treatments, severe endometriosis, uterine fibroids, uterine prolapse (pelvic floor weakness), cervical cancer, or uterine cancer. 

After a hysterectomy, you will no longer have menstrual periods, and you cannot get pregnant. Recovery time after a hysterectomy is usually four to six weeks, but it can be up to eight weeks in some cases. Please continue reading to learn more about hysterectomy recovery.

What are the various types of hysterectomy?

A supracervical hysterectomy involves removing the entire uterus but leaving the cervix intact. A total hysterectomy involves the removal of the uterus and cervix, leaving the ovaries in place. 

Sometimes, in addition to the uterus, other organs in the female pelvis, such as both ovaries and fallopian tubes, are removed. This is called a bilateral salpingo-oophorectomy. Women who haven’t had menopause yet and have their ovaries removed will experience menopausal symptoms after hysterectomy. 

The most extensive type of hysterectomy is a radical hysterectomy, which is done to treat cancer. It involves the removal of the uterus, cervix, ovaries, fallopian tubes, and upper vagina, as well as surrounding tissues and lymph nodes.

How is hysterectomy surgery done?

Vaginal hysterectomy

An external incision (cut) is made in the vagina to remove the uterus. This procedure is done when the reason for the hysterectomy is a non-malignant (non-cancerous) condition such as uterine prolapse. 

Laparoscopic hysterectomy

In this procedure, the surgeon makes a small incision near your belly button and inserts a laparoscope (a tube-like instrument with a camera). Additional small incisions are made in the abdomen for other surgical instruments. The uterus is cut into pieces and removed through the abdominal incisions or the vagina. It can be a laparoscopic-assisted vaginal hysterectomy or a laparoscopic supracervical hysterectomy. This surgery can be done with robotic assistance as well. 

Abdominal hysterectomy

This surgical approach involves making an approximately 6-inch incision in the lower abdomen near the pubic bone, through which the uterus is removed. This surgical method is chosen when there is a medical history of cancer.

Is there a difference in recovery time between abdominal hysterectomy, vaginal hysterectomy, and laparoscopic hysterectomy?

Laparoscopic and vaginal hysterectomies are less invasive procedures with a shorter recovery period compared to abdominal hysterectomies.

A vaginal hysterectomy is the preferred approach whenever possible. This method of surgical removal of the uterus is associated with the fewest complications and the fastest recovery (approximately 4 weeks). You may be able to go home the same day of the surgery.

Recovery after laparoscopic hysterectomy is also faster and less painful compared to an abdominal hysterectomy. You may go home the same day or after an overnight stay.

After an abdominal hysterectomy, you may need to remain in the hospital for 2-3 days. Also, hysterectomy recovery is longer after open abdominal surgery.

How painful is recovery from a hysterectomy?

Hysterectomy is an invasive procedure and major surgery. There can be some residual pain for up to 3 months as your body heals. 

Remember, the surgery itself is done using either general anesthesia or regional anesthesia, so you will not feel any pain during the procedure. However, you may wake up with some pain. Your doctors will prescribe pain medication to relieve discomfort and keep severe pain under control. 

How long is complete recovery after a hysterectomy?

The average recovery time after a hysterectomy is four to six weeks. As mentioned above, recovery after a vaginal or laparoscopic hysterectomy is faster (two to four weeks) compared to an abdominal hysterectomy (six to eight weeks). 

What precautions should I take post-hysterectomy?

It is common to experience light vaginal bleeding for up to six weeks after your hysterectomy surgery. Use a sanitary pad or panty liner for this bleeding. Do not put anything, including a tampon, inside your vagina. You will need to take this precaution for four to six weeks during the recovery period or as long as your doctor advises. Do not have sexual intercourse for at least six weeks post-hysterectomy.

Avoid heavy lifting (objects weighing more than 10 pounds) for four to six weeks. This is to protect your healing incisions.

Keep your incisions clean and dry. A bandage is not usually necessary. You can shower after the surgery. The stitches may dissolve on their own in the first few weeks. If surgical staples are used, you will need to return to your doctor’s office to have them removed. 

You can start driving within a few days after a laparoscopic or vaginal hysterectomy and about two weeks after an abdominal hysterectomy. Do not drive if you are taking narcotic medication for pain control. 

Resume your usual exercise routine gradually over four to six weeks. Stop exercising if you develop discomfort or pain.

Call your doctor without delay if you develop fever, chills, heavy bleeding, foul-smelling vaginal discharge, urinary symptoms, or increased drainage, swelling, or redness in the incision. Also, tell your doctor if you have not had a bowel movement within four to five days of the surgery.

How soon can I walk after a hysterectomy?

Your doctors will encourage you to walk as soon as possible after your surgery to prevent blood clots from forming in your legs.

How long do you have to be on bed rest after a hysterectomy?

You should rest as much as possible for at least two weeks. However, remember that surgery and bed rest can put you at risk of blood clots. Get up and walk around as soon as you can. Slowly increase your activity level and stop to rest if you feel any discomfort or pain.

Can I go back to work 2 weeks after hysterectomy? 

Most people go back to work three to six weeks after a hysterectomy. However, you may be able to go back to work two weeks after a hysterectomy, depending on the type of hysterectomy you had and the type of work you do. For example, if you had a laparoscopic or vaginal hysterectomy and do desk work, you may be able to return to work in two weeks, provided you feel well and have no complications. 

Does sex feel different after a hysterectomy?

Sex does not feel different and sexual function remains intact for women and their partners after a hysterectomy. However, if your ovaries were removed, you may develop early menopause with symptoms including hot flashes, vaginal dryness, mood swings, night sweats, and insomnia. Using a vaginal lubricant during sexual intercourse can help with vaginal dryness. If the menopausal symptoms are severe, your doctor may recommend HRT (hormone replacement therapy)
 

References:

1. https://my.clevelandclinic.org/health/treatments/4852-hysterectomy