Having a hysterectomy

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1 Having a hysterectomy Gynaecology Oncology Information for patients Gynaecology

2 It is expected that you will have discussed other methods of treatment for your health concern with your doctor and have decided upon a hysterectomy. What is a hysterectomy? A hysterectomy is a surgical procedure that involves removing the uterus (womb), cervix (neck of the womb) and the fallopian tubes. Sometimes, one or both of the ovaries may also be removed. Your doctor will discuss and agree the exact procedure with you. Why do I need a hysterectomy? A hysterectomy may have been suggested as a treatment for the following conditions / symptoms: Endometrial (lining of the uterus) cancer Endometrial hyperplasia (thickening of the lining of the uterus) Cervical cancer Prophylactically (family history of related cancers) What are the benefits of having a hysterectomy? The aim will be to relieve or stop the symptoms you have been experiencing. It can provide information to help make a diagnosis or suggest suitable treatment options. page 2 of 8

3 What are the risks of having a hysterectomy? A hysterectomy is generally a safe procedure but as with any operation there are associated risks. These include: Damage to your internal organs (bowel, bladder, and ureter). This may happen during 1 in 500 operations but the risk may be slightly higher if you have had abdominal surgery before. Damage to major blood vessels requiring immediate repair. Infection is rare but may occur in your urinary tract and abdominal wounds. Internal bleeding may happen and in severe cases a blood transfusion may be required. Blood clots in the veins in your legs or lungs. Please also read the leaflet 'Preventing blood clots while you are in hospital and after you leave'. Not all women who have a hysterectomy need to have their ovaries removed. However, even if your ovaries are not removed there is still a small risk that you will experience an earlier menopause. As with any procedure we must seek your consent beforehand. Staff will explain the risks, benefits and alternatives where relevant before they ask for your consent. If you are unsure about any aspect of the procedure or treatment proposed, please do not hesitate to ask for more information. page 3 of 8

4 How is a hysterectomy done? A hysterectomy is usually performed under a general anaesthetic (you are asleep) and can be carried out in the following ways: Total Abdominal Hysterectomy (TAH) This type of hysterectomy is done by removing the uterus, cervix and fallopian tubes through a cut in your abdomen (laparotomy). The cut is usually very low down and is known as a bikini line cut. Sometimes it is necessary to do a cut that runs up and down your abdomen. This usually happens if the uterus is very large or if the doctor needs to get the best possible view inside your abdomen. The operation takes approximately 1 hour. Your estimated length of stay in hospital will be 2-3 days. Radical Hysterectomy This type of hysterectomy is done by removing the uterus, cervix, fallopian tubes, part of the vagina and lymph glands through a cut in your abdomen (laparotomy). The cut is usually very low down and is known as a bikini line cut. Sometimes it is necessary to do a cut that runs up and down your abdomen. This usually happens if the uterus is very large or if the doctor needs to get the best possible view inside your abdomen. The operation takes approximately 1-2 hours. Your estimated length of stay in hospital will be 2-3 days. page 4 of 8

5 Laparoscopically Assisted Vaginal Hysterectomy (LAVH) This type of hysterectomy is done using laparoscopic (keyhole) surgery. When you are under anaesthetic an internal examination will be performed and your bladder will be emptied. A small cut is made in your skin at the umbilicus (navel/belly button) and a needle or port is passed through the skin into your abdominal cavity, which is then filled with gas (carbon dioxide). The laparoscope (telescope) is inserted through this umbilical cut to look inside the abdomen. A second cut is often made above your pubic hair line to allow a second instrument to be inserted. Further small cuts may be made on either side of your abdomen. The remainder of the operation is performed through the vagina. The operation takes approximately 1 hour. Your estimated length of stay in hospital will be 1-2 days. Total Laparoscopic Hysterectomy (TLH) This type of hysterectomy is done using laparoscopic (keyhole) surgery. When you are under anaesthetic an internal examination will be performed and your bladder will be emptied. A small cut is made in your skin at the umbilicus (navel/belly button) and a needle or port is passed through the skin into your abdominal cavity, which is then filled with gas (carbon dioxide). The laparoscope (telescope) is inserted through this umbilical cut to look inside the abdomen. A second cut is often made above your pubic hair line to allow a second instrument to be inserted. Further small cuts may be made on either side of your abdomen. The remainder of the operation is performed through the vagina. Occasionally a cut has to be made in the vagina (an episiotomy) in order to make enough space to remove the uterus, cervix and fallopian tubes. The operation takes approximately 1 hour. You can go home on the same day of your operation or you may need to stay in hospital overnight. page 5 of 8

6 Robotically Assisted Hysterectomy This type of hysterectomy is done using laparoscopic (keyhole) surgery. When you are under anaesthetic an internal examination will be performed and your bladder will be emptied. A small cut is made in your skin at the umbilicus (navel/belly button) and a needle or port is passed through the skin into your abdominal cavity, which is then filled with gas (carbon dioxide). The laparoscope (telescope) is inserted through this umbilical cut to look inside the abdomen. A second cut is often made above your pubic hair line to allow a second instrument to be inserted. Further small cuts may be made on either side of your abdomen. The surgical instruments are robotically controlled using steady and precise movements via a computer. The operation takes approximately 1 hour. You can go home on the same day of your operation or you may need to stay in hospital overnight. page 6 of 8

7 How can I prepare for my operation? Please read the information leaflets provided at your outpatient and pre-operative assessment appointments. They will provide you with useful information so that you know what to expect during your admission to hospital. It is important that you tell us of any health problems you have and any medication you take. Please continue with any medication unless otherwise advised. To make sure that you are in the best possible health before you have your operation, you should: If you are a smoker, try to give up or cut down Lose weight if advised Eat a well-balanced diet Try to stop or cut down on drinking alcohol It is important that in the month before your surgery is planned you use barrier methods of contraception i.e. condoms, as surgery will be cancelled if you are pregnant When will I be able to go home after my operation? This will depend on the type of hysterectomy that you have had. You will be given an estimated length of stay in hospital during your gynaecology clinic appointment. Please refer to the information leaflet Going home after major gynaecological surgery (PIL33). This will provide you with useful discharge information. page 7 of 8

8 Is there anything I should look out for when I go home? You should contact the ward or your GP if you have any of the following: Vaginal bleeding that is heavy or smelly Wound(s) that becomes red, swollen or starts oozing You begin to feel feverish or unwell Pain that is not controlled with paracetamol or ibuprofen (or with the pain relief given by the hospital) Who can I contact if I have any questions? If you need any further information then please do not hesitate to contact: Gynaecology Outpatient Department: Gynaecology Ward G2: Produced with support from Sheffield Hospitals Charity Working together we can help local patients feel even better To donate visit Registered Charity No Alternative formats can be available on request. Please alternativeformats@sth.nhs.uk Sheffield Teaching Hospitals NHS Foundation Trust 2018 Re-use of all or any part of this document is governed by copyright and the Re-use of Public Sector Information Regulations 2005 SI 2005 No Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. infogov@sth.nhs.uk PD8680-PIL3666 v2 Issue Date: May Review Date: May 2021

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