Duration of Bed Rest After a Hysterectomy

A hysterectomy is the removal of the uterus (womb) and usually the cervix (neck of the womb). Depending on the reason for a hysterectomy, the surgeon may also remove the tubes (salpingectomy) and ovaries (oophorectomy). A hysterectomy is performed under general anesthesia. The different types of hysterectomy include:

• Total hysterectomy: The most common type of hysterectomy, this surgery removes the entire uterus, including the cervix. The ovaries and fallopian tubes may or may not be removed.
• Partial hysterectomy: It is also called a subtotal or supracervical hysterectomy. In this procedure, only the upper part of the uterus is removed. The cervix is left in place. The ovaries may or may not be removed.
• Radical hysterectomy: All of the uterus, cervix, tissue on both sides of the cervix, and upper part of the vagina are removed. This is often used to treat certain types of cancer such as cervical cancer. The fallopian tubes and ovaries may or may not be removed.

There are three possible methods of doing a hysterectomy:

• Abdominal hysterectomy: The uterus, cervix, (plus or minus) fallopian tubes, and ovaries may be removed through a vertical (standing direction) or horizontal (sleeping direction) incision in the abdomen. Hospital stay will be for –four to five days.
• Vaginal hysterectomy: The uterus and cervix will be removed through an incision made at the top of the vagina. The fallopian tubes and ovaries may also be removed if there are risk factors. The vagina gets loose approximately 1-2 cm in length as a result of the surgery. A hospital stay may be for –two to three days.
• Laparoscopically assisted vaginal hysterectomy: This hysterectomy is performed under the guidance of a special camera passed through a “keyhole” in the abdomen and with other instruments passed through separate “keyholes.” The uterus is most commonly removed through the vagina, although sometimes it might be morcellated (removed in small pieces) through the keyholes. In some cases, the entire operation is performed through the keyholes (total laparoscopic hysterectomy).

In general, patients may need to be mentally and physically ready to accept the after-effects of a hysterectomy:

• The first 24 hours after a hysterectomy, patients may experience some vaginal bleeding that slowly tapers off. If the bleeding seems to be getting heavier rather than lighter, the physician should be notified immediately.
• Patients may feel extremely tired afterward; tiredness may last for up to several weeks. Try to take frequent rest breaks to gradually regain strength.
• For several weeks, patients may have a vaginal discharge that appears bloody at first, then gradually becomes thinner and lighter over time.
• If both the ovaries are removed, patients may experience symptoms of menopause, including hot flashes, night sweats, and vaginal dryness. If necessary, the physician may recommend hormone replacement therapy to help alleviate discomfort.
• Patients may have a sense of loss that causes depression and decreased appetite, concentration, and sleep. These feelings and reactions are normal and should diminish with time. If they persist or significantly disrupt life, patients are encouraged to talk with the physician or supportive care provider such as a psychologist.

The physician should be immediately notified if patients experience

• Fever or other signs of infection
• Heavy bleeding (soaking through a pad in less than one hour)
• Severe pain that does not respond to medications
• Nausea or vomiting
• Diarrhea or constipation
• Difficulty urinating or a foul odor from the vagina