This is the removal of the womb through the vaginal route. There will not be any scars on the abdomen.
Your doctor will discuss with you about the removal of the ovaries. This is usually recommended if you are approaching menopause or is post-menopausal. This can usually be done by the vaginal route as well.
If there is a prolapse of the bladder (cystocele) or rectum (rectocele), a pelvic floor repair may be done at the same time. Continence procedure like a TVT/TVT-O may also be done if there is stress urinary incontinence.
This depends on individual needs. Your doctor will discuss further with you on this.
Hormonal therapy in the form of oestrogen cream or vaginal pessaries, could be given to you before the operation if you are menopausal. This aids in the surgery and optimises the healing process. Usually, tests are done 1-2 weeks before surgery to assess your fitness for anaesthesia and for operation. You may be admitted a day before the operation. The anaesthetist may review you before the operation if you have other medical problems. You will be given medication to clear your bowels the night before surgery. Fasting starts from 12 midnight the day before surgery.
On the day of surgery, you will be transferred to the "Waiting Area" in the operating theatre about half an hour before the scheduled surgery. The nurses will check on your identification and the type of surgery. The anaesthetist will again review your case before giving you anaesthesia.
Usually you can choose either regional or general anaesthesia. The anaesthetist will discuss with you on this.
You will have a urinary catheter and a vaginal gauze pack inserted. You will be observed for an hour in the operating theatre's "Recovery Area" before being transferred out to the ward, post-operative area in Ward 42 or to the Intensive Care Unit depending on circumstances.
Are There Any Risks From This Surgery?
Complications are rare but just like any other surgery, there are risks involved. The common complications are:
Other risks involved:
Usually, you will be prescribed pain-killers and complete a course of antibiotics. You might be prescribed some medication to aid in passing soft stools.
You can usually start drinking fluids the day after surgery, and sometimes the same evening of the surgery. Once you can retain the fluids, the drip and catheter will be taken off and you can go on to take soft diet.
If anterior pelvic floor repair is done, the catheter will be removed 2 days after surgery and your ability to pass urine monitored by checking the amount of urine remaining in the bladder about 6 hours later. Some patients may need a slightly longer period of catheterisation before normal bladder function returns.
Should vaginal hysterectomy alone be done, then the catheter may be removed the day after surgery and you can pass urine freely on your own.
This is usually done the morning after the surgery. You may have spotting/staining vaginally up to 2 - 3 weeks after surgery.
You usually start with sitting out of your bed the morning after surgery and if you feel well enough, you should be able to walk slowly the afternoon or evening after surgery.
The KK Urogynaecology Centre does not recommend any restriction on your diet.
You can be discharged once you can pass urine well, when there is no complication of surgery and when you feel well enough to be discharged. This averages 1 - 3 days. The doctors will assess you daily and will keep you informed.
Early ambulation is encouraged. Carrying of heavy loads is discouraged in the long run. You will be given 1 month medical leave and will be reviewed by your doctor a month after discharge.
Yes, after healing of the surgical wounds, usually after 4 - 6 weeks.
You are most welcome to consult your surgeon during office hours, and the O&G 24-Hour Clinic.
If you should feel unwell and want to postpone your surgery, please inform your surgeon early so that the operating theatre can be used by another patient.