Total Laparoscopic Hysterectomy: Post Surgery
Starting HRT (hormone replacement therapy)
If your ovaries have been removed during your operation, you may need HRT. This will be discussed with you and is best started about four weeks after surgery, as there is a slightly increased risk of developing DVT if taken too early.
Cervical screening (smears)
If you have had a total hysterectomy, smear tests will no longer be required.
Tiredness and feeling emotional
You will probably feel very tired after your operation as your body is using a lot of energy to heal itself. You may even need to take an afternoon nap for the first few days, and if you were previously very active this may seem uncharacteristic. Don’t worry if you feel emotional as this is common in the first few weeks.
It is important to rest for the first few days after you get home. You must not do any strenuous activity six weeks.
Pelvic-floor muscle exercise
Your pelvic-floor muscles span the base of your pelvis. They help to keep your pelvic organs in the correct position (i.e. prevent prolapse) and tightly close your bladder and bowel (stop urinary or anal incontinence). It is important for you to get these muscles working properly after your operation, even if you have stitches, and your physiotherapist will advise you how to do this.
To identify your pelvic-floor muscles, imagine you are trying to stop yourself from passing wind, or squeeze tightly inside your vagina. When you do this you should feel your muscles ‘lift and squeeze’.
It is important to breathe normally while you are doing pelvic-floor muscle exercises. You may also feel some gentle tightening in your lower abdominal muscles which is normal. Women used to be told to practise their pelvic-floor muscle exercises by stopping the flow of urine midstream but this is no longer recommended.
You can begin these exercises gently once your catheter has been removed and you are able to pass urine on your own. You need to practice short squeezes as well as long squeezes:
- Short squeezes are when you tighten your pelvic-floor muscles for one second and then relax.
- Long squeezes are when you tighten your pelvic-floor muscles, hold for several seconds and then relax.
Start with what is comfortable for you and then gradually increase, aiming for ten long squeezes, up to ten seconds each, followed by ten short squeezes.
You should do pelvic-floor muscle exercises at least three times a day. At first you may find it easier to do them when you are lying down or sitting. As your muscles improve, aim to do your exercises when you are standing up. It is very important to tighten your pelvic-floor muscles before you do anything that may put them under pressure, such as lifting heavy objects.
Keep your bowels working
Your bowels may take time to return to normal after your operation. You may initially need to take laxatives to avoid straining and constipation. You may find it more comfortable to hold your abdomen (to provide support) the first couple of times your bowels move.
Straining to empty your bowels (constipation) may weaken your pelvic-floor muscles and should be avoided. If you suffer from constipation or find the pelvic-floor muscle exercises difficult, you may benefit from seeing a specialist women’s health physiotherapist.
Stopping smoking will benefit your health in all sorts of ways such as reducing the risk of a wound infection or chest problems and DVT following your anaesthetic.
Support from your family and friends
Everyone around you will be keen to help and you should take advantage of this. Some friends and family may offer advice on what you should or shouldn’t do. Bear in mind that this will usually be based on their own experience or something they have read and it may not apply to you This information sheet, together with advice from Dr Martin and the physiotherapists and ward staff should answer any questions you may have.
A positive outlook
Remember that after an initial period of rest we are keen that you quickly start to get back to a normal daily routine.
Your hysterectomy might be a good starting point for other lifestyle choices such as regular exercise, stopping smoking and ensuring a healthy, high fibre diet.
Recovering after an operation is a very individual experience and if you feel that there is a problem, you can seek advice from the hospital or your own GP.