Hysterectomy Considerations
First of all, what is a hysterectomy? The term hysterectomy often refers to the surgical removal of the uterus and cervix. Removal of the fallopian tubes is called a salpingectomy, and removal of the ovaries is called oophorectomy. Oophda!, that is a lot of medical terms!!
Why are we even talking about this? First of all, it’s important to realize that a hysterectomy does not necessarily mean removal of the ovaries which are the hormone producers of the female reproductive system. The ovaries are what keep women of child-bearing age going through menstrual cycles with natural increases and decreases of estrogen and progesterone throughout their monthly cycle. So, removal of just the uterus for a younger women will not immediately cause her to undergo hot flashes, night sweats, and other intense symptoms associated with menopause.
Why do women have a hysterectomy? Some of the top reasons for performing a hysterectomy include:
Heavy bleeding
Intense cramping/pain during menstruation
Large fibroids causing bleeding or urinary incontinence or urgency
Cancer of the reproductive organs (uterus, cervix, endometrial tissue, ovaries)
During repair of prolapse (descending organs in the pelvic floor)
Endometriosis
Severe pelvic inflammatory disease (PID)
How is a hysterectomy performed? Minimally invasive procedures may include intra-vaginal removal of the uterus where a small incision is made at the top of the vaginal canal and the uterus is removed through that. Another is using laparoscopy where small scopes are placed in the abdominal wall to assist with removal of the uterus through an incision in the top of the vaginal canal. Lastly, the most difficulty recovery is with an abdominal hysterectomy which involves having the uterus removed through a larger incision on the abdominal wall. The type of procedure recommended to you would be unique to your situation and why you are needing the procedure to begin with.
What happens after a hysterectomy? All women who undergo surgical removal of the uterus will require some rest and recovery time. Generally, regardless of the type of hysterectomy performed a woman will be asked to avoid heavy lifting (>10-15#) for the first six weeks, and avoid inserting anything into the vaginal canal for that same duration to reduce the risk of an infection. Other items to note would be avoiding baths or swimming until the initial 6 weeks of healing is complete as well.
So, just like having any other surgery and recovery following that surgery, it is important to consider a progressive return to regular activities after the initial healing is complete. Often, women may just assume that they are “good to go” after their 6 week check up. However, if you have a shoulder surgery and are removed from an immobilizer sling after the first 6 weeks after surgery - you wouldn’t just go home and start throwing a baseball in the front yard with your kid!! So, we need to be mindful of this for women after childbirth or pelvic surgery such as a hysterectomy. See your local pelvic floor physical therapist at Shift Physical Therapy to help you safely and progressively return to the active lifestyle you want to be living. During the initial 6 weeks of recovery, there are also plenty of things you will need to be able to do. If you are struggling to move or get out of bed, see your pelvic floor specialist. We aren’t going to be working on “pelvic floor strengthening” or inserting anything into the vaginal canal, but we WILL help you with basic mobility strategies and help you move with less pain during your healing. You’re not alone in those first 6 weeks! You pelvic floor physical therapist can help educate you about what your body is going through and provide you some relief from pain in the healing process.
Written by: Renee Hancock, Pelvic Floor Physical Therapist
