I hope that you find the following information useful in the recovery phase of your abdominal hysterectomy. Your recovery period forms an important part of your wellbeing.

Items you may find useful whilst in hospital:

• Comfortable nightwear/underwear – nothing too tight as it is normal to feel bloated for a couple of weeks after your surgery.
• A small soft pillow – that you can hold in place over your tummy to give support to your wounds when deep breathing or wanting to cough. This pillow will come in handy to place between your tummy and the seat belt on the journey home. You are required by law to wear a seat belt, even after surgery.
• Loose outdoor clothing – for the journey home.
• Sanitary towels – one packet of sanitary towels should be enough for you to use post-operative. There is no preference to the type of sanitary towel you use. You must not use tampons to manage any bleeding following your surgery as this will increase your risk of infection.

Post-operative recovery weeks one and two

I like to describe week one as your “home cruise”. This week is a great opportunity to recharge your batteries and give yourself time to rest after your surgery. Let family and friends pamper you. As difficult as that may be for you “independent” ladies out there, taking this advice will pay off.

If help is limited, pace yourself and prepare meals for the freezer prior to coming into hospital so that you do not have to stand cooking meals for long periods when you get home.

If you were thinking of getting back to your computer or work phone, please don’t. Remember this is your time. Anaesthetics can affect people in different ways. You may find your concentration span short. This is completely normal and will return over the coming weeks. Making major decisions is not wise, especially if you’re taking pain relief.
It is normal to have moments when you feel quite tearful. It is worth mentioning this to your family as they may be taken by surprise when you become tearful with little or no warning. This will settle quickly.

• You will feel tired for the next few weeks.
• It is normal to want to “nap” in the morning and afternoons. We do not recommend that you stay in bed during the day. You can have a rest on the bed in the afternoon.
• Pace yourself. You will need a rest after showering and washing your hair. You will tire quickly.
• Do get up and walk about regularly as this will help keep your bowels regular and help reduce wind in your tummy.
• Be careful not to over eat as you will not be as mobile as usual, therefore calorie burn will not be at your normal rate. This is often the reason why ladies put on weight after a hysterectomy.
• Taking regular analgesia on your return home is recommended. The nurse/pharmacist will talk to you about pain relief on discharge. Taking codeine based pain relief can contribute to constipation so try to avoid using codeine pain if you can.
• Mr Griffiths would have discussed hormone replacement therapy (HRT) with you prior to surgery, if required. Please do not hesitate to talk to your Consultant or myself if you have any questions or concerns relating to HRT.
• Eating a healthy balance diet will aid healing.
• Ensure you have a good fluid intake as this will keep you hydrated and help keep your bowels regular. A fluid intake of 2 ½ litres a day is recommended (this includes tea, coffee and soups).
• Constipation can make you feel very uncomfortable and cause cramping pain in your abdomen, therefore best avoided. We can prescribe medication for you to take home to help prevent constipation. You can use natural remedies such as figs or prunes if you prefer.
• You will be discharged home with a dressing covering your abdominal wound. Do not remove this dressing unless it comes loose or gets wet when showering. Leave the dressing in place until you return to the hospital for removal of stitches. If you are unsure or are concerned about your wound please call the hospital helpline for further advice.
• Your stitches will normally be removed at 7 days if not dissolvable. This is usually done in outpatients at the hospital. If you live some way from the hospital we can arrange for your GP practice nurse to do this if it is more convenient for you. You will be advised by the nurse on discharge if you need sutures removed or a wound check.
• You may shower two days after your surgery as long as you have a waterproof dressing covering your wound. Please do not attempt to shower if you feel faint or dizzy. Have someone with you in case you do become faint whilst in the shower. If you do feel faint, get out of the shower and lie flat on the floor. Sit up slowly after lying down to prevent feeling faint again when sitting. The feeling should pass quickly.
• No lifting anything more than a half filled light kettle.
• You may experience a vaginal discharge/loss in the first week. The vaginal loss can continue for 2-3 weeks but will lessen with occasional spotting. Please do not use tampons to manage your discharge/loss as this can increase the risk of infection. It is possible to see a return in vaginal loss on increased activity. If you do have an increase in vaginal blood loss, rest and the bleeding should settle. If you feel unwell, have a temperature or the bleeding continues after resting, please call for advice.
• You can go for short walks but remember you will tire quickly. Keeping mobile will help prevent constipation and will help to reduce your risk thrombosis (blood clots). You will be advised to wear anti-embolic stockings at home.
• You can start gentle pelvic floor exercises. Do not worry if you are not able to complete many repetitions. If you ache after doing your pelvic floor exercises, leave it a few days before trying again. The physiotherapist will explain how to do the exercises before you leave hospital.

Weeks 3-4

You can now do a little more.

• You can walk a little further each day if you are feeling up to it.
• If you want to work from home, please pace yourself. You may find you still tire quickly.
• Going out for lunch and dinner is completely acceptable. You will not be ready to drive just yet, sorry. Don’t forget, long evenings out at dinner will tire you.
• You may bath if you have no discharge. Avoid heavy perfumed soaps and talcum powder.
• If you go out you will get tired, so let family and friends know that mammoth shopping trips are off for the time being.
• No lifting anything heavier than a half filled kettle.
• No public bathing or Jacuzzis just yet.

Weeks 5-6

You should be feeling much better in the coming weeks. Still be careful not to overdo it. Pacing yourself is very important.

• If you are an ironing fan, this is the time you can start ironing again. Get someone to set the ironing board up for you as these can be tricky to get into the right position. I would suggest you only do a little ironing at a time. You may find it better to sit whilst ironing. Standing for long periods will cause a dragging ache in the vagina/pelvis.
• You may feel ready to start driving. Do not attempt to drive if you are feeling unwell or still have abdominal pain. Before attempting to drive, it is advisable to try an emergency stop on the driveway without a key in the ignition. If you experience any pain, pulling or discomfort we advise that you do not drive. It is best to drive short distances to begin with and take someone with you who can takeover should you find driving uncomfortable. Your car insurance company may impose their own restrictions, so always call them prior to driving for the first time. Some ladies do not feel like attempting to drive until week six.
• Vacuuming – Yes you can vacuum but one room at a time and no carrying the vacuum up the stairs. If you feel any pulling or discomfort whilst doing this, please stop and try again in a few days.
• No heavy lifting. It will be around week 12 before you should start lifting slightly heavier items.
• Still no public bathing or Jacuzzis just yet.

Weeks 6-8

The next two weeks will be the time when you gather a little more pace and feel ready to do more.

• For those ladies who have not tried driving, you may feel more confident to do so in these coming weeks. Please follow the advice above.
• If you have had your cervix removed, it is advisable to wait until your post op check at around six weeks before attempting intercourse. Mr Griffiths will be able to check that your internal wound has healed. Occasionally you can get a little over healing which is very easily treated in clinic at your six week check-up.
• Still no heavy lifting.
• You will feel able to walk longer distances now. No marathons yet though!
• You may also be invited to see the physiotherapist as an outpatient to ensure you are carrying out your pelvic floor exercises correctly.
• If you are self-employed or carry out light work, Mr Griffiths will advise if it is appropriate for you to return to work. It is advisable to work shorter days/part time when you initially return as you will tire quickly. Your Consultant can provide you with a “fit note” for a phased return.

Weeks 9-12

If Mr Griffiths is happy for you to return to work before the 12th week of recovery it is best to return on shorter days. Take the time Mr Griffiths has suggested to complete your recovery.

You will spend the next few weeks gathering pace and resuming your normal activities at your normal pace.

By week twelve you should be able to do the majority of activities you did prior to surgery. Mr Griffiths will advise when you can return to the gym. We do not recommend returning to the gym before the twelve week. Your abdominal muscles are weakened by the surgery and will need time to heal. Return to exercise slowly, and allow time to build up to your pre-surgery fitness.

We recommend that you avoid lifting heavy articles such as flagstones, bags of compost or heavy suitcases to reduce the risk of damage to your pelvic floor. The risk of pelvic floor prolapse is slightly increased for those who have had their cervix removed.

When to call:

If you experience any of the symptoms below:

• If you bleed continually or are passing clots.
• If you have any discharge from your wounds.
• If you have any discharge from your vagina, especially watery, other than explained previously.
• You are feeling unwell; have a high temperature (feeling hot and cold).
• You have increased abdominal pain that is not managed with your regular pain relief.
• You are experiencing difficulty or pain passing urine.

***This information has been compiled as a guide. You may recover at a slightly different pace. If you feel you are slower than I have mentioned, do not worry. There are no hard and fast rules. I know you will be keen to get back to “normality” but be sensible, do not rush your recovery.***

Please do not hesitate to ask for any advice that may not have been covered in this booklet.