Hysterectomy

In a woman of child-bearing age, one or more eggs will mature in the ovaries every 4th week. While the egg is maturing, a mucous lining will be developing in the uterus. It’s in this lining that a fertilized egg can burrow itself. But if no egg is fertilized that month, the lining simply perishes. It’s then expelled along with the egg as menstrual bleeding. This process is controlled by the hormones oestrogen and progesterone, and will normally be repeated once a month until the menopause. After menopause, the lining tends to get thinner.

Reasons for removing the uterus
Surgically removing the womb is the last-resort treatment of bleeding disturbances. So it needs to be considered carefully, and it requires careful investigation before making the decision.  

The reasons for deciding to have a hysterectomy include:

  • Bleeding disturbances: heavy, long-lasting and irregular bleedings. If medical treatment has been tried and failed, surgically removing the uterus can be the solution. Once the uterus has been removed, the menstrual bleedings will stop completely.
  • Fibroids: it is not possible to remove fibroids medically. It’s sometimes not possible to do so surgically either, and that’s the reason why it may be necessary to remove the uterus all together. It all depends on the size, number and location of the fibroids.
  • Pain: if the pain is invalidating, a hysterectomy may be the best solution.
The effects of the operation
Your menstrual bleedings stop and you can’t have children. Your sex life needn’t suffer. Actually, it may even improve if the reasons for the hysterectomy are severe pain or fibroids. Some women experience discomfort similar to the onset of menopause (hot flushes, night sweats and vaginal dryness). In that case hormone replacement treatment may be something to consider. 
If the ovaries are healthy, they’re normally left in place. And therefore they will, in most cases, continue to produce hormones.
Usually it’s not necessary to remove the cervix. But if you have invalidating pain, the pain may also be located in the cervix, and it may be necessary to remove the cervix as well.
If your cervix is not removed, you must continue the regular check-ups for cervical cancer.

Below you can read more about what happens during the operation.  

Before the operation

A hysterectomy requires that you stay in at our clinic for 1-2 days. When you’re released, you must have somebody to come and pick you up at the clinic and stay with you for the next 24 hours. It’s important that you tell the specialist before the procedure about any drugs or medicine you take, because some of them are dangerous in combination with the anaesthesia. Before the operation we’ll take some blood tests (e.g. haemoglobin percentage and blood group).
It’s also a good idea to stop smoking before the procedure if you can, because smoking slows down the healing of wounds, and that goes for the period after the operation as well. 

Fasting:
  1. You are not allowed to eat anything 6 hours before your operation.
  2. You are allowed to drink water and juice until 2 hours before your operation.

The operation

You’ll have general anaesthesia for the operation.  We’ll put an IV line in the back of your hand and give you the anaesthesia through it. There are two different ways to perform a hysterectomy: 
  • The uterus can be removed from below, through the vagina. The uterus is cut from the ligaments in the abdomen and removed through the vagina. 
  • The uterus can be removed from above, through the abdomen. Your abdomen is cut horizontally, just above the pubic hairline (bikini incision).
Which method is chosen depends on the reason why you’re having a hysterectomy. The operation takes 1-2 hours. The uterus is sent to the University’s Department of Pathology. You’ll have the results of their tests about 10 days after the operation.

After the operation

You should take it easy for a couple of days after the operation. 

Pain
It’s normal to experience pain after an abdominal hysterectomy; the pain is caused by the wound healing. A vaginal hysterectomy doesn’t normally cause any pain afterwards. 
But some women experience diffuse pelvic pains, a bearing-down sensation and pain during sexual intercourse for some months after the hysterectomy. 

Bleeding
You can expect a bit of bleeding for up to 4 weeks after the operation. The crust of the wound from the cervix will be expelled about 8-14 days after the operation, and then there may be a bit of fresh bleeding.

Hygiene
To avoid infection, you should not use tampons. And also, to avoid infection take showers only and don’t go swimming for a least 4 weeks after the operation.

Activity
You should take 4-6 weeks’ sick leave after the operation. How long exactly depends on the nature of your job and your age. For the first week after the operation, you’ll need help for most daily tasks. 
You can have sex again after 3-4 weeks.

Diet
It’s important to stay regular by eating foods with lots of fibres and taking walks. You should drink about 1½ litres of fluid every day. 

Check-up
You come in for a check-up 4 weeks after the operation.

Side-effects and complications

If you have severe pain, fever or bleeding heavier than an ordinary period, you must contact the clinic at +45 8612 6121 or 2320 4221.