Patient education: Hysterectomy – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

What is a hysterectomy? — A hysterectomy is surgery to remove the uterus (figure 1). The uterus is the part of your body that carries a baby if you are pregnant. If you have a hysterectomy, you will not be able to get pregnant.

A hysterectomy can be done in 3 ways:

●Open surgery – During an open surgery, the doctor makes a cut, or "incision," in the belly to remove the uterus.

●Minimally invasive surgery – "Minimally invasive" surgery lets the doctor make smaller cuts in the belly. They insert long, thin tools through the cuts. One of the tools has a camera (called a "laparoscope") on the end, which sends pictures to a TV screen. The doctor can look at the screen to see inside the belly. Then, they use the long tools to do the surgery. They can control the tools directly, or with the help of a robot (this is called "robot-assisted" surgery).

●Vaginal surgery – For this type of surgery, the doctor makes a cut in the vagina to remove the uterus.

How long it takes for you to recover, and what you need to do, depends on which type of surgery you had. If you had minimally invasive surgery or a vaginal hysterectomy, you likely will return to your normal activities sooner. With an open surgery, it usually takes longer to recover.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

For the first 24 hours after surgery:

●Do not drive or operate heavy or dangerous machinery.

●Do not make any important decisions or sign any important papers.

●Do not drink alcohol of any kind.

You should also:

●Use pads if you have some light vaginal bleeding or spotting. This can be pink to brown or yellow colored and can last for a few weeks.

●Avoid putting anything in your vagina until the tissues are completely healed. Putting things in the vagina can increase the risk of infection and affect healing. This includes tampons, douches, fingers, and all types of sexual activity that involve the vagina.

●Take all of your medicines as instructed. If the doctor removed your ovaries, you might start hormone treatment after surgery.

●Take care of your incision – You might have stitches, skin staples, surgical glue, or a special skin tape on your incision. If you had laparoscopic surgery, you might have more than 1 incision. With a vaginal hysterectomy, your stitches are inside of your vagina and will dissolve on their own.

•Keep your incision dry and covered with a bandage for the first 1 to 2 days after surgery. Your doctor or nurse will tell you exactly how long to keep your incision dry.

•Once you no longer need to keep your incision dry, gently wash it with soap and water whenever you take a shower. Do not put your incision underwater, such as in a bath, pool, or lake. This can slow healing and raise your chance of getting an infection.

•After you wash your incision, pat it dry. Your doctor or nurse will tell you if you need to put an antibiotic ointment on the incision. They will also tell you if you need to cover your incision with a bandage or gauze.

•Always wash your hands before and after you touch your incision or bandage.

●Increase your activity slowly – Start with short walks around your home, and walk a little more each day.

•Use your incentive spirometer (if you got one) after you go home. This is a handheld device that you breathe into. This will help prevent lung infections.

•If you had an open surgery, press a pillow across your incision when you cough, sneeze, or take deep breaths. This will support the wound and help ease pain.

•Your doctor or nurse will talk with you about how long to avoid activities like heavy lifting, sports, or swimming. The length of time is based on what type of surgery you had (laparoscopic, open, or vaginal).

●Eat when you are hungry – If you have an upset stomach, it might help to start with clear liquids and foods that are easy to digest, like soup, pudding, toast, or eggs. You can eat other types of foods when you feel ready. If your doctor or nurse gave you specific instructions about what to eat or avoid, follow them.

●Be aware that your bowel movements might take some time to get back to normal. Eat small meals that are high in fiber. Drink plenty of water each day to avoid constipation. Taking opioid pain medicines can also make you constipated. Take a stool softener to prevent this problem. Ask your doctor or nurse if you have questions about this.

●Be aware that if you had laparoscopic surgery, you might have some pain in your shoulder. This is from the gas the doctor put into your belly for the surgery. Walking and moving around will help to reduce the gas and ease the pain.

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. Go to these appointments.

If you have stitches or staples in your skin, you will need to have them taken out. Your doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or tape, it will fall off on its own. Do not pick at it or try to remove it yourself.

When should I call the doctor? — Call for advice if you have:

●A fever of 100.4°F (38°C) or higher, or chills

●Redness or swelling around your incisions

●Vomiting for more than 24 hours after going home

●So much vaginal bleeding that you soak a large pad in an hour

●Trouble having a bowel movement

●Vaginal discharge that is smelly, green, or dark yellow

●Symptoms of depression, like feeling sad most of the time or losing interest in things you used to enjoy

●Any symptoms that worry you

More on this topic

Patient education: Hysterectomy (The Basics)
Patient education: Deciding to have a hysterectomy (The Basics)
Patient education: Uterine cancer (The Basics)
Patient education: Uterine fibroids (The Basics)
Patient education: Endometriosis (The Basics)
Patient education: Postpartum hemorrhage (The Basics)
Patient education: Pelvic organ prolapse (The Basics)

Patient education: Care after gynecologic surgery (Beyond the Basics)
Patient education: Vaginal hysterectomy (Beyond the Basics)
Patient education: Abdominal hysterectomy (Beyond the Basics)
Patient education: Endometriosis (Beyond the Basics)
Patient education: Uterine fibroids (Beyond the Basics)
Patient education: Menopausal hormone therapy (Beyond the Basics)