I hope the following information will be useful to you in preparation for your Laparoscopic Hysterectomy. Your recovery period forms an important part of your wellbeing.

Before coming into hospital:

• Make sure you are well hydrated before your surgery. This will help prevent nausea and constipation after your operation.
• Have some peppermint tea or cordial at home ready for your return. Peppermint is very helpful in relieving wind which many ladies experience after surgery.

Useful items to take into 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.
• 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 for you to bring. You must not use tampons to manage any bleeding following your surgery as this will increase your risk of infection.

Post-operative recovery week one:

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 for long periods cooking meals when you get home.

For you ladies who are thinking of getting back to your computers and work phones, please don’t – remember this is your time.

Anaesthetics can affect people in different ways. You may find your concentration span is 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.

• You will feel tired for the next few weeks. It is not unusual to “nap” in the afternoon.
• You may experience trapped wind after your procedure. This can present with shoulder tip pain whereby you feel discomfort at the top of your shoulders which may or may not radiate up through to your neck. You can also experience discomfort under your ribs. If this happens, sit up and take slow deep breaths to allow the trapped wind to dissipate. This discomfort should pass quickly.
• Do get up and walk about regularly as this will help keep your bowels regular and help reduce the wind.
• Be careful not to over eat as you will not be as mobile as usual so will not burn calories at your normal rate. This is often the reason why some ladies put on weight after a hysterectomy.
• Eating a healthy balanced diet will aid healing.
• Ensure you have a good fluid intake. This will help with keeping your bowels regular. A fluid intake of 2 ½ litres a day is recommended (this includes tea, coffee and soups).
• Constipation should be avoided as this can make you feel very uncomfortable and cause cramping pain in your abdomen. We can prescribe medication for you to take home to help prevent constipation or you can use natural remedies such as figs or prunes if you prefer.
• You will be discharged home with waterproof dressings covering your abdominal wounds. Do not remove these dressings unless they pucker, come loose or get wet when showering. If you change your dressings, please do not touch your wounds directly.
• You may shower the day after your surgery as long as you are not feeling faint or dizzy. Avoid having the water too hot and have someone with you in case you do feel faint whilst in the shower. If you do feel faint, get out of the shower and lie flat on the floor. The feeling should pass quickly. Sit up slowly after lying down to allow your blood pressure to settle.
• No lifting anything more than a half filled light kettle.
• You may experience a vaginal discharge/loss in the first week. This will lessen over the next 2-3 weeks with some occasional spotting.
• 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 no warning. This will settle quickly.
• You can start gentle pelvic floor exercises but please do not get concerned if you feel achy after doing them. You may find them difficult especially if you didn’t do them before your surgery. Just do one or two repetitions to start with. By week two to three surgical swelling should start to settle which makes doing your pelvic exercises easier. Please speak to the physiotherapist before you leave the hospital if you are not sure how to do these.

Post-operative recovery week two:

You can now do a little more.

• Your stitches will be removed one week after surgery. This is usually done 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 can go for short walks if you are feeling up to it.
• For those of you who work from home (computer/telephone), pace yourselves. You may find you tire quickly. If you are still taking pain relief it may be better to wait another week before working from home.
• Going out for lunch and dinner is completely acceptable! You will not be ready to drive just yet! Be patient.
• If you go out, you will get tired, so let family and friends know that mammoth shopping trips are off for a week or two.
• Still no lifting anything heavier than a half filled kettle.

Week 3-4

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 no longer taking pain relief and you are feeling well, you may drive. 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. Drive short distances to start and it is advisable to take someone 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.
• For those ladies who like ironing, these are the weeks you can get back to your ironing stations. 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 the time. You may find it better to sit whilst ironing. Standing for long periods will cause a dragging ache in the vagina/pelvis.
• Vacuuming – Yes you can vacuum but one room at a time and no carrying the vacuum up stairs. If you feel any pulling or discomfort whilst doing this, please stop and try again in a few days.

Week 4-6

Over next two weeks, you gather a little more pace and feel ready to do more.

• Remember, no heavy lifting. This may require life style changes for some when lifting is involved, as we do not advise you to lift heavy furniture or carry out heavy manual work. This will reduce your risk of prolapse in the future.
• You will feel more able to walk longer distances now. No marathons yet though!
• No public bathing, saunas or Jacuzzis yet.
• If you have not had your cervix removed, it will be fine for you to attempt intercourse if you feel comfortable. Many ladies feel very anxious about this. Some prefer to wait until their six week post-operative check-up for reassurance.
• Those of you who have had their cervix removed, we advise you to wait until your six week check-up before attempting intercourse. Occasionally you can get a little over healing at the top of the vagina which is very easily treated in clinic at your six week check-up.
• Week six is the time when you are invited to see the physio. The physio will check that you are using the correct muscles to do your pelvic floor exercises. To keep up your pelvic floor tone you will need to do them regularly.
• You will have a follow up appointment with Mr Griffiths to check you are recovering well. If you have had your cervix removed or any surgery to your pelvic floor, a vaginal examination may take place. This will allow Mr Griffiths to check that you have healed internally.

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, 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.
• You experience persistent chest pain or calf pain.

***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.