You can expect to be in hospital for three to five days, occasionally longer. Before leaving the hospital, discuss with your Physiotherapist the exercises you need to do to facilitate a good recovery.

It is important to understand the level of activities you are capable of doing. It will take you up to six weeks to recover from your surgery, so you will need someone to help you for at least the first week after you get home. If there is no one at home to do the general housework, you will need to try and arrange for someone to come in and help. If this is a problem for you, discuss it with your Nurse who can assess whether you qualify for home help arranged through the hospital. This facility is limited.

At Home

• Rest is important in assisting your recovery, so ensure that you are looking after yourself and getting the rest your body requires. Some days you will need more rest than others - take it if you need it! You may find it useful to take mild pain relief medication in the morning and evening for the first few days that you are home.
  

• Exercise - Walking - Plan a daily walking programme, starting slowly and building up a little each day. Listen to your body and assess how you feel after a short walk. If you have managed that distance comfortably, increase it a little the next day

• Abdominal's - after abdominal surgery your muscles need to be strengthened again. You should start doing abdominal exercises one week after your surgery and continue for 6 - 8 weeks. Check with your Physiotherapist which abdominal exercises and what sort of programme is suitable for you.

• Sports - activities of high impact, for example, running, tennis, netball, should be avoided for 10 - 12 weeks following surgery. Low impact activities may be started gradually 6 weeks following surgery

To begin with avoid:

When you resume lifting, it is important to use correct bending and lifting techniques

Driving should be avoided for the first two weeks after your operation to allow your stomach muscles to recover some of their strength. You may also find that your concentration is poor and your reactions are slower due to the after effects of the anaesthetic. Insurance companies have different rules regarding driving after surgery. Check your insurance policy first.

Your pelvic floor muscles are attached from the pubic bone (at the front) to the tail bone (at the back), and to the sides of the pelvis. The main function of the pelvic floor muscles is to support the pelvic organs, bowel, uterus and bladder. If you have had a hysterectomy, the uterus will have been removed, but the pelvic floor muscles still need to support the bowel and bladder.

Following surgery the muscles can become weak and it is very important to exercise them to build up strength again. Pelvic floor muscle exercises should be started following surgery and continued for the rest of your life.

It may take a week or two for your bladder and bowels to function normally again. It is important to avoid constipation and particularly important that you do not strain when going to the toilet. It is better to take a mild laxative than to strain.

Your food intake has an important effect on bowel function. For the sake of your general health and bowel activity, make an attempt to change the way you eat so that you can say yes to each of the following:

• I drink at least 8 glasses of fluid a day

• I eat at least 4 slices of wholemeal bread a day. Remember to choose breads labelled wholemeal or with a dietary fibre content of at least 6g/100g

• I choose to eat high fibre breakfast cereals e.g, Weetbix, Branflakes, Muesli

• I have at least 5 servings of fruit and vegetables

• I eat meals and snacks at regular intervals throughout the day

• I include a daily walk

• I allow myself time to go to the toilet

As with all major surgery, a hysterectomy can be followed by the development of complications.

The immediate risks are:

Some of the long term complications may include:

After you have had a hysterectomy, it is important for you to find out from your Doctor whether or not you need to continue to have smear tests.

If you have had normal smears before your hysterectomy was done, and provided there were no abnormalities found when your uterus and cervix were examined, you do not need to have another smear test.

If your surgery was done because of cell abnormalities or cancer, you should have annual smear tests. This is called a vault smear as it taken from the top of the vagina.

Full recovery of health and well-being comes from a good balance and harmony of body, mind, emotions and spirit. Spiritual, psychological, emotional, physical, and social connections assist the healing process.

Physical ‘un wellness’ (such as excessive bleeding and pain) disturbs the overall sense of well-being. This causes harmony and balance to be lost.

For some women having a hysterectomy, grief and identity issues emerge. These are often related to loss of unique womanly body parts and the inability to have a child. Discussion of these issues and feelings with a trusted person can contribute to a return to health and well-being.

Hysterectomy may bring a sense of relief, excitement, a new lease of life, new beginnings and a desire to celebrate. Celebration signals a woman’s return to well-being, harmony and balance.

In addition, use of ritual , visualisation and meditation can also assist in the restoration of one’s spiritual well-being in particular. The result can be a new sense of wellness.

There is a variety of books and tapes available from book shops to assist you on your journey to full health and well-being.

It takes about four weeks for the top of the vagina to heal after a hysterectomy. If you have intercourse too soon after your hysterectomy the top of the vagina could hurt and the wound could get infected. It is important that your partner understands this as well as you.

If you wish to have sex with full penetration, ask your partner to go gently. Increasing the time spent love-making before penetration will help make things more enjoyable. Otherwise you might find this an excellent time to be as imaginative and creative as you can. Experiment with different positions that may lessen penetration. With the focus off penetrative sex you can experiment with new forms of sensuality and intimacy. Feel free to express yourself through plenty of touching, cuddling, massage, or anything else you enjoy.

Initiating sexual contact is difficult for many women. However, bear in mind that your partner is probably unsure as to when it is safe to resume your normal relationship so if you make the first move he will probably be grateful and it may give more confidence in yourself. If you take a dominant position, i.e. if you are the one on top, you can control the level of penetration more easily.

Sex could be tried just before the 6 weeks visit to the Doctor. If there have been any difficulties you can discuss these with the Doctor at this visit.

If you have a vaginal repair as well as a vaginal hysterectomy you may find your vagina is a little narrow to begin with, so you will both need to take care. It may take a few weeks before your vagina feels quite comfortable again. Sometimes a lubricant makes intercourse easier - try using KY jelly which can be bought at a chemist or supermarket.