My laparascopic total vaginal hysterectomy – Samira’s Story

Hi, I wanted to share my experience in the hope it might help others. I had severe and persistent daily bleeding for about 2 years before I decided to have an operation. I had biopsies and tests to check it wasn’t something nasty over that period. Despite the fact I was tired and at some point anaemic I wanted to try non surgical options.

I had a Mirena coil inserted and that reduced the severity of bleeding but wouldn’t stop. So I had a 6 month course of norethisterone which stopped the bleeding for 2 weeks out of 4 weeks at a time. Again this was better than before but still hadn’t solved the problem. My specialist advised me I couldn’t keep taking it and I made a decision to finally go ahead.
I wanted a laparoscopic procedure if possible as I had read recovery is quicker and I wanted to avoid a large abdominal wound. I also wanted the cervix removed because of I had a colposcopy 4 years ago, and though there was no further abnormality, I needed yearly smears, so I thought this is an opportunity to solve that as well. I had no other obvious abnormality so we agreed I would keep the ovaries and avoid premature menopause.

I am now about 7 weeks following a total laparoscopic assisted vaginal hysterectomy performed under general anaesthetic.

My operation was in the afternoon so I fasted from 7 am and has a last drink of water at 10 am as instructed. I went to the hospital at midday and admitted to the ward. I was very anxious. I found that the welcoming and matter of fact attitude of the staff is what helped me to remain calm. I changed into a theatre gown and put on surgical tights. The nurses joked at how unattractive the paper knickers were but it all helped. I had known from my pre op appointment that I would have a bladder catheter and vaginal pack – something they put to help stop bleeding and I was worried about how painful it might be afterwards.

The surgeon came to see me and I signed a consent form. I then met the anesthetist who was very cheery and reassuring. I was then collected by the cheery theatre staff at 1.45 pm, I almost changed my mind but my partner held my hand and before I knew it I was whisked down to the theatre and into the anaesthetic room. The staff talked to me all the time and I breathed through the mask and the next thing I knew I was all wrapped up, warm and comfortable in the recovery room. I looked at the clock on the wall, it was 5 pm and a huge rush of relief came over me!

When I returned to the ward my partner had been informed that it had taken around 2 hours to do the operation and around 45 minutes to recover but all went as planned.

That evening I remember as being comfortable. I did not have anything other than a drip though I must have had some sort of pain relief during and just after the surgery. The tights kept squeezing my lower legs but other than that I was warm and comfortable.

At midnight I had the catheter and vaginal pack removed. The nurse was very gentle but warned me it would be uncomfortable. The pack came out first, it was stuck and needed a gentle pull, then pulled out over about 10 seconds. That was sore, then the bladder catheter came out. It was sore as quickly the nurse deflated the little balloon and then in about 3 seconds, it was out. That was more painful but over very quickly and not as bad as I had been worried about before surgery.

I had to keep sipping water so that I would then be able to pass urine. At 5 am I called the nurse to help me to the toilet as I then felt I had to go. I was helped on to the toilet and she waited outside, door slightly ajar. It was the most difficult moment for me. No matter how hard I tried in my head, I couldn’t pee! It was like a fire down below and a small trickle of blood. I gave up and the nurse was so kind, that’s what helped me.

She told me not to worry, it was like this for lots of patients, I should try again in a few hours and eventually I would manage. I watched TV and fell asleep but woke at 7 am really needing to relieve myself and with the nurses help I sat on the toilet.

I was afraid it would be sore but a little push, I held my breath bracing myself, and a tiny trickle of urine which just dripped slowly over a minute into the toilet. I remember thinking of the relief and as if I had won some sort of race or battle ! Over the next 2 hours I returned to pee several times getting better each time. I thought, how fragile we are that my most major accomplishment is to be able to pass urine successfully!

Being able to go to the toilet gave me confidence to stand up and get out of bed. I had 3 small wounds on my tummy covered in small sticky dressings. My abdomen was swollen but not sore. Gas is used in laparoscopic surgery and in those first 2 days it irritated my breathing and made it painful to cough, laugh or lie down in certain ways, but it got better.
I had a shower the day after my surgery and walked out of the hospital to go home. I know that I could not have done this with an abdominal wound.

The surgeon came to see me before I left and told me everything had gone well and that I could stay another day or go home.

I was pleased as it was just as I had read about laparoscopic surgery. I was very tired and slept a lot but walked about the house in the first week. I did my pelvic floor exercises as instructed by the physio who I had met in hospital. They were hard and sometimes painful. I didn’t have a lot of pain in that first week but I needed strong painkillers to help me sleep. I was very worried about bowel movements as I didn’t want to strain and I took some over the over the counter laxatives, ate dried figs, fruit and drank lots of water and managed a gentle bowel movement after 3 days. I tried to avoid opiate painkillers like cocodamal to reduce constipation.

From then on I would say it isn’t like the information given about this procedure. I was able to walk outside after 10 days, around 20-40 minutes but vaginal bleeding would be worse on those days I did walk and even at 7 weeks, I still have bleeding though now its a pink dribble. I had to start iron and vitamins at 10 days which have helped me greatly.

Pelvic pain like period pains occur throughout though improve with time. It isn’t until at least 6 weeks that I felt anything like I had energy to get up and do things during the day though I still go to bed earlier than before surgery.

I had irritating bladder emptying until recently, having to get up at night anything up 6 times to relieve myself even though very little urine came out but it’s not painful. I had hot flushes several times a day, being soaked at night for the first 2-3weeks but they settle.

I am having physiotherapy to help my pelvic floor as the risk of prolapse is higher if the cervix is removed at time of hysterectomy.

In summary, I would still opt for a laparoscopic vaginal hysterectomy procedure but though the abdominal wound is smaller and heals quickly the information leaflets underestimate the vaginal bleeding, vaginal trauma, pelvic floor discomfort, tiredness, and bladder irritation with a vaginal hysterectomy. In my case it would take at least another 2 weeks ie up to 9 weeks for me to be normal at this rate of recovery and I still have another 4-6 weeks of hard work on the pelvic floor.

I am happy I did it, and am confident I will be much better for it in the end but recommend lots of rest and time off work for maximum benefit.

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