Hysterectomies are the most common gynaecological surgeries. The fact that it is a routine surgery can lead to a down playing of the fact that it is a major surgical procedure. It can also be a surgery that has a complex health and emotional backstory.
From my own experience and study of this issue I know that there 3 key areas of consideration that you will have to address as you do through this experience.
The reason for having a hysterectomy are many and varied. They can range from lifesaving cancer surgery to life enhancing relief from multiple fibroid growth. There are a variety of surgical techniques for hysterectomy from the traditional abdominal incision (similar to a C-section) to key hole and/or vaginal. These last two are less invasive procedures and have quicker recovery times. The reason for both the surgical approach and the type of hysterectomy can be dictated by the reason for the surgery but, if the surgery is elective, there is often a choice.
The different types of hysterectomy.
Subtotal Hysterectomy– removing uterus only
Total Hysterectomy - removing uterus and cervix
Radical Hysterectomy – removing uterus, cervix and ovaries
Discussing the pros and cons of the type of procedure you have is an important part of the clinical process. However, I know from my own experience of this procedure and from treating many women who have had hysterectomies, often this is not fully explained, or it is hidden in technical language. I met so many women that do not know what has been taken or left. There can also be assumptions made by the surgeon that, once past a certain age or post childbirth, you might as well “have the whole lot out”. Many women, especially those that have had a complicated gynaecological history may well share that view. However, it is important to do some research and have a discussion of the pros and cons of the various options so that you make an informed decision.
The journey to a hysterectomy can be a very emotional one. There may have been an extended period of ill health or it may be extremely sudden as the result of a cancer diagnosis or traumatic birth experience. Either way it is a surgery that goes to the very heart of being a woman. The loss of the womb, our extraordinary cradle of life, can be a deep and unsettling experience, that we may need to make our peace with.
Having agency over the process, developing a mindset that this is being done FOR us and not to us, is crucial to our emotional journey.
Setting realistic expectations for our recovery and return to movement, normal life, work and exercise is very important. Not only for ourselves but for our families. Knowing at the outset what you will be doing (looking after yourself) and not be doing (looking after anyone else).
The final and almost the most important is understanding that in our recovery the greatest battle will be with ourselves. Of all the women I know who have had hysterectomies at least half have had a troublesome recovery and when you ask them about it, they say it is because I did too much, too soon. We are masters as pushing on, no matter how rubbish we feel. We are generally poor at relinquishing control of household responsibilities and chores. Women are generally rather poor at putting themselves first. When you are recovering from a hysterectomy this is absolutely NOT the headspace we need to be in.
To relinquish this can be a very challenging thing and we ourselves, are the barrier.
The practicalities of preparing for, and recovering from, a hysterectomy need a bit of planning. This goes hand in hand with having a clear and realistic appreciation of the recovery process. When I work with hysterectomy clients, the best case scenario is seeing them before the surgery. Then we can set the scene and get to work putting in place all the arrangements. This is really not (just) about cooking a month’s worth of frozen “nutritious” meals for the family.
Thinking about your hospital visit, how you make it as pleasant as possible (noise cancelling headphones and pillow scent are a great tip). How you will get home? Where you will sleep? Is it close to the loo? How will you your get your knickers on when you can’t bend down? Who is