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By Mayo Clinic staffDuring a vaginal hysterectomy, the surgeon detaches the uterus from the ovaries, fallopian tubes and upper vagina, as well as from the blood vessels and connective tissue that support it. The uterus is then removed through the vagina. Rarely, the upper vagina and pelvic lymph nodes also are removed (radical hysterectomy).
During the vaginal hysterectomy
You'll be put under general anesthesia, so you won't be awake for the surgery. Your legs will be placed in stirrups, similar to the position you're in for a Pap smear. Sometimes, a urinary catheter is passed through your urethra to empty your bladder. Your vagina is cleaned with a sterile solution prior to the surgery.
To perform the hysterectomy, the surgeon makes an incision inside your vagina to access the uterus. Using long instruments, the surgeon cuts your uterus away from the blood vessels, connective tissue and fallopian tubes. The uterus is removed through the vaginal opening, and absorbable stitches are used to control any bleeding inside the abdomen. Except in cases of suspected uterine cancer, the surgeon may cut an enlarged uterus into smaller pieces before removing it in sections (morcellation).
There is always a risk that severe endometriosis or pelvic adhesions may force your surgeon to switch from a vaginal to abdominal hysterectomy during the surgery. Your doctor should discuss this possibility with you before the surgery begins.
After the vaginal hysterectomy
After surgery, you'll be in a recovery room for a few hours and in the hospital for one to three days. You'll take medication for pain and to prevent infection. Your health care team will encourage you to get up and move as soon as you're able.
It's normal to have bloody vaginal discharge for several days after a hysterectomy, so you'll need to wear sanitary pads.
Physical aftereffects
After a hysterectomy, you'll no longer have periods or be able to get pregnant.
If you were still having periods before the surgery and your ovaries were not removed, you'll continue producing hormones and eggs until you reach menopause. If your ovaries and fallopian tubes were removed with your uterus, you'll begin menopause immediately after surgery and may experience symptoms such as vaginal dryness and hot flashes. Your doctor may prescribe medications to treat the symptoms.
Recovery after a vaginal hysterectomy is shorter and easier than after an abdominal hysterectomy. Most women feel better within a week and make a full recovery in one to two weeks. Even if you feel like you're back to normal, don't lift anything over 20 pounds or have vaginal intercourse until six weeks after surgery. Contact your doctor if your pain worsens instead of letting up, or if you develop nausea, vomiting or bleeding heavier than a menstrual period.
Emotional aftereffects
After hysterectomy, many women report improved mood and increased sense of well-being. Others enjoy life more because they're no longer experiencing symptoms such as bleeding or pelvic pain. Many report an increase in sexual satisfaction as well — perhaps because they're not afraid of becoming pregnant, or perhaps because, before the hysterectomy, a condition such as uterine fibroids was causing pain during intercourse.
Some women feel a sense of loss and grief after hysterectomy, which is normal. Others may experience depression related to losing the ability to become pregnant. If sadness or negative feelings begin to interfere with your enjoyment of everyday life, talk to your doctor.
