Ashley’s Vaginal Hysterectomy

Vaginal Hysterectomy
Age at Surgery 45
Location: Maryland

I was diagnosed with fibroids in July 2018. For about a year before my diagnosis, I would have at least one day every cycle with extremely heavy bleeding. In early July, my period started and didn’t stop. I was also starting to have constant pain and pressure, and became anemic. I kept thinking it would go away, but it didn’t. Ultrasound showed that I had a 9 cm fibroid and at least one smaller one, maybe more. I was treated with transexamic acid by my primary doctor, which worked great to stop the bleeding.

I have never been interested in having children, so I didn’t have to worry about fertility. I wanted the problem to be addressed with one method of treatment, and not risk having more fibroids form. I had an initial appointment with a gynecologist in August, who offered either an abdominal hysterectomy or uterine fibroid embolization (UFE). I wasn’t comfortable with having a lot of dead fibroids as a result of UFE, and I had read studies that showed that it wasn’t as effective on fibroids over 8 cm or so (although it can work great for some women). I felt that hysterectomy was my best option to stop the bleeding, get rid of the pain/pressure, and prevent recurrence.

I had heard about dual port hysterectomy offered through a surgeon in my area. They said they could remove even large fibroids with the help of two small laparoscopic abdominal incisions, and the uterus would be removed vaginally – basically a variation of laparoscopic assisted vaginal hysterectomy. This procedure is supposed to have a shorter recovery than most other hysterectomies – they advertise that women can return to normal activities within one week of surgery. I had a consult and was told I was a great candidate. After an endometrial biopsy to confirm my uterus was otherwise ok (it was), my surgery was performed on September 27th, 2018.

My surgery was done as an outpatient at their ambulatory surgery center. I was under general anesthesia. I did have a lot of problems with vomiting during my immediate recovery despite being given anti-nausea medication, but that’s me and anesthesia. The staff and doctors were great, and I felt well taken care of. I went home the same evening. I did feel a bit like I was sent home before I was quite ready to go, but never felt that I needed to go to a hospital. With my husband’s help, I was able to take short walks around my house that night, as was recommended by the nurses.

I had my uterus, Fallopian tubes, cervix, and left ovary removed. I have a history of ovarian cysts, especially on the left side, and asked the surgeon to remove either or both ovaries if they looked abnormal. Biopsy showed endometriosis in my left ovary, so I’m glad it’s gone! I even got pictures of intraoperative views of everything, as well as the tissue once it was removed – I’m in the medical field myself, so this part was very interesting!

I felt like my recovery went fairly well overall. Initially I had pelvic pain and a lot of fatigue. I took prescription strength ibuprofen regularly for the first two weeks or so, then was able to wean myself off of it. I was prescribed oral narcotics as well, but only took those sparingly for the first 3-5 days. The first 4-5 days were somewhat tough since I felt weak and didn’t want to eat much. For the first 2-3 days I had some burning during urination, likely due to the urinary catheter placed during surgery. I also had a bit of a sore throat from being intubated during surgery. All of my issues improved daily. My visible incisions are very small, about the width of a fingertip. I never felt any incisional pain at all, even when I pressed on them. All the pain I ever felt from this procedure was pelvic. I was also sure to take a stool softener as long as I was on the narcotics – thanks to advice from the surgery nurse, as well as from my Hystersisters. As a result, I didn’t have any problems with constipation.

Around day 5 I started to see more noticeable improvement. I was able to use the stairs normally and even take short walks around my neighborhood. My appetite improved and I could slowly do more and more. I posted a lot in my post-op recovery thread here on Hystersisters.com, and was able to get a lot of reassurance as questions came up. It’s been great to have a place to feel comfortable asking even very personal questions about ones health, and know that you have support and information available. I was able to return to work part time after two weeks, and full time after three weeks (my job is pretty physical). I did have lifting restrictions for a week after I returned to work, but was completely cleared at three weeks post op.

I did have a bit of a complication post-op when I developed an intestinal infection a few weeks after surgery. While I was never definitively diagnosed, my doctors felt it was a C. diff infection secondary to the antibiotics I was prescribed after surgery. I got pretty sick from that, sicker that I was during my recovery from surgery. That was my greatest challenge. Fortunately, I responded well to treatment so far.

My health has improved overall since my surgery, although I don’t feel I’m quite 100% yet. I am able to easily do my regular activities, including being on my feet at work for 10 hour+ days. I haven’t been able to start exercising again, but I know I’ll be able to before too much longer. The pain and pressure that I was feeling 24/7 for months is gone, and that’s my biggest relief! No more bleeding and anemia either. I’ve had to take iron supplements for years, but should be able to stop taking them soon. I’m very glad I had a hysterectomy given the problems I was dealing with.

As far as my recovery goes, C. diff infection aside, I don’t feel it was as fast or as smooth as advertised for the dual port procedure. I’m sure there are women who are fully recovered at one week, but I wasn’t one of them. The internal healing that needs to happen seems like it’s the same no matter how the surgeon gets to your uterus. I am very happy that I chose this procedure since I do feel my recovery was a lot quicker that it would have been with an open procedure. My fibroids were too big for a vaginal-only or a laparoscopic procedure. The vast majority of the time I feel no pain at all now. I do have the occasional twinges here and there, but those should resolve in time.

As for advice, take a stool softener after anesthesia and for the whole time you are on narcotic pain medicine, even if you aren’t having constipation problems. If you don’t take one, you will have a problem. The most important advice? Use the resources at Hystersisters.com! The people are great and all the articles are helpful.

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