DEFINITION

Removal of the uterus, cervix, fallopian tubes and ovaries through an incision in the vagina.
This surgery is frequently accompanied by a plastic surgery to repair weakened bladder and rectal muscles in a case of Prolapse uterus (aka - colporrhaphy)

REASONS FOR SURGERY

• Uterus:
  Cancer or suspected cancer, large fibroids, chronic bleeding, prolapsed (dropped) uterus, endometriosis, chronic pelvic infection
• Fallopian tubes and ovaries:
  Cancer or suspected cancer of the ovaries, precancerous or twisted ovarian cysts;, ovarian abscess, damage to the ovaries from severe endometriosis.

DIAGNOSTIC TESTS

• Pre-operative tests: routine pre-op panel; X-rays of abdomen and kidneys; dilatation and curettage of the uterus (D & C).

ANESTHESIA

General or Spinal anesthesia.

DESCRIPTION OF OPERATION

• The vaginal walls are separated from the bladder muscles and rectal muscles.
• The deepest recesses of the vagina are opened. The cervix, uterus, fallopian tubes and ovaries are cut free and removed. The rear part of the vagina is closed with sutures.
• The bladder muscles and rectal muscles are sewn back in place. Supporting tissue is repaired.
• A small catheter is left in the bladder for 7 to 10 days.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Wound infection.
• Muscles supporting bladder and rectum may require a second repair.
• Inadvertent damage to bladder, rectum or ureters.

AVERAGE HOSPITAL STAY

5 to 7 days.

TREATMENT

GENERAL MEASURES

• Sutures will fall out of the vagina, ignore them.

MEDICATION

Your doctor may prescribe

• Pain relievers.
• Vaginal pessaries if vaginal discharge develops a foul smell.

ACTIVITY

• Resume work and normal activity as soon as possible.
• Resume driving 2 weeks after returning home.
• Resume sexual relations as soon as able.

DIET

Clear liquid diet until the gastrointestinal tract functions again. Then eat a well-balanced, high-protein diet.

CONTACT YOUR DOCTOR IMMEDIATELY, IF

• Vaginal bleeding that soaks more than 1 pad per hour.
• Frequent urge to urinate or excessive vaginal discharge that persists longer than 1 month.
• Increased pain or swelling in the operated area.
• Signs of infection eg headache, muscle aches, dizziness or a general ill feeling and fever.
• Abdominal swelling or pain.