Depending on the type of surgery and sometimes the preference of you and your doctor, general anesthesia (full sleeping) or epidural or spinal anesthesia in which your lower back is completely numb (you can stay awake during this time or sleep with light sedatives) may be chosen. There are different hysterectomy methods. Vaginal hysterectomy is the removal of the uterus through an incision inside the vagina. There is no incision outside the body. This method is most often applied due to uterine prolapse, the uterus has already sagged to the lower parts of the vagina and sometimes even out of the vagina. It is considered the most preferred approach for this reason, with the least complications and the fastest recovery time. Patients usually go home the same day of surgery. In laparoscopic hysterectomy, a laparoscope (a thin tube with a video camera at the end) is inserted into the abdomen through a small incision in the belly button. Surgical instruments are inserted through several other small incisions. The uterus is taken out of the body through an incision made at the top of the vagina. It is a very comfortable method for the patient, patients can usually be discharged on the same day of the surgery or the next day. The recovery period is shorter and less painful than with an abdominal hysterectomy. Robotic hysterectomy is performed with the help of a
robotic machine. Technically, it is a kind of laparoscopic surgery; thus a laparoscope is inserted into the abdomen to view the pelvic region. Small, thin surgical instruments are inserted through three to five incisions around the belly button. Robotic arms and instruments are controlled by the surgeon. Recovery is similar to laparoscopic hysterectomy.

Abdominal hysterectomy, on the other hand, is the classical method, the operation is performed through an incision of approximately 10-12 cm in the lower abdomen (such as a cesarean section incision). The incision is then closed with self-dissolving hidden sutures. It usually requires a longer hospital stay (two or three days) and a longer recovery time.
Uterine removal surgery can take between one to three hours. This period varies depending on the surgical method to be chosen, the size of the uterus, adhesions due to previous surgeries, and which organs are removed (tubes – ovaries) together with the uterus. In closed surgeries, the surgery takes longer due to the longer preparation of the surgical environment.

Healing Process

The length of time you spend in the hospital after a hysterectomy varies depending on what type of surgery you had. Post-operatively, if you have had general anesthesia, you may feel dizzy and nauseated; these are common side effects of anesthesia and pass quickly. Close monitoring is required for several hours until fully awakened and able to eat, drink and urinate. You will be asked to get up and walk around as soon as possible after surgery to prevent blood clots in your legs. If you have had an abdominal hysterectomy, you may need to be hospitalized for a few days; for vaginal and laparoscopic hysterectomies, you can usually be discharged the same day or the next morning.
Most women fully recover and return to life in about four to six weeks after a hysterectomy. The recovery process depends on the type of hysterectomy and how the surgery was performed.
Recovery from vaginal and laparoscopic hysterectomy is much quicker than recovery from abdominal hysterectomy. Recovery after vaginal and laparoscopic hysterectomy takes about two weeks.
Complete recovery after abdominal hysterectomy can take up to four to six weeks.
There are some things you should pay attention to after uterine removal surgery. You may have light vaginal bleeding for a few weeks, but should not exceed the amount of pads per day. Do not be misled by the fact that you do not have visible stitches, especially after closed or vaginal surgery, uterine removal is a major surgery and there are many stitches in the abdomen. Even if you don’t feel pain or anything else, rest lightly for a few weeks, don’t lift too heavy things. Do not insert tampons, water, cleansers into the vagina for 40 days, do not have intercourse. In this process, you can take a standing shower every day. Except for the first one or two days, you do not need to close
or dress the wound. You can return to sports after a month. In general, you can return to work after two weeks, in open surgeries, this period may be three to four weeks.

Period after surgery

The most important change you will feel physically after a hysterectomy will be that you no longer have a menstruation. If your ovaries have not been removed, you will not enter menopause hormonally, the only difference is that there is no more bleeding. For example, you may feel bloated when your periods come and experience symptoms similar to those during menstruation. When the ovaries remain, hormonal effects are not experienced. If the ovaries are removed together with the uterus in a non-menopausal woman, this situation is called surgical menopause, menopause begins suddenly and symptoms such as hot flashes, which are often seen in menopause, may start suddenly. In this case, hormone replacement therapy may be considered by your physician to relieve menopausal symptoms.
You may feel discomfort at the incision site for about four weeks, if there is any redness, bruising or swelling it will completely disappear within four to six weeks. A burning or itching sensation around the incision is normal and may last a long time. Laparoscopic surgeries cause smaller, less visible scars, unlike abdominal hysterectomy. If the cervix has been completely removed after hysterectomy, you no longer need to have annual smear follow-ups. However, if you have had surgery for cervical cancer, etc., your doctor may want to continue doing vaginal smears; if you have had a hysterectomy for cancer, you should continue to have a Pap test. Hysterectomy mostly does not affect sexual life. If the ovaries were removed along with the uterus, this can initiate menopausal symptoms, which can produce symptoms such as sexual and vaginal dryness. A water-based lubricant can be used for dryness. If you experience reluctance, share it with
your doctor. Removal of the uterus does not make a physical difference in sexual life, your vagina is not removed and its length is not shortened. A woman can still orgasm and ejaculate after a hysterectomy. This is because after a simple hysterectomy, the external genitalia and pelvic nerves supplying the lower genital tract are still intact. Studies show that sexual pleasure does not change after a hysterectomy. Only in very specific rare cases, such as cancer or uterine prolapse, the shape of the vaginal canal may change after hysterectomy and this may cause pain, especially during the initial insertion. If you experience such a situation, share it with your doctor.