Laparoscopic Assisted Vaginal Hysterectomy and Bilateral Salpingo Oophorectomy
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A vaginal hysterectomy is surgery to remove the uterus through the vagina. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus. A bilateral salpingo oophorectomy is a surgery to remove both ovaries and both fallopian tubes.
In a vaginal hysterectomy and a bilateral salpingo oophorectomy assisted with laparoscopy, the doctor uses a tool called a laparoscope to help with the removal. A laparoscope is a thin tube with a light and tiny camera.
When is it used?
There are many reasons why you and your health care provider may decide to take out your uterus. Some of the problems that may be treated with a vaginal hysterectomy are:
- Tumors in the uterus.
- Constant heavy bleeding that has not been controlled by medicine or dilation and curettage (D&C).
- Endometriosis that causes pain or bleeding and does not respond to other treatments.
- Chronic pelvic pain.
- A fallen (sagging) uterus.
- Precancerous or cancerous cells or tissue on the cervix.
What are the benefits of this procedure?
A hysterectomy takes care of problems you may have been having with your uterus. For example, it removes any tumors that may have been in your uterus and it stops menstrual periods. Also, with this procedure, there will be only small punctures in your abdomen from the laparoscope. This means you will probably have less pain and discomfort after this operation than if your uterus were removed through a cut in your abdomen. Recovery is usually faster from a vaginal hysterectomy than from an abdominal procedure. You may be able to leave the hospital sooner. The vaginal procedure does not leave a visible scar.
What are the risks associated with this procedure?
There are some risks when you have general anesthesia. Discuss these risks with your health care provider. A regional anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. However, regional anesthesia is considered safer than general anesthesia.
- If your blood vessels leak or are injured, your health care provider may open your stitches to stop the bleeding.
- Your bladder or rectum might be injured and need repair.
- The tubes leading from your kidneys to your bladder (ureters) could be injured and need surgical repair.
- If your doctor has trouble removing your uterus through the vagina, it may be removed through an abdominal cut instead.
- You may develop an infection or bleeding.
- You may have nausea and vomiting.
- You may develop a hernia in the top of the vagina.
- Sometimes the carbon dioxide gas that is used to inflate your peritoneal cavity will cause pain in your right shoulder. It usually goes away after a day or two of bed rest.
- You may develop a blood clot in your legs, pelvis, or lungs.
- You may develop bulging in your rectum (rectocele) or your vagina (vaginal vault eversion) or your bladder (cystocele).
- You may have difficulty emptying your bladder.
- You may have damage to your colon or intestines that could cause infection or a tract (fistula) between the intestines and vagina.
How do I prepare for this procedure?
Follow your health care provider’s instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your wounds will heal much better if you do not smoke after surgery.
If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your surgery.
Be sure to tell your health care provider what medicines you are taking, including nonprescription drugs and herbal remedies.
Follow any other instructions your provider gives you. If you are to have general anesthesia, do not eat or drink after midnight. Do not even drink coffee, tea, or water.
Your provider may give you a laxative to take the night before surgery or an enema the morning before the surgery.
What happens after the procedure?
The IV and catheter are removed 1 or 2 days after the surgery. You may stay in the hospital 1 to 3 days. If your doctor repaired the walls of your vagina, you may stay in the hospital longer or go home with the catheter to drain your urine until the bladder starts working well again. Your provider will check how well your bladder is working at a follow-up visit.
After you go home, get plenty of rest. Do not do any heavy lifting or otherwise strain the stomach muscles for 4 to 6 weeks. Follow your health care provider’s instructions for activity, dealing with pain, and preventing constipation. Ask your provider what other steps you should take and when you should come back for a checkup.
If you were having menstrual periods before the surgery, you will no longer have them after the operation. You also cannot become pregnant. If you have concerns about this, discuss them with your health care provider before the surgery.
When should I call Greenville OB/GYN?
Call our emergency number at any time if:
- You develop a fever over 100 F (37.8 C).
- You cannot urinate or you have pain or a burning feeling when you urinate.
- You have pain in your abdomen or your abdomen becomes swollen.
- You become dizzy or faint.
- You have nausea and vomiting.
- You become short of breath or have chest pain.
- You develop a rash.
- You have heavy bleeding from the vagina.
- You have swelling, redness, or pain in your leg.
Call during regular office hours if:
- You have questions about the procedure or its results.
- You want to make another appointment.