So you’re preparing for surgery, where do you being? It is important for all women to remember that the decision to operate is not one to be take lightly. All surgical procedures come with risks and making sure that your doctor and surgical team have discussed in detail the options available to you and the risks involved in your particular procedure is vital to aiding recovery and reducing any worries you may have. Being well informed before surgery is your first step to recovery, it will help you make the right choices for aftercare when you first leave hospital and the right diet choices to help you recover quickly and safely.
- Preparing for hospital
- Before any surgery, make sure that you follow the advice of your doctor and take any medicines that you have been prescribed.
- It is widely reported that smoking can cause lung disease, heart disease, cancer and early death. Giving up is one of the most important things you can do to improve your health and ensure a swifter recovery with limited complications and better healing. Smokers who have surgery are at higher risk of developing a wound infection, or to have heart or lung complications during recovery. Smoking also slows down your healing process.If you do smoke and are having surgery it is advisable to give up smoking or seek the necessary support to help you begin the process.
- Sometimes your doctor or surgical team will send you for tests before your surgery. This is called a pre-operation or “pre-op” assessment. They usually take place a week or two before your operation.The type of tests you have depend on your age and the type of surgery you’re having. They might include a blood test, a chest X-ray, an electrocardiogram (ECG) or a urine sample. The tests will help your anaesthetist and surgeon plan your surgery, and check that you are well enough to have it. You can discuss the operation and recovery process during this assessment and ask any questions you might have concerning the procedure and recovery process.
Fasting
- If you are having a general anaesthetic, you will be asked to follow fasting instructions. You must not eat or drink for approximately six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand. Check the information given to you by your doctor concerning your surgery to make sure you are equipped with all of the required information and if you feel unsure of anything call and check.
good preparation makes the experience easier
- If you get a cough, cold, sore throat or virus, telephone the hospital for advice before you go in; the date of your appointment may need to be changed as undertaking surgery when your immune system is low can cause complications during the procedure.
- Types of surgery
Laparoscopy
- Laparoscopy involves looking inside the stomach with the help of a telescope. The procedure is performed while you are under general anaesthetic. The inside of the tummy is pushed out by introducing carbon dioxide gas to make the procedure safe. A telescope is then passed through the belly button which reveals all of the organs, namely the uterus, ovaries and fallopian tubes to check for any abnormalities which may be present.Who is it for?
- Laparoscopic procedures are often used for those women who suffer from heavy periods, fibroids, suspected endometriosis, suspected pelvic inflammatory disease, undiagnosed pelvic pain and suspected ectopic pregnancy etc. This procedure can also be used to check that the fallopian tubes are functioning correctly by injecting a harmless dye through the cervix.
- When the laparoscopy is performed to diagnose a gynaecological condition it is called a diagnostic laparoscopy. There are also therapeutic laparoscopies which involves treatment of conditions like ovarian cyst, removal of ectopic pregnancy, treatment of endometriosis, separation of adhesions as a result of pelvic inflammatory disease. At the end of the procedure the gas is removed and absorbable sutures are inserted to appose the skin and the belly button.
- In some cases you may notice that you have two other small holes on either side of the abdomen. These minor ports are a result of incisions made to help the insertion of other instruments in order to perform the operation, also known as keyhole surgery.
- The procedure is usually carried out as a day case. However for operative laparoscopy you may be required to stay over night which will be at the discretion of your doctor.
Hysteroscopy
- This is involves a very thin telescope (hysteroscope) being introduced through the neck of the womb (cervix). It is used to detect abnormalities inside the womb. A sample of tissue called a biopsy can be taken at the time of hysteroscopy. A simple biopsy can be carried out or polyps can be removed.
- This procedure is often carried out on women who are experiencing irregular bleeding, excessive bleeding or heavy periods. Hysteroscopy can also be performed to remove polyps or fibroids from inside the womb. This is called operative hysteroscopy.
- Hysteroscopy can be performed as an outpatient procedure where a local anaesthetic is used. It can also, depending on the patient’s requirements, be carried out under a short anaesthetic as a day case. Operative hysteroscopy usually requires general anaesthetic but diagnosic hysteroscopy can be carried out under local anaesthetic in the outpatient’s department procedure suite. Depending upon the type of hysteroscopy you have your stay in hospital may vary from a few hours to one day.
- A hysterectomy is an operation to remove your womb.
Types of Hysterectomy
- Vaginal hysterectomy – when the womb is removed vaginally.
- Subtotal hysterectomy – the womb is removed through the tummy but the cervix is left in place.
- Total hysterectomy – the womb and the cervix are removed.
- Radical hysterectomy – the womb, cervix, ovaries and the fallopian tubes are removed. Sometimes a part of the vagina is removed as well.
Who is it for?
- This is a common procedure for women who suffer from Heavy or painful periods, Fibroids, Endometriosis, Chronic pelvic pain, Cancer of the womb, cervix or ovaries, Prolapse of the womb (womb drops into the vagina)
As a young woman you will, in most cases, have not reached menopause, usually your ovaries are left in place as these produce oestrogen which is required. Removal of the ovaries will lead to premature menopause.
How Long Will It Take?
- Surgery is performed under general anaesthetic and can take several hours.
- You can usually expect to be in hospital between 3 and 5 days post surgery.
- A prolapse is caused when there is damage or weakness to the pelvic floor muscles which support the uterus and other pelvic organs. Weakness of these muscles can be a result of childbirth or chronic coughing and straining. Prolapse frequently occurs around the age of menopause as oestrogen levels fall which can cause the pelvic floor muscles and tissues to thicken.
Types of Prolapse
There are a number of different types of prolapse
- Cystocele where the bladder protrudes into the anterior wall of the vagina.
- Ureterocele where the tube that carries urine from the bladder protrudes into the anterior vaginal wall.
- Rectocele where the rectum protrudes into the posterior wall of the vagina.
- Enterocele where the bowel protrudes into the posterior wall of the vagina.
- Uterine prolapse where the uterus drops into the vagina which could again be in various degrees.
- Vaginal wall prolapse where the top of the vagina falls on itself. Sometimes associated with hysterectomy that is removal of the uterus.
How Long Will It Take?
- Vaginal repair operation is performed to rectify the pelvic prolapse. In some cases a hysterectomy may be required. In other cases, the uterus is kept in tact and just the prolapse is corrected. A vaginal repair aims to tighten, strengthen and lift the weakened tissues so that the uterus, bladder and rectum return to their original position alleviating any associated symptoms. The operation is performed vaginally and dissolvable stitches are used.
- You can expect to be in hospital between 3 and 5 days following this procedure
- This is a term for the surgical removal of fibroids, with the womb remaining intact. Fibroids are benign, non cancerous tumours which grow in the muscle layers of the womb.
How is a Myomectomy Performed?
A Myomectomy can be performed by three different methods.
- Abdominal Myomectomy – through the abdomen
- Laparoscopic Myomectomy- through the belly button
- Hysteroscopic Myomectomy- through the neck of the womb (cervix)
- You can expect to be in hospital for between 3 and 5 days
- Surgery can take a few hours , under general anaesthetic
Oopherectomy
- Oophorectomy is the surgical removal of the ovaries
- Oophorectomy is sometimes recommended when the hormones produced by the ovaries begin to rpduce cancerous cells which can cause breast cancer or severe endometriosis.
- Prophylactic oophorectomy - Where the ovaries are removed in an attempt to reduce the possibility of developing a future disease, such as ovarian cancer
- Bilateral oophorectomy- When oophorectomy involves removing both ovaries
- Unilateral oophorectomy- When a single ovary is removed
- About 10% of women who have a hysterectomy also have a condition or disease that may increase the need for an oophorectomy. The following are a list of conditions which may require an ooperectomy:
- Inherited Diseases. Women who have certain abnormal genes (known as BRCA1 and BRCA2) have an increased risk for developing ovarian cancer before the age of 70. These women often develop cancer around age 45, which is about 20 years earlier than women who do not have these genes although it is increasingly becoming an issue which affects younger women between the ages of 25 and 35.
- Following this surgery you will not be able to conceive naturally and your risk for developing ovarian cancer will drop to nearly zero. Your breast cancer risk will also be lower.
- Breast cancer. Hormones produced by the ovaries increase the risk of breast cancer. Oophorectomy may reduce the risk of breast or ovarian cancer in women who have the abnormal genes BRCA1 or BRCA2. Oophorectomy is sometimes recommended to treat breast cancer, because it eliminates the hormones produced by the ovaries.
- Suspected disease. Where disease is suspected, removal of both ovaries may be recommended if disease is found.
- Surgery can take a few hours
- You can expect to stay in hospital between 3 and 5 days following surgery
- What to expect
- Each persons stay in hospital will differ significantly depending on the type of healthcare package they have (NHS or private) but regardless of which facility will be administering your treatment the basics are always the same. Whilst in hospital you can expect to receive 3 square meals a day from a menu which offers a selection dishes often catering for different cultural needs.
- A pharmacist will visit you during the course of your stay to provide you with information about the course of medication you will be on and any pain killers you will be taking. This visit is also an opportunity for you to discuss any concerns you may have and eliminate any unnecessary stress.
- Depending upon the type of surgery you have you may require a visit from a physiotherapist, they will help you get up and moving and instruct you on how best help aid your recovery through physical exercise in a safe way.
- Nurses will be available to help you 24 hours a day in case of any emergency and provide assistance.
- You should be visited by members of your surgical team to discuss how your surgery went and how long recovery will take you.
- Your doctor may request a follow up appointment following your release from hospital to check how your recovery is going.
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Love from
The WombRoom
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From The WombRoom xx
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