What is Vaginal Hysterectomy? Purpose, Procedure & Recovery

A vaginal hysterectomy is a surgical procedure where your uterus is removed through your vagina, without making any cuts on your belly. This approach feels less invasive than other types of hysterectomy because your surgeon works entirely through your natural body opening. Many women find this method appeals to them because it typically means faster healing, less pain, and no visible scars on their abdomen.

What is vaginal hysterectomy?

Vaginal hysterectomy means your surgeon removes your uterus by working through your vagina instead of making incisions in your abdomen. Think of it as taking an internal route rather than an external one. Your cervix may also be removed during this procedure, depending on your specific medical needs.

This surgical approach has been used safely for decades and is often the preferred method when it's medically appropriate for your situation. Your surgeon will carefully disconnect your uterus from surrounding tissues and blood vessels, then remove it through your vaginal canal. The opening is then closed with dissolvable stitches.

Why is vaginal hysterectomy done?

Your doctor might recommend vaginal hysterectomy to treat several conditions that affect your quality of life or health. The most common reason is uterine prolapse, where your uterus slips down into your vaginal canal because the supporting muscles and tissues have weakened.

Here are the main conditions that might lead to this recommendation:

• Uterine prolapse that causes discomfort or interferes with daily activities
• Heavy menstrual bleeding that doesn't respond to other treatments
• Chronic pelvic pain that significantly impacts your life
• Large fibroids that cause symptoms like pressure or bleeding
• Endometriosis that hasn't improved with other treatments
• Abnormal uterine bleeding when other treatments haven't worked
• Adenomyosis, where the uterine lining grows into the muscle wall

Your doctor will always explore less invasive options first. Surgery becomes the recommendation when other treatments haven't provided the relief you need to live comfortably.

What is the procedure for vaginal hysterectomy?

The procedure typically takes one to two hours and is performed under general anesthesia, so you'll be completely asleep and comfortable throughout. Your surgeon will position you similarly to how you'd lie for a pelvic exam, with your legs supported in stirrups.

Here's what happens during your surgery:

1. Your surgeon makes a small incision around your cervix inside your vagina
2. The uterus is carefully separated from the bladder and rectum
3. Blood vessels and ligaments supporting the uterus are sealed and cut
4. Your uterus is removed through the vaginal opening
5. The top of your vagina is closed with dissolvable stitches
6. A temporary packing might be placed to control bleeding

Your surgical team monitors you closely throughout the procedure. Most women can have this surgery as an outpatient procedure or with just one night in the hospital.

How to prepare for your vaginal hysterectomy?

Preparing for your surgery helps ensure the best possible outcome and smoother recovery. Your doctor will give you specific instructions, but preparation usually begins about a week before your procedure.

Your pre-surgery preparation will likely include:

• Stopping certain medications like blood thinners as directed
• Taking prescribed antibiotics to prevent infection
• Using a special vaginal preparation the night before surgery
• Not eating or drinking anything after midnight before your surgery
• Arranging for someone to drive you home and stay with you
• Completing any required blood tests or imaging studies

Your healthcare team will walk you through each step and answer any questions. Following these instructions carefully helps reduce your risk of complications and supports optimal healing.

How to read your vaginal hysterectomy results?

After your surgery, you'll receive a pathology report that examines the removed tissue under a microscope. This report confirms whether any abnormal cells or conditions were present and helps guide your ongoing care.

Your pathology report will typically show:

• Normal uterine tissue with no concerning findings
• Confirmation of conditions like fibroids or adenomyosis
• Evidence of endometriosis if that was suspected
• Inflammatory changes that might explain your symptoms
• Rarely, unexpected findings that require follow-up

Your doctor will review these results with you during your follow-up appointment. Most reports show exactly what was expected based on your pre-surgery symptoms and examination.

How to recover from vaginal hysterectomy?

Recovery from vaginal hysterectomy is typically faster and more comfortable than abdominal hysterectomy because there's no abdominal incision to heal. Most women feel significantly better within two to four weeks, though complete internal healing takes about six to eight weeks.

Your recovery will likely follow this general timeline:

• First week: Rest, manage discomfort with prescribed medications
• Weeks 2-4: Gradually increase activity, return to light work
• Weeks 4-6: Resume normal activities except heavy lifting
• Weeks 6-8: Full recovery, including exercise and intimacy

Everyone heals at their own pace, so don't worry if your timeline looks slightly different. Your doctor will monitor your progress and let you know when it's safe to resume all activities.

What are the risk factors for vaginal hysterectomy complications?

While vaginal hysterectomy is generally very safe, certain factors can slightly increase your risk of complications. Understanding these helps you and your doctor make the best decision for your situation.

Factors that might increase your surgical risk include:

• Previous pelvic surgery that may have caused scar tissue
• Very large uterus that's difficult to remove vaginally
• Severe endometriosis with extensive adhesions
• Obesity, which can make surgery more technically challenging
• Chronic medical conditions like diabetes or heart disease
• History of blood clotting disorders
• Smoking, which slows healing and increases infection risk

Your surgeon will carefully evaluate these factors during your consultation. Even if you have risk factors, vaginal hysterectomy may still be the best option for you.

What are the possible complications of vaginal hysterectomy?

Serious complications from vaginal hysterectomy are uncommon, occurring in less than 5% of procedures. However, it's important to understand what could happen so you can make an informed decision and recognize warning signs.

Potential complications include:

• Excessive bleeding that requires transfusion (very rare)
• Infection in the pelvis or at the surgical site
• Injury to nearby organs like the bladder or bowel
• Blood clots in the legs or lungs
• Adverse reaction to anesthesia
• Vaginal cuff separation where the incision reopens
• Rarely, conversion to abdominal surgery if complications arise

Your surgical team takes many precautions to prevent these complications. Most women have no significant problems and are very satisfied with their results.

When should I see a doctor after vaginal hysterectomy?

Most recovery symptoms after vaginal hysterectomy are normal and expected. However, certain signs warrant immediate medical attention to ensure your safety and proper healing.

Contact your doctor right away if you experience:

• Heavy bleeding that soaks more than one pad per hour
• Severe abdominal or pelvic pain that worsens
• Fever over 101°F (38.3°C) or chills
• Foul-smelling vaginal discharge
• Difficulty urinating or burning during urination
• Leg swelling, redness, or calf pain
• Shortness of breath or chest pain

Don't hesitate to call your healthcare provider if something doesn't feel right. They're there to support you through your recovery and want to address any concerns promptly.