Patient Information

Hysterectomymeans removal of the womb (uterus). If the tubes and ovaries are also removed at the same time, a ‘salpingo-oophorectomy’ is added. All the tissues removed are sent for examination by a pathologist. Under a general or regional anaesthetic, the entire womb, including the cervix, is removed through a cut in the abdomen. This can be a vertical cut (from navel to pubic hairline) or a horizontal cut (at the level of the bikini line). The surgeon will examine all the contents of the abdominal cavity to check for disease. On occasions the cervix may not be removed.You may wish to have your ovaries/ tubes.

• conserved
• removed
• removed if thought indicated during surgery

A catheter is used to drain the bladder during the operation and one or more soft drainage tubes may be left in to remove fluid from the abdomen for a few days after the operation.

This means repairing and strengthening the front vaginal wall, particularly where the bladder or the urethra has prolapsed.

Under a general anaesthetic, the front vaginal wall is cut from behind the urinary opening to the top to allow the surgeon to expose the damaged tissues around the bladder and urethra. These tissues are reinforced using stitches that absorb slowly or that remain permanently. If necessary, any excess vaginal skin is cut away. The vaginal skin is then closed with an absorbable stitch and the vagina may have a sterile pack left in place for a day after the operation to absorb secretions and control minor bleeding. If necessary, this operation may be combined with other prolapse repairs. A urinary catheter is placed in the bladder and brought out through the urethra or the abdominal wall. This usually remains in place for a few days to keep the bladder empty and the area dry to allow healing to start.

This means an operation to minimise the risk that a cyst on the inner lip of the vulva will recur. The cyst arises in the duct that carries normal secretions from a gland to the surface of the vulva. If the contents become infected, this can form an abscess. The operation allows the secretions to continue to lubricate the vulva and lower vagina in the normal way.

Under a general anaesthetic, a cut is made in the skin over the cyst and then the cyst wall is opened. The thick, mucus contents of the cyst are wiped out and the edges of the cyst are sewn to the skin edge using absorbable stitches. The wound may be loosely packed with a dressing for a few hours.

An incision is made in the abdomen either in the midline below the umbilicus, or in the hairline just above the pubic bone. A vertical (Classical) or horizontal (Lower Segment) incision is made on the uterus and the baby (s) and placenta are delivered. General, Regional or Local anaesthetic is used.

This means removing a cone or cylinder-shaped piece of tissue from the centre of the cervix using a scalpel or laser beam. This is done for treatment or diagnosis. Under a general anaesthetic, a sterile speculum is placed in the vagina. Sutures are placedon either side of the cervix, to tie off blood vessels that feed the cervix and so reduce blood loss during the procedure. Using a special telescope (colposcope) for good vision, the cone of tissue is then cut out and sent for detailed microscopic examination. Any remaining bleeding is stopped.

This means the neck of the womb is stretched gradually to allow instruments to be used to scrape out the lining of the womb. Under a light, general anaesthetic, a series of rods is passed through the cervix, each one slightly larger than the one before. Once the cervix is open enough, other instruments are used to scrape out the lining of the womb. The scrapings are then usually sent for detailed examination. At the end of the procedure, the cervix gradually closes again.

An ectopic pregnancy is one that begins to develop outside the womb (usually in one of the fallopian tubes). The pregnancy will always be lost and usually needs to be removed surgically to prevent severe bleeding and limit damage to the tube.

This means the cervix (neck of the womb) is stretched gradually to allow instruments to be used to suck out the contents of the womb. Under a light general anaesthetic, the cervix is dilated using a series of rods that gradually increase in size until theopening allows a small tube to enter the womb. This is attached to suction equipment and is used to remove the womb’s contents. When the procedure appears to be complete, the surgeon may do a final check, using a curette (long-handled spoon) to scrape the lining of the womb. At the end of the procedure the cervix will close again over a few days.

This means examining the pelvic organs under an anaesthetic, gently stretching the neck of the uterus (womb), inspecting the lining of the uterus using a small telescope (hysteroscopy) and scraping the lining of the uterus out (curettage) to examine it in detail. When the woman is asleep under the anaesthetic, her muscles are fully relaxed, so the surgeon can feel the pelvic organs more easily both vaginally and through the abdominal wall. The uterus is then filled with saline or carbon dioxide and the telescope is used to examine the lining of the uterus. Any abnormalities, such as polyps or adhesions, are removed. The surgeon then uses a curette (an instrument shaped like a long-handled spoon) to scrape out the lining of the uterus. Samples are usually sent for microscopic examination. At the end of the operation the cervix will close again over a few days.

The opening of the uterus (cervix) is stretched open and the lining of the uterus is sampled to obtain tissue for study. The hysteroscope is a telescope like instrument used to look inside the uterus and possibly remove any abnormal tissue such as fibroids, polyps or scar tissue.

This procedure involves inserting a 4cm long implant containing a female sex hormone (a progestogen) under the skin as a contraceptive. The hormone is released slowly and works mainly by preventing the release of an egg each month. The implant lasts for up to three (3) years. Under a local anaesthetic, a special needle is used to insert the implant just under the skin of the inner upper arm on the non-dominant side (i.e. the left if you are right-handed and vice versa). A woman can ask for the implant to be removed at any time if she wishes to become pregnant or is unhappy with the implant for any reason.

This means examining the pelvic and abdominal organs using a telescopic camera. Small pieces of tissue (biopsies) may be taken for microscopic examination to help make a diagnosis. A dye may be used to check that the passage from cervix to ovaries is open.Under an anaesthetic, the surgeon makes a small cut below the umbilicus (“belly button”) to insert the telescope into the abdomen. Carbon dioxide gas is used to make a space inside the abdominal cavity so the organs can be seen clearly. Other fine instruments may be needed (for example, to move organs around or take samples of tissue) and if necessary up to four other small incisions may be made in the abdominal wall for these instruments. The surgeon inspects the contents of the pelvis and can correct any minor abnormalities (such as separating any tissues that are stuck together abnormally). If a dye test is being done to check if the tubes are blocked, a small tube is then inserted into the cervix (neck of the womb) and a fluid containing a blue dye isinjected. The dye passes through the uterus and along the tubes. If the dye is seen coming out of the Fallopian tubes, there is no blockage. When the surgeon has finished, as much gas as possible is removed and the cuts closed with stitches or steristrips.

This means removing an ovary, with or without its Fallopian tube using a special operating telescope (laparoscope) inserted through the abdominal wall. There are no large wounds afterwards.
Under a general anaesthetic, the surgeon makes a small cut belowthe umbilicus (“belly button”) to insert the telescope into the abdomen. Carbon dioxide gas is used to make a space inside the abdominal cavity so the organs can be seen clearly. Additional cuts are then made so that other instruments can be used for operation. The surgeon checks the contents of the pelvis and frees any small adhesions. The tube and ovary and their ligaments and blood supply are separated from the womb and their coverings using various techniques. When they are free, the tube and ovary are removed through the laparoscope. The operation site is checked to make sure there is no bleeding. As much gas as possible is removed. The wounds are then closed with stitches and/or steristrips.

This means both tubes between the ovaries and the womb are closed so sperm are unable to reach and fertilise eggs for a pregnancy. Carbon dioxide gas is used to inflate the abdomen to create a space for the surgeon to work. The surgeon uses a telescopic camera (laparoscope), inserted through a small cut near the umbilicus (“belly button”). Other instruments are inserted through extra small cuts in the abdomen. The doctor may use a specialised staple gun to place one or more Filshie clips across each tube to close them. These clips can be seen afterwards on X-ray if required. At the end of the operation as much gas as possible is removed and the abdominal wounds are closed using stitches, steristrips or tissue glue.

This means treatment of endometriosis (tissue that normally lines the womb that has seeded in abnormal sites in the pelvis or abdomen) using a telescopic camera (laparoscope) thus avoiding a large abdominal wound. Under a general anaesthetic, a small cut is made close to the umbilicus (“belly button”) to put the laparoscope into the abdomen. Carbon dioxide gas is used to inflate the abdominal cavity so the surgeon can see the contents clearly, confirm the diagnosis of endometriosis and assess the extent ofthe disease. Separate stab cuts are also made for other instruments as required (usually 2-3).

A laparotomy is a surgical procedure where an incision is made into the abdominal cavity. It is routinely performed to examine the abdominal organs and aid diagnosis of any medical conditions.

This means removing abnormal tissue from the cervix using a hot wire. A speculum is placed in the vagina just like having a PAP smear. The doctor then numbs the cervix with a local anaesthetic injection. A special sticky pad is placed on one of the patient’s thighs to ‘ground’ the patient and complete the electrical circuit that is used to heat the wire loop. Either a dilute vinegar solution, or Iodine solution is painted onto the cervix to show the abnormal areas of cells or the wire loop is used to cut away the abnormal areas. The hot wire seals small blood vessels as the tissue are removed, controlling minor bleeding. The tissue that is removed is sent to pathology for microscopic examination.

This means repairing a weakness in the tissues of the rear wall of the vagina that separates the vagina from the back passage (rectum). This operation treats a prolapse of the rectum (rectocele).

Under a general anaesthetic, a cut is made in the back wall of the vagina from its entrance to the top. The tissues are dissected so the muscles of the floor of the pelvis can be seen. The tissues around the vaginal wall are strengthened using stitches that only absorb very slowly and any muscle weakness is also repaired. The vaginal wall is then closed with absorbable stitches and a gauze pack may be placed in the vagina to absorb any secretions and help control any minor bleeding from the wound. This will be removed on the day after the operation. A urinary catheter may be left in the bladder for a few days to keep the area dry.

This means fixing the top of the vagina to firmer tissues within the pelvis to prevent prolapse. Under a general anaesthetic, a urinary catheter is placed in the bladder. A cut is made in the back vaginal wall and the tissues dissected to expose the spines on the back wall of the pelvic bone. The sacrospinous (pelvic) ligaments and muscle are cleared and two non-absorbable stitches are placed through this tissue and the top of the vagina. As each stitch is tightened, the vagina is drawn upwards against these tissues. The wound in the vagina wall is closed with absorbable stitches and the vagina is packed with an antiseptic dressing.

After you have been given a general anesthetic, your cervix (the neck of the womb) will be dilated (pushed open) just a few millimetres, and then sterile suction instruments will be inserted inside your womb to remove the pregnancy tissue. The termination procedure usually takes between 5 and 10 minutes to complete. You will then spend some time in the recovery area until you are awake enough to safely go home. Alternatives to the proposed operation includemedical termination.

This means removing the womb using a special telescopic camera inserted through the abdominal wall (laparoscope). This avoids a large abdominal wound. The tubes and ovaries may be removed using the laparoscope at the same time, if necessary. Under a general anaesthetic, carbon dioxide gas is used to inflate the abdomen to create a space for the surgeon to work. The surgeon sees what he/she is doing using the laparoscope inserted through a small cut near the umbilicus (“belly button”).

Several other instruments are inserted through small cuts in the abdomen to enable the surgeon to examine the pelvic contents thoroughly. The surgeon frees the womb from the tubes, ligaments and blood vessels on either side. A cut is made around the upper vagina below the neck of the womb and it is then removed through the vagina. If the tubes and ovaries are being removed at the same time, their attachments are freed and these are also removed through the vagina. The vagina is then closed with absorbable stitches. The pelvic cavity is washed out with sterile solution, and as much gas as possible is removed before the small abdominal wounds are closed.

This means removing the womb via the vagina, using a laparoscope (telescopic camera) inserted through the abdominal wall) to help to free the womb. The tubes and ovaries may also be removed using the laparoscope at the same time, if necessary.

Under a general anaesthetic, a urinary catheter is put in the bladder. A small cut is made near the umbilicus (“belly button”) to insert the laparoscope through the abdominal wall. Carbon dioxide gas is used toblow up the abdominal cavity so the surgeon can see the contents clearly.

Separate small cuts are made for other instruments as needed (usually only 2-3) and the ovaries, tubes and as much of the womb as possible are freed from their attachments. The surgeon then frees the cervix from the vagina and works upwards from below. The tissues can be removed through the laparoscope or the vagina as convenient. The wounds are closed. A pack may be left in the vagina for a day to absorb secretions and control any minor bleeding.

This means the damaged ligaments are replaced by a 1 cm wide tape of synthetic mesh. This tape returns the support for the urethra to the surrounding tissues that had been lost. The TVT Tape is usually put in under local anaesthesia whilst you are under sedation, or general anaesthetic.

Two 1 cm cuts are made, both in the pubic hair, one on either side of the middle. A further 1 cm cut, is made just inside and on the front wall of the vagina.

The tape is threaded from the vaginal cut, one half o the tape on each side of the urethra (this is the tube that leads from the bladder to the outside) out through the cut in the pubic hair. This is followed by looking into the bladder, during which time you will be asked to cough. The tape is slowly tightened until the urine loss with coughing stops. The tape is cut off and the cuts are all closed. A camera is introduced into the bladder during the procedure to check the passage of the tape.

Hysterectomy means removal of the womb (uterus). All the tissues removed are sent for examination by a pathologist. Under a general or regional anaesthetic, the entire womb, including the cervix, is removed vaginally. A catheter is used to drain the bladder during the operation and one or more soft drainage tubes may be left in to remove fluid from the abdomen for a few days after the operation.

Under a general anaesthetic, the uterus is removed vaginally; the front vaginal wall is cut from behind the urinary opening to the top to allow the surgeon to expose the damaged tissues around the bladder and urethra. These tissues are reinforced using stitches that absorb slowly or that remain permanently.

If necessary, any excess vaginal skin is cut away. a cut is made in the back wall of the vagina from its entrance to the top. The tissues are dissected so the muscles of the floor of the pelvis can be seen. The tissues around the vaginal wall are strengthened using stitches that only absorb very slowly and any muscle weakness is also repaired.The vaginal skin is then closed with an absorbable stitch and the vagina may have a sterile pack left in place for a day after the operation to absorb secretions and control minor bleeding. If necessary, this operation may be combined with other prolapse repairs. A urinary catheter is placed in the bladder and brought out through the urethra or the abdominal wall. This usually remains in place for a few days to keep the bladder empty and the area dry to allow healing to start.

You may experience some discomfort. Simple analgesia eg. Panadol or Nurofen may be taken for
pain relief.

You may experience some discomfort when passing urine for the first day or two. If you are unable
to pass urine & have associated discomfort please contact Dr Rana

Vaginal discharge may be clear or blood stained and may continue for 2 – 3 weeks.

To avoid the risk of infection/bleeding and promote healing:

• do not insert tampons for 6 weeks following surgery
• avoid sexual intercourse, baths, and swimming for 6 weeks following surgery
• practice regular hand hygiene

If you think you may have a wound infection within 30 days of your surgery, symptoms include but
are not limited to feeling hot to touch, temperatures, wound ooze, smelly discharge or if bleeding
heavier than a normal period, please contact your surgeon’s rooms

You may experience a period type pain following the procedure.

You may experience some discomfort when passing urine for the first day or two. If you are unable to pass urine & have associated discomfort please contact Dr Rana

Simple analgesia eg: Panadol or Nurofen may be taken for pain relief.

Light vaginal blood loss may continue for up to two weeks.

Use of tampons and sexual relations should not be resumed until bleeding stops post procedure.

Use clean sanitary items & practice regular hand hygiene.

If you think you may have a wound infection within 30 days of your surgery, symptoms include but” are not limited to feeling hot to touch, swollen, temperatures, wound ooze, smelly discharge or if bleeding becomes heavier than a normal period please contact your surgeon’s rooms.

You may experience a period type pain following procedure.

You may experience some discomfort when passing urine for the first day or two. If you are unable to pass urine & have associated discomfort please contact Dr Rana

Simple analgesia eg: Panadol or Nurofen (NOT ASPIRIN) may be taken for pain relief.

Light vaginal blood loss may continue for up to two weeks.

Use of tampons and sexual relations should not be resumed until bleeding stops post procedure.

Use clean sanitary items & practice regular hand hygiene.

If you think you may have a wound infection within 30 days of your surgery, symptoms include but are not limited to feeling hot to touch, swollen, temperatures, wound ooze, smelly discharge or bleeding heavier than a normal period, please contact your surgeon’s rooms.

If you have any other concerns following your surgery, please contact:

You may experience a period type pain following the procedure.

You may experience some discomfort when passing urine for the first day or two. If you are unable to pass urine & have associated discomfort please contact Dr Rana
Simple analgesia eg: Panadol may be taken for pain relief.

You may have some light loss.

Practice regular hand hygiene

Please follow the instructions given to you by the QFG Nurse

If you think you may have a wound infection within 30 days of your surgery, symptoms include but are not limited to feeling hot to touch, swollen, temperatures, wound ooze or gaping, please contact your surgeon’s rooms.

You may experience some cramping type pain, similar to strong menstrual cramps, especially during the first 24-48 hours after your procedure.

You may experience some discomfort when passing urine for the first day or two. If you are unable to pass urine & have associated discomfort please contact Dr Rana

Simple analgesia eg: Panadol or Nurofen (NOT ASPIRIN) may be taken for pain relief.

Some women experience a heavier discharge/bleeding 10- 14 days after the procedure.

aginal blood loss/discharge may continue for up to 6 weeks following your procedure. This is normal and is part of the healing process.

Until the discharge settles, following the procedure, do not have a bath, go swimming or have intercourse. Use of clean sanitary pads and NOT tampons is advisable. This is to reduce the risk of infection.

Practice regular hand hygiene.

If you think you may have a wound infection within 30 days of your surgery, symptoms include but are not limited to feeling hot to touch, swollen, temperatures, wound ooze or smelly discharge, please contact your surgeon’s rooms

You may experience some pain at the site of the incisions. A stitch is used to close your incisions. These stitches are self-dissolving and do not need to be removed.

You may experience pain at the operation site for a few weeks after discharge. Simple analgesia eg: Panadol or Nurofen can be taken for pain relief. It may be best to take something before the pain becomes too severe.

If you are someone who gets constipated, please use regular Lactulose/ Movicol for 7 days after the procedure. Leave the dressing/ skin glue intact for 6 days or as instructed.

Please wash hands with soap & water prior to removing dressing/ glue on day 7.

You can shower normally with or without dressing/ skin glue. Dry the wound area by blotting with a clean towel, do not rub the wound. DO NOT apply talc or lotions near wound.

Light vaginal spotting is normal following surgery particularly between week 2 and 3. If the bleeding is heavy like a period, please contact Dr Rana’s rooms.

If you think your wounds may be infected, (feels hot to touch, swollen, temperatures, wound ooze or gaping) please contact Dr Rana’s rooms or your own GP.

It is normal to have vaginal bleeding for up to 6 weeks. It will become lighter slowly.

You will have a glued tape or a dressing on your cut with self-dissolving stitches under the skin. Please peel your tape/ dressing on day 7 in the shower.

After removing the tape, dab dry your skin with towel after showers to keep it dry.

Most women will need pain killer medication for at least one week after the Caesarean.

Dr Rana’s administrative staff will send you a 6 week follow up appointment after discharge.

You may experience some pain at the site of the incisions. A stitch is used to close each of the small incisions. These stitches are self-dissolving and do not need to be removed.

Simple analgesia eg: Panadol or Nurofen can be taken for pain relief. It may be best to take something before the pain becomes too severe.

If you are someone who gets constipated, please use regular Lactulose/ Movicol for 7 days after the procedure. You can shower normally with skin glue. Please wash hands with soap & water and peel off your glue on day 7.

Dry the wound area by blotting with a clean towel, do not rub the wound. Ensure that your navel is clean and dry. DO NOT apply talc or lotions near wound.

You may experience an ache in the shoulder area and sometimes under the rib cage caused by a small amount of gas used during the procedure irritating the diaphragm. This is normal and usually disappears within 24 -48 hours.

Light vaginal spotting is normal following surgery; it may even be blue/green colour due to dyes used.

You may experience a sensation of swelling in the abdomen.

If you think your wounds may be infected, (feels hot to touch, swollen, temperatures, wound ooze or gaping) please contact Dr Rana’s rooms or your own GP.

You may experience some pain at the site of the incisions. A stitch is used to close each of the small incisions. These stitches are self-dissolving and do not need to be removed.

You may experience an ache in the shoulder area and sometimes under the rib cage caused by a small amount of gas used during the procedure irritating the diaphragm. This is normal and usually disappears within 24 -48 hours.

Simple analgesia eg: Panadol or Nurofen can be taken for pain relief. It may be best to take something before the pain becomes too severe.

If you are someone who gets constipated, please use regular Lactulose/ Movicol for 7 days after the procedure. Leave the dressing/ skin glue intact for6days or as instructed. Please wash hands with soap & water prior to removing dressing/ glue on day 7.

You can shower normally with or without dressing/ skin glue. Dry the wound area by blotting with a clean towel, do not rub the wound. Ensure that your navel is clean and dry. DO NOT apply talc or lotions near wound.

Light vaginal spotting is normal following surgery particularly between week 2 and 3. If the bleeding is heavy like a period, please contact Dr Rana’s rooms.

If you think your wounds may be infected, (feels hot to touch, swollen, temperatures, wound ooze or gaping) please contact Dr Rana’s rooms or your own GP.

You may experience some pain in your vagina, pelvis and right buttock. All stitches are self-dissolving and do not need to be removed.

Simple analgesia eg: Panadol or Nurofen can be taken for pain relief. It may be best to take something before the pain becomes too severe.

Do not get constipated, please use regular Lactulose/ Movicol for 6 week safter the procedure.

You can shower normally but do not take a bath for the first 4 weeks. Dry the wound area by blotting with a clean towel, do not rub the wound.

Light vaginal spotting is normal following surgery for 7-10 days.

Please contact the hospital/ Dr Rana if you have heavy vaginal bleeding.

If you think your wounds may be infected, (offensive discharge) please contact Dr Rana’s rooms or your own GP.

Commence Pelvic floor exercises soon after your surgery (8-10 times a day): TIGHTEN the ring of muscle around your back passage (anus) as though preventing a bowel movement or wind escaping, and then TIGHTEN the muscles around your front passages, LIFT them up inside, HOLD, and then…RELAX slowly.

Remembering to keep your buttocks and thigh muscles relaxed. Breathe normally throughout.