Table of Contents

Introduction 1 Understanding your reproductive system Hysterectomy 4 When a hysterectomy is recommended - Reasons for needing a hysterectomy - Alternatives to hysterectomy, some treatment options - The different types of hysterectomy - Some risk factors Vaginal repair for anterior and/or posterior vaginal wall prolapse 12 Causes of prolapse - Vaginal repair - Sexual activity Surgery for stress incontinence 15 TVT (Tension-free vaginal tape) or TOT (Trans Obturator Tape) - Colposuspension Prepare for your operation 17 General advice - Physical fitness - Smoking - Diet - Emotional wellbeing - Cultural/religious issues - Pre-operative assessment Admission to hospital 19 Pre-operative preparation - During the operation - Immediate post-operative recovery period General care after your operation 20 Pain relief - The first few days following your operation - Depression, or 'post-op' blues - Food and drink - Bladder care in hospital - Bowels and wind - Wound care - Stitches - Hygiene - Vaginal bleeding or discharge - Rest - Circulation, and prevention of thrombosis - Leg exercises - Deep breathing - Coughing - Back care in bed - Turning over in bed - Getting out of bed - Posture Exercises after your operation 29 The pelvic floor muscles - Pelvic floor muscles exercise - The abdominal muscles - Abdominal hollowing exercise - Pelvic tilting - Knee rolling After leaving hospital 33 Rest and exercise - The convalescent period - Fatigue - Vulnerability - Concentration - Personal cleanliness - Weight control and eating sensibly - Constipation - Urinary problems - Bladder care at home - Walking - Stairs - Housework - Lifting - Driving - Back to work - Travel and holidays - Sport and other activities - Sexual activity Smear tests 42 The menopause 43 Hormone replacement therapy (HRT) 44 In conclusion 46 Useful sources of information 46 Additional reading 48

About the Author

Sally Haslett is a retired Registered General Nurse, Midwife and Health Visitor, with additional qualifications and counselling experience in family planning and women's health. Molly Jennings is a retired Member of the Chartered Society of Physiotherapy and a Certificated Member of the Association of Chartered Physiotherapists in Women's Health. Hilary Walsgrove is a Registered Nurse, with a Nurse Practitioner degree and Masters degree in practice development. She works in the National Health Service as a Lead Nurse for Pre-operative Assessment and is Programme Leader for an Advanced Nurse Practitioner Course. She has a specialist interest in women's health. Wendy Weatheritt is registered with the Health Professions Council and a Member of the Chartered Society of Physiotherapy. She is also a Certificated Member of the Association of Chartered Physiotherapists in Women's Health, with additional qualifications in the field of continence. She works in the National Health Service as a senior physiotherapist in women's health.