A vaginal cuff is a closure made at the top of the vagina, near where the cervix is usually located. A surgeon creates a vaginal cuff by stitching together the top part of the vagina, usually as part of a total or radical hysterectomy.
Doctors recommend hysterectomies for women who would benefit from the surgical removal of the uterus. The cervix is the lowest part of the uterus where it meets the vagina.
During a total or radical hysterectomy, a surgeon removes the woman’s whole uterus, including her cervix. The surgeon will then create a vaginal cuff in the place of the cervix.
Sometimes, a vaginal cuff procedure will be done separately from a hysterectomy if this area needs to be repaired due to tearing or improper healing.
Share on PinterestA surgeon will create a vaginal cuff during a total or radical hysterectomy.
It is essential to speak to a doctor about the recovery process, as every woman is different and may benefit from an individualized recovery plan.
Usually, a doctor will give the following instructions to a woman who has just undergone a total hysterectomy:
- Get plenty of bed rest for the first few weeks.
- Avoid strenuous activities.
- Do not lift more than 10 pounds.
- Stay away from any activity that puts pressure on the pelvic area.
- Control chronic coughs.
- Avoid straining during bowel movements.
- Abstain from sexual activity.
- Do not use tampons.
- Do not insert anything other than prescribed medication into the vagina.
A doctor will also prescribe medications to prevent infections and reduce pain. A doctor may also recommend an estrogen cream that can be applied to the vaginal cuff to help it heal.
Recovering from a hysterectomy with a vaginal cuff takes a minimum of 6–8 weeks, but may take longer depending on a person’s overall health.
While recovering from a hysterectomy with a vaginal cuff, a woman may be asked to see a doctor for a checkup.The doctor will make sure the vaginal cuff is healing properly and that there are no signs of infection.
If scar tissue is forming on the vaginal cuff site, the doctor may apply a small amount of silver nitrate to burn off the scar tissue and aid healing.
Removing the scar tissue may be uncomfortable but should not be painful. It can usually be done in the doctor’s office without any need for a separate appointment.
Share on PinterestObesity increases the risk of experiencing a vaginal tear following a hysterectomy.
While vaginal cuffs are generally safe, there is a small risk of the cuff tearing. A vaginal cuff tear occurs when the edges of the wound split or rip.
A vaginal cuff tear, also known as vaginal cuff dehiscence, is rare. Due to the suturing or cutting technique, women are more at risk for this complication if they have undergone a laparoscopic or robotic hysterectomy instead of an abdominal or vaginal hysterectomy.
If the vaginal cuff tear is very large, additional complications may occur, including a bowel evisceration. This happens when the bowels push through the torn vaginal cuff.
Factors that increase the risk of a vaginal tear after a hysterectomy include:
- weakened pelvic floor muscles
- engaging in sexual activity before the vaginal cuff has healed
- smoking cigarettes
- uncontrolled diabetes
- obesity
- chronic constipation
- any condition that causes chronic or severe coughing
- vaginal infections
- vaginal atrophy
- weakened immune system
- history of radiation in the pelvic region
While vaginal cuff tears are rare, they can be a life-threatening medical emergency.
Women who are having a vaginal cuff as part of a hysterectomy should seek immediate medical attention if they develop any of the following symptoms:
- sudden or severe abdominal or pelvic pain
- vaginal discharge or bleeding
- pressure in the vagina or lower pelvic region
- fluid rushing into the vagina
- foul smell coming from the vagina
While vaginal cuff tears are most likely to occur within a few days of the hysterectomy, they can occur at any time following the procedure.
Most of the time, tears occur spontaneously, but they can also be triggered by sexual activity or a bowel movement.
Share on PinterestA doctor will recommend plenty of rest and avoiding any strenuous activity.
A person will need surgery to repair the vaginal cuff if they experience a vaginal cuff tear. Other complications that require vaginal cuff repair include:
- an abscess
- peritonitis, which is inflammation of the lining of the abdomen and its organs
- hematoma, which is a buildup of blood outside of the blood vessels
- bowel evisceration
In some cases of a partial vaginal cuff tear, a surgeon can repair the cuff through the vagina instead of making an external incision.
A person will be given intravenous fluids and antibiotics before and after surgery. The length of the surgical procedure may vary based what caused the tear or other complication.
After surgery, the person will be taken to a recovery room and monitored while the anesthesia wears off. They may have to stay overnight in the hospital, particularly if bowel function was affected.
After a vaginal cuff repair, people need to allow 8 to 12 weeks of recovery time. During this time, a doctor will recommend avoiding any activity that strains the new incision, including heavy lifting and sex. Many doctors will also suggest getting lots of rest and limiting strenuous exercise.
The best way for a woman to manage a vaginal cuff is to follow all of her doctor’s instructions following a hysterectomy.
Some women may feel better in just a few weeks after surgery. They may push themselves too hard physically or have sex before the vaginal cuff has healed, accidentally causing an injury or tear.
A woman healing from a hysterectomy and a vaginal cuff procedure should be gentle on their body and avoid physical and sexual activity until the cuff has fully healed.
Vaginal cuff tears and complications are rare, but it is important to take precautions. Women can reduce their risk of experiencing these complications by following an individualized recovery plan after surgery and giving their body plenty of time to heal.
If a woman needs a vaginal cuff repair, she will likely need to spend up to 12 weeks recovering before a doctor clears her to resume normal activities, including exercise and sexual activity.
If you’ve had a hysterectomy or are anticipating having the procedure performed, your first questions may be, “What happens internally after a hysterectomy?” or “What happens inside my body?”
These are completely normal questions to have. After all, the surgeon is removing a good portion of your abdominal tissues and organs, especially if you get a radical hysterectomy.
To understand what happens internally after a hysterectomy, we’ll first take a look at how the surgeon performs the procedure. Then we’ll answer many of the detailed questions women frequently ask about what to expect internally after a hysterectomy.
Types of Hysterectomy Procedures
What happens inside your body after a hysterectomy will depend on the type of hysterectomy and how the surgeon performs the procedure.
There are three different types of hysterectomy. The type your doctor recommends for you is based on your circumstances.
- Partial hysterectomy (supracervical hysterectomy) removes the uterus but leaves the cervix intact. This type affects the body the least, internally.
- Total hysterectomy removes the cervix as well as the uterus. In some cases, the surgeon may also remove one or both of your ovaries and fallopian tubes. This type requires a vaginal cuff and may affect your hormones if you have your ovaries removed.
- A radical hysterectomy removes the cervix, the uterus, and part of the vagina. The surgeon may also remove your fallopian tubes, ovaries, and local lymph nodes. This type is like the total hysterectomy in how it affects your body internally, but it may also require some vaginal cosmetic surgery.
There are also four different ways the surgeon can perform your hysterectomy on the day:
- Through the vagina (no abdominal incisions)
- Via the abdomen (open surgery)
- Using laparoscopy (a minimally invasive technique)
- Robotic hysterectomy (laparoscopic surgery that uses a robot)
Each of these techniques has its pros and cons. As you can imagine, having open surgery that requires the surgeon to cut through abdominal muscles causes many more internal side effects than laparoscopy, which only requires a couple of small slits.
Now let’s get to your questions.
First up, questions about internal changes
Do the Remaining Organs Shift to Fill Up the Void?
Yes. After a hysterectomy, the remaining abdominal and pelvic organs will shift slightly to fill in the space. This shift can cause incontinence as well as other problems. Keeping your pelvic floor muscles strong by doing Kegels and regular exercise can help prevent these problems.
How Do the Ovaries Stay in Place?
The fallopian tubes connect the ovaries to the uterus. Ligaments that extend from the upper part of the uterus to the lower part of the ovaries hold them in place. If you want to preserve your ovaries, your surgeon can reattach them after they’ve separated them from your uterus.
What Happens to My Bowels After a Hysterectomy?
Everything in your pelvis sits close together, so it’s natural that your bowels would be affected by a hysterectomy.
You may experience
- gas incontinence
- an urge to defecate
- cramping
- constipation
- irregular bowel movements
- fecal incontinence
- an inability to distinguish between gas and feces.
You can expect your first bowel movement within 4-5 days after surgery. Bowel problems should go away anywhere from several days to weeks after your hysterectomy.
Can My Internal Pelvic Organs Get Messed Up After a Hysterectomy?
Some women have pelvic organ prolapse after surgery. The vagina may collapse, the tissue between the bladder and vaginal wall or rectum and vagina may weaken, or the small intestine may drop into the lower pelvic cavity.
Prolapses usually occur in women who have preexisting pelvic floor problems. Women who have no issues with prolapse prior to surgery are at a much lower risk of developing post-surgery prolapse.
In a Total or Radical Hysterectomy, What Replaces My Cervix?
Don’t worry. Things do change internally after a hysterectomy. But your surgeon is not going to leave you with a big gaping hole at the top of your vagina. Instead, they will make a vaginal cuff by stitching together the top part of the vagina to create a closure.
And Now, Your Questions About How Internal Changes Might Affect Your Sex Life
Can a Man Feel When a Woman Has Had a Hysterectomy?
This is a concern of many women who want to have sex after a hysterectomy. If the surgeon only removed your uterus, sex after hysterectomy for the man may feel surprisingly similar. In procedures that remove the cervix or some of the vagina, the surgeon will take steps to maintain vaginal functionality and do some reconstructive surgery if necessary.
Will I Still Get Wet After a Hysterectomy?
It takes time for sensation and natural lubrication to return after a hysterectomy. Using water- or silicone-based lubricants can ease penetration.
Can I Still Climax After a Hysterectomy?
The answer is yes. After a hysterectomy, you still have your clitoris and labia, which are highly sensitive. Stimulation to these areas can bring on an orgasm. More research needs to be done to understand what role the cervix plays in orgasm.
Where Does Sperm Go After a Hysterectomy?
After a hysterectomy, sperm ejaculated into the vagina has nowhere to go because the remaining areas of your reproductive tract are closed off from your abdominal cavity. Your body will eventually expel sperm along with your normal vaginal secretions.
Does HPV Go Away After a Hysterectomy?
Since hysterectomy removes the cervix, you have eliminated the risk of developing cervical cancer because of persistent HPV infection. However, HPV can still hang out in cells of the vagina.
Finally, Let’s Talk About What Can Happen Inside Your Mind After a Hysterectomy
What happens internally after a hysterectomy is one thing. However, if your ovaries are removed, your body will go into premature menopause if you’ve not already gone through it naturally. This means that your hormones will be out of balance, and you will have all the symptoms of peri/menopause.
Even if you don’t have your ovaries removed, you still have a 4-6% chance of being affected by depression or anxiety after a hysterectomy. Unfortunately, younger women are at a higher risk (12%) of suffering from depression after a hysterectomy.
We are here for you.
Hopefully, we’ve answered all of your questions. However, if we haven’t, don’t hesitate to contact us.
Our team at Nava is serious about your wellbeing, and we will do whatever we can to support you in your post-hysterectomy journey.
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