Will getting a vaginal hysterectomy cause my stomach and intestines to drop?

Dear Reader, 

Going into major surgery can be unnerving and it can bring up concerns about what your life will look like afterwards. You might find it helpful to know that, while any surgery carries risks, developing a stomach “pouch” isn't considered a likely one for hysterectomies. Some organs do shift in the abdomen after an organ is removed but any visible protrusions are more likely due to weight gain or swelling. If you do find your stomach in a pouch, there are exercises and even surgical options to address this. If you want to learn more, read on! 

What is a vaginal hysterectomy?  

A hysterectomy is a surgical procedure to remove the uterus. Hysterectomies are used to address a variety of medical conditions. A vaginal hysterectomy is a procedure done to remove the uterus through the vagina, as opposed to the abdomen. This method is considered less invasive, which can promote a faster recovery.  

What happens to the empty space?  

When the uterus is removed, some empty space is created in the abdomen. The extra room doesn’t stay vacant for long. Instead, other organs—most commonly the small and large intestine—fill it in. But beyond the movement of your intestines, your organs mostly stay put. This is even true for organs that are normally held up by the uterus! For example, if you get a hysterectomy but keep your ovaries, they remain in place held up by ligaments, even without the fallopian tubes that normally hold them up. 

Why might your abdomen protrude after a hysterectomy? 

You might feel like your abdomen is protruding slightly after a hysterectomy if you gain weight in your belly region. Gaining weight after hysterectomy isn’t unusual and can sometimes result from being sedentary and overeating during recovery. Additionally, you might gain weight if your hysterectomy includes the removal of ovaries, which can impact hormone production and bring on early onset menopause. 

It’s also common to have a swollen stomach after a hysterectomy. The swelling might lead you to believe that you’ve gained weight or that your intestines have “dropped”. But swelling is just one of the body’s natural responses to surgery and will likely resolve over the course of a few months. 

It’s also possible that you might be experiencing vaginal vault prolapse, which is one of many possible side effects of hysterectomies. Vaginal vault prolapse involves the top of the vagina dropping into the vaginal canal. Because the uterus provides muscular support for the top of the vagina, its removal may cause the top of the vagina to slowly fall towards the vaginal opening. You might experience a feeling of fullness or heaviness in your pubic area, but there might not be a visible pouch on the outside of your body.  

What can you do to limit your abdomen from protruding after a hysterectomy?  

As is the case with any surgery targeting a specific part of the body, focused exercise may help with recovery from your hysterectomy. You may want to have a conversation with your surgeon about abdominal core and vaginal muscle exercises you can do post-operation. While these exercises won’t necessarily help you lose weight, they can help you tone the stomach as well as relieve pain and promote better posture. 

If you still feel bothered by your stomach, you might consider speaking with a health care provider about a panniculectomy—a surgery that removes the lower stomach pooch. They will be able to guide you through the ins and outs of the surgery, including risks and recovery time. 

Hopefully this helps alleviate any fears about drooping pouches while preparing you for what surgery can bring. 

Good luck with your surgery,