Hysterectomy - Preoperative work up

Hysterectomy - Preoperative work up

Preoperative work up involes a through clinical evaluation, relevant lab tests and the precautions to be followed before surgery.

Preoperative evaluation includes the following:

•  A complete history and physical examination to rule out any co-morbid conditions such as diabetes mellitus, hypertension, cardiac disease or asthma.
•  Use of medications such as use of aspirin, oral hypoglycemics, heparin, or warfarin should be documented
•  Biopsy of the endometrium, which is the inner lining of the uterus is essential to rule out cancer or pre-cancer of the uterus. This procedure is called endometrial sampling.
• PAP smears to rule out cervical cancer maybe necessary in some cases..
• Ultrasonography to study the pelvic anatomy ans assess the size of the uterus.
• CBC count (complete blood count), blood type and cross match.
• ECG and chest radiograph to assess the cardiac and respiratory systems.

Preoperative preparations

1. Informed consent- written consent is obtained from the patient prior to performing the surgery.

2. It is recommended that the patient take nothing by mouth (food, water, etc.) for at least 6 hours before the scheduled operation or after midnight if the operation is planned in the first few hours of the morning.

3. Painkillers and antibiotics may be prescribed before the procedure.

4. A sedative maybe useful to relieve the anxiety of surgery.

5. The Abdomen and genital area maybe shaved and prepared for the surgery.

6. Before surgery or during the previous night a bath maybe advisable. During the bath thorough cleaning of the abdomen and genital area with soap and water a few times can help in lowering the bacterial count and lessen the chances of any infection from surgery.

7. An enema maybe administered to the patient prior to performing the surgery. Sometimes a laxative maybe given to clear the bowels on the previous night.