Prior to surgery, the gynecologist or surgeon typically takes a complete medical history and performs a thorough physical examination in order to evaluate the overall physical health of the patient. Hysterectomy is often performed on an inpatient basis, meaning that an overnight hospital stay is required. This procedure is performed with the patient under general anesthesia (the woman is asleep during the procedure).

Patients may be asked to donate blood prior to the hysterectomy procedure in case a transfusion later becomes necessary. The woman should inform her physician about all medications she may be taking to ensure that none of them will adversely interact with medications used during the surgery.

Patients are typically asked to refrain from eating or drinking for eight to 12 hours prior to surgery. The patient should also abstain from smoking for at least two weeks before and two weeks after the surgery since it can delay healing time. It is also advisable to avoid taking certain vitamins or even aspirin for a period of time prior to surgery. 

During the surgical consultation, the physician will discuss the surgical technique, the type of anesthesia and the patient’s expectations. They may also discuss any alternative treatment options, scarring, and recovery from the procedure.

The physician will review the patient’s signs and symptoms and conduct a thorough pelvic examination. Based on the findings, the physician may order the following preoperative tests:

• Urine tests to check for a urinary tract infection
  
  
• A chest x-ray (common before using general anesthesia)
  
  
• Blood tests to determine blood type and check for any possible clotting disorders
  
  
• Pregnancy test (if there is any chance the patient may be pregnant)
  
  
• An electrocardiogram (EKG), which is a test used to diagnose any heart abnormalities by recording electrical changes during the patient’s heartbeat

In most cases, the patient will meet with an anesthesiologist prior to the procedure, although often this will occur on the same day as the surgery. The meeting is an opportunity for the patient to inquire about the various options for anesthesia and discuss any concerns or known disorders including coagulopathy (clotting disorder), obesity, any abnormalities of the spine and a personal history of cardiovascular or respiratory diseases that could interfere with the anesthesia.

Before the hysterectomy, the patient will be prepared for surgery. Her abdomen will be washed and shaved and a catheter (small tube) will be placed in the bladder, allowing urine to empty outside of the body. Other preparations will include a small tube being placed in the vein of the patient’s arm to allow for fluids and medications, including possibly anesthesia, during surgery.