The usual treatment for a molar pregnancy is surgery to remove the molar tissue from the womb.
But your surgeon might advise you to have a hysterectomy if:
- the molar pregnancy is causing a lot of bleeding from your womb
- you already have a condition of the womb, such as fibroids
- you don’t want to have any more children
Before the operation
You might have some tests, such as blood tests, a heart trace (ECG) and a chest x-ray.
A member of the surgical team will tell you about the operation you are going to have and what to expect afterwards.
Your nurse will check your:
- blood pressure
Your nurse might give you a tablet or an injection to help you relax. This will be an hour or so before you go to the operating theatre. This makes your mouth feel dry but you can rinse your mouth with water to keep it moist.
How you have it
You have the operation under general anaesthetic. The anaesthetist puts a small tube into a vein in your arm (cannula) and injects the general anaesthetic. This sends you into a deep sleep. When you wake up, the operation will be over.
Your surgeon removes your womb and cervix. This is called a total hysterectomy.
When you wake up
After your operation you usually wake up in the recovery room in theatre. You go back to the ward as soon as you're awake and your temperature, blood pressure, pulse and breathing rate are stable.
You'll feel drowsy for a while because of the anaesthetic and painkillers.
Tubes and drains
When you wake up, you’ll have several tubes. This can be frightening, so it helps to know what they’re for.
You might have:
- drips (intravenous infusions) to give you fluids until you are eating and drinking again
- a tube into your bladder (catheter) to measure how much urine you pass
- wound drains to drain any blood or fluid
The wound you have after surgery depends on the type of operation you had.
You might have a wound that runs vertically, up and down your lower abdomen. This is called a mid line incision. Or you may have a wound that runs from right to left across your lower abdomen (your bikini line). This is called a transverse incision.
Your surgeon will talk to you before your operation about the type of cut they are likely to do and why.
You might have a dressing over your wound after the operation. After a couple of days your nurse takes the dressing off and cleans the wound. They are likely to leave the dressing off unless the wound is oozing.
If you have wound drains, these stay in until they stop draining fluid. They can usually come out about 2 to 7 days after your operation.
You might have stitches that gradually dissolve, so you don't need to have them taken out. Other types of stitches or clips stay in for at least 7 to 10 days. Your nurse may take them out before you go home. Or a nurse at your GP surgery or a district nurse can usually remove them.
It’s normal to have pain for the first week or so. Your doctor and nurses give you painkillers.
Tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.
Immediately after surgery you might have painkillers through a drip into the bloodstream that you control. This is called patient controlled analgesia (PCA). Or you might have painkillers through a small thin tube that is put into your back. This tube is connected to a pump that gives you a constant dose of painkiller. This is called an epidural.
You will have painkillers to take home. Follow the instructions your nurse gives you about how often and when to take them. Contact your doctor if you still have pain or if it gets worse.
Eating and drinking
You can usually drink and eat as soon as you feel up to it. This may be a few hours after surgery, as long as you don't feel sick. Your nurse will tell you when you can start drinking and eating.
Getting up and walking is likely to be difficult at first. Moving about helps you to get better, but you need to start gradually. Your nurses will encourage you to get out of bed and sit in a chair as soon as possible, usually a day or two after surgery. They will help you with any drips and drains.
The physiotherapist might visit you every day after your operation to help you with breathing and leg exercises.
Over the next couple of days, the tubes, bottles and bags will be taken away. Then it will be much easier to get around.
You usually go home between 4 and 7 days after surgery. You will need to rest for about 4 to 6 weeks after you come out of hospital.
During this time, you won't be able to:
- do heavy housework, such as vacuuming
- carry heavy bags of shopping or washing
This is because all these activities put pressure on your abdominal muscles and skin. These need time to heal. It will take longer to get over your operation if you put too much strain on the area.
You will gradually be able to increase the amount you can do. Your nurse and surgeon will advise you about this.
A short walk every day is a good idea. You will get a bit of fresh air and you can gradually go further as you regain your strength. Do take it easy at first though.
Follow up tests after your surgery
For most women, the surgery removes all of the molar tissue. So no more treatment is needed. But sometimes there might be a few cells remaining in the body that can carry on growing after the surgery.
You need to have regular follow up to make sure you have no signs of remaining molar tissue after your surgery. Molar tissue produces a hormone called hCG. So you have regular blood or urine tests to check the levels of hCG.
If the hCG levels stay high or they go up, it is called persistent trophoblastic disease or PTD.
You might need to have a course of chemotherapy.
How you might feel
It’s not easy to deal with a molar pregnancy and you might have very strong emotions that feel overwhelming. Your nurse or midwife will support you and offer some options for counselling and support.