Gynecology And Obstetrics-

Pain after removal of the uterus

The removal of the uterus (hysterectomy) is a frequently performed and usually minimally invasive operation. However, pain in the pelvic area may occur after the procedure. This pain can be treated well with pain medication and will subside after a while. If there are other symptoms in addition to the pain after the removal of the uterus, such as fever, it must be clarified whether there is an infection or other complications.

causes

When the uterus is removed, minimally invasive surgery is often used. This means that no large cut is made, just a few small cuts. Even so, much of the tissue around the uterus becomes irritated or injured during the operation. Moving tissue and organs and injuring nerve fibers in particular can be the cause of postoperative pain. These can then persist for a few days to weeks after the operation.

One must differentiate between regular pain after removal of the uterus and that of a surgical complication. The normal postoperative pain can usually be relieved well with pain therapy. In addition, there are no other symptoms except perhaps fatigue. Severe pain in combination with, for example, fever or reddening of the seams can be caused by an infection. This must then be clarified.

Pain as a sign of a complication is often more intense and has different characteristics. After the operation, small tubes are inserted in the operating room so that the wound fluid can flow outwards. Although these tubes are a small foreign body, they can still be the cause of pain. As soon as the tubes have been pulled a few days after the operation, many women report an improvement in their pain symptoms.

Read more on the topic: Operation on the uterus

Concomitant symptoms

It is normal to be slightly tired for a few weeks after the operation. In addition to the pain in the surgical area, pain in the neck area from the anesthesia can also occur. For general anesthesia, a breathing tube is inserted into the windpipe. This can irritate the mucous membrane and lead to sore throats, swallowing difficulties and hoarseness. However, these symptoms are only temporary and usually do not last longer than a few days. Pain can also occur in various parts of the body due to the positioning during the operation.

pain in the stomach

The removal of the uterus is an operation that takes place in the lower abdomen or pelvis. Therefore, the pain after removal is also localized in this area. Pain in the pelvis can occur at the surgical site and the puncture sites can also trigger pain stimuli.

Painful urination

After a hysterectomy, there is an increased risk of painful urination (dysuria). This can be temporary, but there are also cases where the pain persists. Other symptoms that may occur in connection with the painful urination are increased urination, increased nocturnal urination (nocturia) and stress incontinence.

Also read the article on the topic: Hysterectomy

Pain in the groin

Pain in the groin may indicate nerve compression from surgery or from the formation of scar tissue. Depending on which nerve is affected, the pain can also radiate into the abdominal area or the labia. Such pain must be differentiated from normal postoperative pain, which can radiate from the lower abdomen to the groin.

Painful intercourse

Sexual intercourse should not resume until four to six weeks after the hysterectomy. During the operation, the top of the vagina is closed after the uterus has been removed. In some women, this area can still be painful later on.As a rule, pain during intercourse subsides a few months after the operation, so that the intercourse can be carried out as before the operation.

stomach pain

Abdominal pain can occur from the stimuli of the operation alone. The bowel must be held up during the operation so that it is not injured by the operation. This movement can lead to diarrhea or abdominal pain a few days after the operation. Abdominal pain can also be a symptom of another postoperative illness. Urinary tract infections often occur after operations. In addition to abdominal pain, there is a burning sensation when urinating and an increased need to urinate. In some cases, pneumonia can also manifest itself with abdominal pain.

Pain after months / years

As a rule, the pain caused by the operation subsides within 6 weeks. The surrounding tissue needs this time to heal. However, women with endometriosis can still experience pelvic pain months or years later. This then indicates that there is still some dislocated uterine lining in the lower abdomen.

This mucous membrane reacts to the hormone fluctuations and thus leads to pain. If the endometriosis is so severe that the uterus has to be removed, the ovaries are removed at the same time. This is the only way to ensure that the pain can be controlled. In women without endometriosis who have had their uterus removed, persistent pain for months or years is unusual and needs to be investigated. If pain recurs and was preceded by a pain-free interval, adhesions or an infection should be considered.

Also read the article about: Treatment of endometriosis

diagnosis

The intensity of pain can be easily indicated using a scale. Such scales use either a point system or a line, the end points of which symbolize “no pain” and “strongest imaginable pain”. Since pain is subjective, these scales are particularly suitable for documenting the course. Such a scale would also be used in the diagnosis of pain after a uterine removal. If the pain persists over the normal period for reasons that are initially inexplicable, you can also keep a pain diary in order to obtain more information about the temporal course of this.