Just like other major surgeries, hysterectomy carries health risks and complications. Pain after hysterectomy is common with 85 percent of women experiencing moderate to severe pain after the procedure. And 32 percent of these women will experience chronic pain one year after the surgery.
What to expect after the surgery:
As you would expect, the first 24 hours after your surgery is the most uncomfortable time. The pain is mainly in your tummy, and some patients describe it as being like a bad period pain. If you have undergone vaginal hysterectomy, the feeling is more of a bearing down pain or tenderness.
The degree of pain will vary depending upon the organs (uterus, ovaries, fallopian tubes) removed or rearranged. Some studies and research suggest that women have less pain after laparoscopically assisted vaginal hysterectomy than they do after the traditional vaginal or abdominal hysterectomy.
Sitting on a chair is uncomfortable in the beginning. But after a day or two the pain gradually starts decreasing. Although in most of the cases, this pain after the surgery starts diminishing after four weeks, but you need to accept that soreness may linger on for some time.
Gas post hysterectomy
Painful cramps in the abdomen and bloating is something you may expect after surgery. During surgery your bowels hardly move and gas builds up inside. This can cause great discomfort and pain until the moment you are is able to pass gas or have your first bowel movement.
Don’t be embarrassed to pass gas and hold it until you can discreetly go to the bathroom. This is not the time to think about good manners. The air has to come out and is a necessary part of your recovery.
Remedy for gas pain after hysterectomy:
- Get out of bed and start walking to encourage peristaltic of the bowels. This is the best way to get rid of the build-up gas.
- Apply a heating pad to reduce the gas pain. Do not apply heat near the wound as there is less sensation and the skin can easily get burned.
- Drink some hot tea. Especially peppermint tea promotes bowel movement and helps to ease gas pains.
- You may try Simethicone (Gas X). This is a medication that helps the body to get rid of excessive gas.
- Constipation after hysterectomy can cause gas pain when stool blocks the rectum. Then taking Colace (a stool softener) may help.
- You should also know that the pain medication and antibiotics that you get after surgery can slow down and disrupt the bowel activity. If you feel you don’t need it anymore, consider stopping the pain medication.
Common after a laparascopic surgery is that trapped gas causes shoulder pain. This is because of the CO2 gas they introduce to expand the abdomen. This trapped gas irritates the nerves of the diaphragm that then sends pain signals upward to the shoulder.
It is not unusual that this shoulder pain lasts up to a week. Apply a heating pad and lying on your side may help to relief the pain. Though they may help; remember be cautious with pain medication as they may slow down your bowels. If the pain persists contact your surgeon for advice.
Causes of pain after hysterectomy:
Women are at risk of developing persistent pain after hysterectomy. If the pain becomes worse during the recovery phase, there are chances of you may have complications.
1. Vaginal or bladders prolapse
The most common cause of pain after hysterectomy is vaginal or bladders prolapse.
When they remove the uterus, the vagina suddenly lacks its support and roughly 10% of women will experience a vaginal vault prolapse in the years following their hysterectomy.
If this happens you may experience:
- A dragging, uncomfortable sensation as the top of the vagina drops down in the vagina.
- Pain during sex.
- Lower back pain after hysterectomy
- Aching in the pelvic area.
- Problems with urinating.
2. Pain around the wound after hysterectomy
Pain around the incision can be the result of a late surgical infection or abscess in the abdomen. Signs there may be an infection is if the pain is accompanied by fever, the area around the wound is red and feels warm and you are overall feeling bad.
3. Painful sex after hysterectomy
After the removal of uterus, they stich the top of the vagina (vaginal vault). The area around the vaginal cuff is less elastic for some time after the surgery, causing a weird loss of sensation, discomfort or pain during intercourse.
But also abnormalities of the vaginal vault or cuff sometimes cause chronic pain after hysterectomy. At times, the pain at the very top end of the vagina can be neuropathic, and due to nerves sending abnormal pain signals.
Usually there is no visible damage, but even the gentle touch is felt as pain.
4. Pelvic pain after hysterectomy
Adhesions (or bands of scar tissue in the abdomen) can also cause abdominal pain after hysterectomy, cramping and at times a bloating sensation. Adhesions can bind different structures like your bowel, vagina or bladder causing an unusual feeling of tightness or pulling in the pelvis.
Other symptoms women with adhesions may experience are:
- Lower back pain
- Constipation or pain with bowel movements
- Bladder pain after hysterectomy
- Pain during intercourse
Having a hysterectomy does not always cure persistent pelvic pain due to endometriosis. Pain after hysterectomy due to reoccurrence of endometriosis may happen when the endometriosis lesions are not thoroughly removed during surgery. Women who choose to keep their ovaries should know that they have a 6 times higher chance of reoccurrence compared to women who have the ovaries removed.
5. Ovarian pain after hysterectomy
By keeping their ovaries women may still experience monthly, menstrual or ovulation pains. After they remove the uterus, ovulation continues normally. Without the uterus, the eggs that are produced, fall in the pelvic cavity where they are absorbed.
About 10% of women will develop ovarian cysts after hysterectomy. They believe this happens because there is less blood flow to the ovaries after they remove the uterus. Some of these cysts cause no symptoms at all but others can be the reason for severe abdominal pain after hysterectomy.
Ovarian cysts always need a closer examination. The majority of these cysts are harmless but there is always a small risk that they twist, burst or contain cancerous cells. Ovarian cancer in the early stages has few and vague symptoms.
More specific symptoms such as bloating, persistent pelvic pain and being nauseous, usually develop in later stages, when the cancer has already spread.
6. Painful joints after hysterectomy
Pain in legs, knees and shoulders is common after a total hysterectomy with bilateral salpingo-oophorectomy. You can read more about menopausal arthralgia and why this occurs in our post sudden and widespread post hysterectomy joint pain.
Treating pain after hysterectomy:
How they treat pain after hysterectomy depends on the cause and severity of the pain. In normal cases, pain after hysterectomy responds well to pain medications. Taking enough rest during the recovery phase is important and doing too much too soon may lead to increased pain or tenderness.
It is important for you to know that the soreness and aches in the body may persist for quite few months. Therefore, to get your mind distracted from pain, involve yourself in some relaxation techniques or hobby classes or light household chores. Be patient with yourself and keep in mind that your pain will eventually completely fade away.
The pain should gradually decline and should be intermittent in later stages of recovery. However, if this pain becomes severe, your physician will check your condition to find out the underlying medical condition. Then you may need a complete examination by your gynecologist, and running the necessary laboratory tests.