Just like other major surgeries, after a hysterectomy women will have to deal with pain.
How much pain you will feel after the operation depends on what type of hysterectomy they performed and your individual susceptibility to pain.
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.
However, 5 to 32 percent of the women who had a hysterectomy report that they still have pain 4 months 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.
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, you need to accept that soreness may linger on for some time.
Gas post hysterectomy
Painful cramps in the abdomen and bloating are something you may expect after surgery. During the operation, the bowels are motionless and gas builds up in your belly. This can cause great discomfort and pain until the moment you are is able to pass some 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. The air has to come out and is a necessary part of your recovery.
A 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 laparoscopic 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 relieve the pain. Though they may help; remember to 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:
There are several reasons women may develop 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 bladder 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 at 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 when the pain is accompanied by fever, the area around the wound is red and feels warm, and one is generally not feeling well.
3. Painful sex after hysterectomy
After the removal of the uterus, they stitch the top of the vagina (vaginal vault). Sex after hysterectomy can be uncomfortable when the wound has not completely healed. This usually takes 6 to 8 weeks but can also take longer. Like with any wound, in the beginning, the tissues around the vaginal cuff may be less sensitive and flexible.
But also abnormalities of the vaginal vault or cuff cause on occasion 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
In general, after surgery, your body will start to form scar tissue as part of the normal healing process. When two healing tissues become connected with scar tissue, they form what they call adhesions. Because the normal surface has been disrupted organs that would normally slide along each other will now stick together. This may cause pelvic pain after hysterectomy and a number of other symptoms.
Other symptoms women with adhesions may experience are:
- Lower back pain
- Constipation or pain with bowel movements
- Bladder pain after hysterectomy
- Pain during intercourse
Pain after hysterectomy due to the reoccurrence of endometriosis may happen when the endometriosis lesions are not thoroughly removed during surgery. Having a hysterectomy does not always cure persistent pelvic pain due to endometriosis. 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
Monthly ovulation pain can continue after hysterectomy when a woman still has her ovaries. 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 cancer has already spread.
6. Painful joints after hysterectomy
Following a full hysterectomy, women can also suffer from joint pains. This can affect various joints in the body like such as the knees, shoulders and the hips. 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 a 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 a 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.