As with most surgeries, women will have to deal with pain after a hysterectomy. How much pain you will feel after the operation depends on the type of hysterectomy performed and your individual susceptibility to pain.
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The degree of pain will vary depending on the type of incision made. Some studies and research suggest that women have less pain after laparoscopically assisted vaginal hysterectomy than they do after a traditional vaginal or abdominal hysterectomy.
Vertical abdominal incisions are usually less painful than horizontal incisions. Vaginal hysterectomies have the least amount of pain.
However, 5 to 32 percent of the women who had a hysterectomy reported 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 bad period pain. If you have undergone a 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 this pain after the surgery starts diminishing after four weeks, you need to accept that soreness may linger on for some time in most cases.
Gas post hysterectomy
You may expect pain in the abdomen and bloat after surgery. During the operation, the bowels are motionless, and gas builds up in your belly. This can cause great discomfort and pain until you can 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 must 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 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 you get after surgery can slow down and disrupt bowel activity. If you feel you don’t need it anymore, consider stopping the pain medication.
Common after 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, which 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 that you may have complications.
1. Vaginal or bladder prolapse
The most common cause of pain after hysterectomy is vaginal or bladder prolapse.
When they remove the uterus, the vagina is attached to supporting ligaments, but these tissues can weaken over time. 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.
- 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.There may be an infection when the pain is accompanied by fever, the area around the wound is red and feels warm, and one is generally notfeeling well.
3. Painful sex after hysterectomy
After the removal of the uterus, they stitch the top of the vagina (vaginal vault). Sex after a 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, the tissues around the vaginal cuff may be less sensitive and flexible initially.
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 due to nerves sending abnormal pain signals.
Usually, there is no visible damage, but even a gentle touch is felt as pain.
4. Pelvic pain after hysterectomy
After surgery, your body will start forming scar tissue as part of the normal healing process. When two healing tissues connect 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 several other symptoms.
Other symptoms of 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 endometriosis’s reoccurrence 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 than women who have the ovaries removed.
5. Ovarian pain after hysterectomy
Monthly ovulation pain can continue after a hysterectomy when a woman still has her ovaries. After they remove the uterus, ovulation continues normally. Without the uterus, the eggs 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. Most 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 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, such as the knees, shoulders, and hips. You can read more about menopausal arthralgia and why this occurs in our post about sudden and widespread post-hysterectomy joint pain.
Treating pain after hysterectomy:
How they treat pain after ahysterectomy 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.
You need to know that the body’s soreness and aches may persist for quite a few months. Therefore, to distract your mind from pain, involve yourself in relaxation techniques, 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 determine the underlying medical condition. Then you may need a complete examination by your gynecologist and running the necessary laboratory tests.
Reviewed by: Kimberly Langdon M.D. (OB/GYN)
Date reviewed: 18/3/2019
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Where is the location of pain after hysterectomy? ›
Hysterectomy improved pain in most women (tables 2 and 3). However, 362 women (31.9%) had pain in the pelvic area 1 yr after surgery. The most common pain location was in the middle of the pelvic region, but 70 women reported pain located in the abdominal scar.How long will my insides hurt after hysterectomy? ›
How long is it normal to have pain after a hysterectomy? This can certainly vary based on each person and situation but we give a general timeframe of 3 months. A hysterectomy is an invasive surgery so it naturally requires downtime and will come with some residual pain and discomfort.Why is my pain getting worse after hysterectomy? ›
About 2-3% of women who have had hysterectomy develop a new pain problem after surgery. Because we specialize in the evaluation and treatment of pain, we often see women with this problem.In some instances, the pain comes from scar tissue that has formed during the healing process of the original hysterectomy surgery.How do you get rid of pain after a hysterectomy? ›
Your doctor will write you a prescription for pain medication and an anti-inflammatory (Motrin) when you go home. After surgery, discomfort and mild to moderate pain are common. Take your pain medication before the pain becomes severe. This will give you better pain control.