Post-Hysterectomy: What To Expect After Your Surgery
What to Expect after Hysterectomy
Frederick R. Jelovsek MD, MS
"Since my hysterectomy 4 1/2 months ago, I experience bleeding after intercourse. Is this normal? It is a small amount of fresh blood, bright red. Is it possible that I have not healed internally yet? "
I am age 45. My menstrual history was normal and the hysterectomy was performed because of a large rapidly growing fibroid tumor." S. B.
Complications can occur after hysterectomy ranging from minor problems such as urinary tract infections or vaginal spotting to major health concerns such as wound infections that take 3-4 months to heal or persistent severe pain with sexual intercourse.
It is difficult for you to know exactly what to expect since most female friends who have had a hysterectomy tend to forget the minor difficulties, and sometimes they may expand out of proportion, any major problems they have had.
Are You In Danger If You Have Post Hysterectomy Bleeding?
Doctors almost never inform women of all the changes they will feel during recovery from major surgery because there are too many possible changes. Most changes and symptoms go away on their own.
The surgeons also do not cover all of the unusual or rare but recognized complications of hysterectomy. If you are a person who develops those problems, they will be totally unexpected and you will think the surgeon "bungled" the operation because something happened that you had never heard of before.
Finally, other procedures such as removing the ovaries or having cystocele, rectocele, or urinary support surgery can have their own unique sets of complications and symptom effects.
For example, support surgery with several incision lines from the vaginal opening to the end of the vagina is much more likely to result in painful intercourse than would a plain hysterectomy.
Post operative, decreased sexual libido is a much greater magnitude when the ovaries are removed than when surgical menopause does not take place at the surgery. Then there is another variation in intensity of libido level when estrogen replacement is adequate versus being too low or none at all.
This article will focus only on the hysterectomy side effects and complications and not on the interplay of adding other procedures.
Is vaginal bleeding after a hysterectomy comon and how long should it last?
Normal post operative bleeding lasts from several days to several weeks after surgery. After the first couple of days the bleeding turns into spotting, usually dark red but sometimes bright red. Then in most instances, the bleeding stops for good.
Sometimes there may be a burst of bleeding at about 2-3 weeks if there was a collection of blood clot in the pelvis from right after the surgery. And occasionally at about 2 - 8 weeks after surgery, there may be some bright red vaginal spotting due to suture dissolving.
The timing depends upon the type of suture used and how fast it dissolves. This may be spontaneous bright red spotting (it is rarely ever heavy) or it may happen after intercourse or physical activity.