Undergoing a hysterectomy is a major surgery and turning point in your life; if you begin to experience pelvic floor pain after your procedure, you may struggle to discern the cause or understand the best way to treat it.

In a nationwide study of 1,299 women, 31.9% experienced chronic pain one year after their surgery. Doctors identified several risk factors of post-hysterectomy pelvic floor pain that can be useful in determining why they experienced these symptoms and the best way to go about treating them.

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Pelvic Pain After Hysterectomy Statistics

Here are the statistics on pelvic pain after hysterectomy:

• Six months following hysterectomy, 15 (11.9%) patients reported persistent pelvic pain defined as failure to achieve 50% or more improvement in
• One year after surgery, 22.4% of women with preoperative pain reported pelvic pain and 7.8% reported de novo pelvic pain
• 31.9% of women had pain in the pelvic area 1 year after surgery
• As many as 25% of women still suffer from pelvic pain after hysterectomy

The statistics show that a significant percentage of women experience pelvic pain after hysterectomy, ranging from 11.9% to 31.9% in the first year after surgery.

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Is It Normal to Have Pelvic Pain After a Hysterectomy?

Between 2 and 3% of women experience pain in their pelvic floor after undergoing a hysterectomy. Some of the pain is linked to the development of scar tissue, and it may appear similar to menstrual cramps.

Post-surgical pelvic floor pain can vary; some women experience pain that is similar to what they felt before their operation while others have pain at different times and in varying intervals.

Pain After Urination

It’s not uncommon for women to report changes to their bladder after a hysterectomy. These changes include changes and duration of urination, pain increasing prior to urination and relieving after, feeling a strong urge to urinate and feeling as though you cannot enter your bladder enough.

If you experience pain after urination, this could be the result of bladder spasms, a common symptom women report after surgery. Bladder spasms are often caused by weakened pelvic floor muscle or damage to the nerve areas surrounding the bladder.

These symptoms tend to resolve on their own within three months, but you can help alleviate them by practicing pelvic floor exercises. Some patients also find it helpful to manage their pain with medication as per their doctor’s recommendation.

Pain During Sexual Intercourse

Sexual intercourse can be painful for women following a hysterectomy due to unhealed muscle and tissue. You should wait at least six weeks post-op before engaging in any sexual intercourse; likewise, doctors advise avoiding any other insertions, such as tampons, during this time to allow the body enough time to heal.

Because orgasm includes the contraction of pelvic muscles, attempting to be sexually intimate in other ways may also be uncomfortable or painful. If you underwent a total hysterectomy, you may also experience significant fluctuations in your hormone levels. This can trigger hormonal menopause, which can cause vaginal dryness, weakened vaginal muscles and even vaginal atrophy.

In addition to sharing these symptoms with your doctor, you might also consider incorporating pelvic floor therapy into your treatment. By strengthening the pelvic muscles, you can provide greater strength and support to your internal organs. This can also decrease the pain caused during intercourse and orgasm.

General Pain

Pelvic pain after a hysterectomy can be disruptive and persistent; this is often due to a condition called hypotonia. Hypotonia reduces the muscle tone of your pelvic muscles, though they are still contracted. Reduced blood flow to the area can increase inflammation, which only worsens irritation and painful symptoms.

Pelvic hypotonia can lead to bladder issues as well, including difficulty emptying the bladder, urinary tract infections (UTIs) and incontinence.

What Causes Pelvic Pain After a Hysterectomy?

Many women develop pelvic floor dysfunction after surgery due to muscle trauma; even when a procedure is carried off flawlessly, the lower abdominal wall and pelvic muscles undergo trauma during a hysterectomy.

Generally, symptoms resolve over time as the muscles and connective tissues heal. However, in some cases, women may experience pelvic pain for years after a hysterectomy. Residual ovarian syndrome (ROS) can occur in women whose operation left one or both ovaries intact. After their procedure, they may develop ongoing pelvic floor pain and dysfunction that leads to residual symptoms.

How Long Does Hysterectomy Pelvic Pain Last?

The pain from your surgery is likely to last for several weeks and gradually resolve over time. However, it’s important to recognize the typical post-operative symptoms so you can manage them to the best of your ability.

It’s common to experience some mild pain and discomfort after a hysterectomy, including:

• Bleeding and vaginal discharge.
• Vaginal dryness.
• Menopausal symptoms, such as night sweats, hot flashes and insomnia.
• Redness, burning, itching and pain around the incision site.
• Numbness around your stitches that moves down your leg.

While most patients recover fully on their own within 6 weeks, some problems may persist for longer. Although it is uncommon, some women develop pelvic organ prolapse, a condition in which pelvic organs, like the bowel, slip from their normal position into the vagina.

Pelvic floor exercises can help prevent organ prolapse, especially after surgery when you are more likely to develop the condition.

Risk Factors for Pelvic Floor Dysfunction After Hysterectomy

There are several primary risk factors to be mindful of after your surgery. The most common cases of post-op pelvic floor dysfunction are:

• Limited mobility
• A weak core and pelvic muscles
• History of pelvic hypotonia

In all of these cases, the best way to reduce your risk and moderate pain is to perform pelvic floor exercises. However, you may experience a combination of symptoms that require multiple specialists to develop the most effective pain management plan.

How Pelvic Floor Therapy Can Help Your Recovery

Hysterectomy surgery often limits how much and what types of physical activities you can perform for at least six weeks following your procedure. However, you can safely perform pelvic floor exercises in therapy that not only aid the healing process but help reduce painful symptoms.

Pelvic floor physical therapy is a specialized service that helps address both general pain and specific symptoms unique to your body. If you are in the early stages of recovery, strengthening your pelvic floor muscles can help improve bladder function, reduce incontinence and make transitioning back into sexual intercourse easier.

Strengthening the pelvic floor muscles can also help reduce the risk of pelvic organ prolapse. By stimulating the muscles in a safe and easy way, you learn how to control your pelvic muscles to increase blood flow, ease nerve pain and ease muscle tension.

What to Do if You Experience Pelvic Pain After Surgery

After your hysterectomy, you should reach out to your primary care physician if you experience any pain, discomfort or other problems. They may refer you to a specialist to further help you treat your symptoms.

If you are interested in exploring pelvic floor therapy as one way to manage your pain or post-op symptoms, we are here to help. Please contact the team at Lake City PT to schedule an appointment.

Vaginal pain after hysterectomy

Vaginal pain after a hysterectomy is a relatively common concern that many women may experience during their recovery period. This discomfort can stem from various factors, including surgical trauma, inflammation, or nerve sensitivity. While some degree of pain or discomfort is expected in the immediate aftermath of the procedure, it should gradually subside over time as the body heals. However, persistent or severe vaginal pain should be promptly addressed with a healthcare provider to rule out any potential complications, such as infection or adhesions. Effective pain management strategies, such as medication or physical therapy, may be recommended to alleviate discomfort and help patients resume their normal activities and enjoy an improved quality of life after their hysterectomy. Open communication with a healthcare team is crucial in ensuring the best possible post-operative experience.

Lower abdominal pain years after hysterectomy

Physical therapy can be a valuable resource for women experiencing lower abdominal pain years after a hysterectomy. This pain often arises from changes in pelvic and abdominal musculature, scar tissue formation, or altered posture and biomechanics due to the surgery. A skilled physical therapist can assess these issues and develop a personalized treatment plan to address them. Through a combination of targeted exercises, manual therapy, and education, physical therapy aims to improve muscle strength, flexibility, and coordination while also promoting better alignment and posture. These interventions can help alleviate pain, reduce muscle tension, and enhance overall pelvic health. By restoring proper function and balance to the pelvic region, physical therapy can provide significant relief and improve the long-term quality of life for individuals experiencing lower abdominal pain after a hysterectomy.

Sharp pain in left side after hysterectomy

Physical therapy can play a crucial role in addressing sharp pain on the left side after a hysterectomy. This discomfort can result from a variety of factors, including scar tissue formation, muscle imbalances, or altered movement patterns due to the surgery. A skilled physical therapist can conduct a comprehensive assessment to pinpoint the exact cause of the pain and design a tailored treatment plan. This plan may include exercises to improve core and pelvic muscle strength, stretching to alleviate muscle tension, and manual therapy techniques to release scar tissue and improve tissue mobility. Additionally, education on posture and body mechanics can help individuals move more comfortably and avoid exacerbating the pain. By addressing the root causes and providing targeted interventions, physical therapy can be an effective approach to reduce or eliminate sharp left-sided pain post-hysterectomy, ultimately improving the patient’s well-being and quality of life.

What causes pelvic pain years after hysterectomy

Pelvic pain that persists for years after a hysterectomy can be attributed to various underlying factors. Some common causes include the development of scar tissue or adhesions in the pelvic area, which may result from the surgical procedure itself. These adhesions can lead to pain and discomfort as they limit the normal movement of pelvic structures. Additionally, conditions such as endometriosis or pelvic inflammatory disease that were present before the hysterectomy may continue to cause pain even after the uterus has been removed. Pelvic floor dysfunction, which can occur due to muscle imbalances or nerve damage, is another potential cause of long-term pelvic pain. In some cases, chronic pain may also be related to psychological factors, such as stress or unresolved emotional issues. Accurate diagnosis and a multidisciplinary approach involving healthcare providers, including gynecologists and physical therapists, are essential in addressing and managing pelvic pain years after a hysterectomy.

Pelvic Pressure After Hysterectomy

Pelvic pressure following a hysterectomy is a common postoperative symptom that many women may experience during their recovery. This sensation often occurs as a result of the surgical changes and adjustments in the pelvic region. The removal of the uterus can alter the distribution of weight and pressure within the pelvis, potentially causing discomfort or a sense of heaviness. While some degree of pelvic pressure is typical in the immediate postoperative period, it usually diminishes over time as the body heals and adjusts to the changes. However, if pelvic pressure persists or becomes bothersome, it is essential to consult with a healthcare provider for a thorough evaluation. They can assess whether there are any underlying issues, such as pelvic floor dysfunction or adhesions, that need addressing and recommend appropriate management strategies to alleviate the pressure and improve the patient’s overall comfort and well-being. Open communication with healthcare professionals is crucial in ensuring a smooth and healthy recovery process after a hysterectomy.

Cramping After Hysterectomy

Cramping after a hysterectomy is a common occurrence and is typically part of the normal healing process. The surgical removal of the uterus can result in temporary changes to the pelvic area, leading to cramping sensations that are similar to menstrual cramps. These cramps are often more noticeable in the immediate postoperative period but gradually subside as the body heals. However, some factors, such as the extent of the surgery or individual variations in pain tolerance, may influence the intensity and duration of cramping. It is essential for individuals to closely follow their postoperative care instructions, including pain management recommendations from their healthcare provider, to help alleviate cramping and ensure a smoother recovery. If cramping persists or worsens over time or is accompanied by other concerning symptoms, it’s crucial to seek medical advice to rule out any potential complications or underlying issues that may need addressing. Open communication with healthcare professionals is key to managing and understanding cramping after a hysterectomy.

How soon after hysterectomy can prolapse occur?

Prolapse, the descent or displacement of pelvic organs, can potentially occur at any time after a hysterectomy, but it’s more common in the years following the surgery. The risk of prolapse varies depending on several factors, including the type of hysterectomy performed, the patient’s overall pelvic health, and lifestyle factors such as heavy lifting, obesity, or chronic coughing. In some cases, prolapse may be evident shortly after the procedure due to weakened pelvic support structures, while in others, it may develop gradually over time as tissues and ligaments in the pelvic area continue to weaken. To minimize the risk of prolapse, it’s important for individuals to follow postoperative guidelines, including pelvic floor exercises, and to maintain a healthy lifestyle. Regular follow-up appointments with a healthcare provider are crucial for early detection and management of any potential prolapse issues after a hysterectomy.