A hysterectomy is a surgical procedure to remove a woman’s uterus. It’s a major surgery that carries risks of complications. Many women wonder how much pain to expect with a hysterectomy. Here is an overview of hysterectomy pain.
How is pain managed for a hysterectomy?
There are several options for managing pain during and after a hysterectomy:
- Anesthesia during surgery – General anesthesia or regional anesthesia (epidural or spinal block) prevents pain during the procedure.
- Medications after surgery – Prescription medications like opioids or acetaminophen help control post-surgical pain.
- Cold therapy – Applying ice packs can reduce swelling and pain.
- Gentle movement – Light walking and stretching helps recovery.
- Comfortable rest – Plenty of rest, pillows for support, and loose comfortable clothing.
Doctors work to minimize pain as much as possible during and after the surgery. However, some degree of pain is normal as the body heals.
What does it feel like immediately after surgery?
Right after surgery, while still in the recovery room, most women report feeling groggy from anesthesia. There may be some cramping or dull ache in the pelvis. Nausea is also common.
Pain medications given through an IV help control pain. However, some women report the following levels of pain/discomfort in the first few hours after hysterectomy surgery:
- Mild – Feels like minor menstrual cramps.
- Moderate – More intense cramping, ache, or soreness in pelvis and abdomen.
- Severe – Significant pain not relieved by medication.
Pain that is not controlled by medication may be a sign of serious complications. It’s important to alert medical staff to severe pain after surgery.
How much pain is typical 1-3 days after a hysterectomy?
The first few days after a hysterectomy tend to be the most painful part of recovery. Pain levels can vary based on the surgical approach:
| Surgical Approach | Pain Level Days 1-3 |
|---|---|
| Vaginal hysterectomy | Mild to moderate |
| Laparoscopic hysterectomy | Moderate |
| Open abdominal hysterectomy | Moderate to severe |
An open hysterectomy with a large abdominal incision typically involves the most pain. Vaginal hysterectomy is the least invasive with smaller incisions.
What women experience in the days after surgery:
- Incision pain – Throbbing or stinging around incision sites.
- Cramping – Mild contractions as the body adjusts.
- Pelvic soreness – Achy feeling inside pelvis and lower abdomen.
- Gas pain – Shoulder pain or cramps from surgery gas.
- Sore muscles – From anesthesia and positioning during surgery.
- Fatigue – Exhaustion from the surgery and anesthesia.
Doctors prescribe narcotic pain relievers to take the edge off during the first few days. Pain is often managed best with round-the-clock medication dosing.
Pain management medications
Common medications prescribed include:
- Opioids – Oxycodone, hydrocodone, codeine.
- NSAIDs – Ibuprofen, naproxen.
- Acetaminophen – Tylenol.
- Anesthetics – Lidocaine patches, creams.
Side effects like nausea and constipation are common with narcotic pain relievers. Stool softeners and laxatives can help prevent constipation. Some women switch to acetaminophen or ibuprofen 3-5 days after surgery when pain starts improving.
How much pain at 1 week after hysterectomy?
For most women, pain decreases significantly around 1 week after surgery:
- Incision pain – Improves as incisions start healing.
- Interior pelvic pain – Subsides as inflammation resolves.
- Cramping – Lessens as the body adapts.
- Gas pain – Usually goes away within a week.
Many women describe the pain at 1 week as:
- Mild – Managed with extra-strength acetaminophen or ibuprofen.
- Intermittent – Pain comes and goes.
- Improving – Gets a little better each day.
Doctors often prescribe less narcotic medication at 1 week post-op as discomfort improves. Some lingering fatigue, bloating, and emotional ups and downs are common.
When can you expect to be pain-free after hysterectomy?
Most women are fully off prescription pain medication by 2-4 weeks after a hysterectomy procedure. Here is the typical time to becoming pain-free for each surgical approach:
| Surgery Type | Time to Becoming Pain-Free |
|---|---|
| Vaginal hysterectomy | 2-3 weeks |
| Laparoscopic hysterectomy | 3-4 weeks |
| Open abdominal hysterectomy | 4-6 weeks |
However, each woman’s recovery is unique. It may take a bit longer for pain to resolve entirely if:
- Large fibroids were removed.
- Endometriosis was extensive.
- Adhesions were surgically removed.
- Ovaries were removed.
- There were surgical complications.
Full healing continues for several months. But mostpain typically subsides within 1-2 months even after large surgeries.
Tips for managing pain weeks later
If pain persists longer than expected, try these tips:
- Use heating pads for muscle soreness.
- Wear loose clothing to avoid irritation.
- Ask about physical therapy for pelvic rehab.
- Consider acupuncture for pain relief.
- Increase walks and gentle activity daily.
- Get counseling if emotional stress could prolong pain.
Let your doctor know if you have ongoing bothersome pain more than 6-8 weeks after surgery so any issues can be identified.
Does a vaginal hysterectomy hurt less?
Yes, a vaginal hysterectomy is usually less painful than other hysterectomy approaches. Benefits include:
- No large abdominal incision – Only a small vaginal opening.
- Faster recovery – Typically back to normal in 2-3 weeks.
- Less pain medication needed after surgery.
- Lower risk of wound infections.
- Shorter hospital stay – Often goes home the same day.
However, vaginal hysterectomy is not ideal for all conditions. The surgeon has less visualization than with laparoscopic surgery. And enlarged uteruses may not be removable through the vagina alone.
When is vaginal hysterectomy an option?
Vaginal hysterectomy may be an option if:
- Uterus is normal size or only mildly enlarged.
- Only the uterus needs removal.
- No extensive scarring is present.
- Uterus can successfully detach vaginally.
- Fibroids are small and accessible.
For women who are candidates, vaginal hysterectomy generally hurts less with a faster recovery. But all surgical approaches have risks and benefits to discuss with your surgeon.
Do laparoscopic hysterectomies hurt less?
Laparoscopic hysterectomies are less painful than open abdominal hysterectomies. Benefits include:
- Smaller incisions – Only 1-4 tiny cuts.
- Faster recovery – Often back to normal in 3-4 weeks.
- Less pain medication required.
- Lower risk of wound infection.
- Shorter hospitalization – Can sometimes go home the same day.
Since the uterus is removed through the vagina, there is more post-op vaginal pain than a vaginal hysterectomy. But laparoscopic hysterectomies avoid the large abdominal incision.
This results in significantly less pain than open hysterectomies. Laparoscopic procedures also have fewer complications and quicker return to activities.
Considerations with laparoscopic hysterectomy
The approach has some limitations:
- Not ideal for very enlarged uteruses.
- More difficult with extensive adhesions.
- Challenging if cancer is suspected.
- Risk of conversion to open surgery if complications.
For appropriate candidates, it typically hurts less than open abdominal surgery. But patients should discuss both risks and benefits with their doctor.
How painful is recovery from open hysterectomy?
Open hysterectomies with a large abdominal incision are often the most painful approach. Disadvantages include:
- Large incision – Up to 6-8 inches long.
- Prolonged recovery – At least 4-6+ weeks.
- Most pain medication required.
- Higher complication risks.
- Typically a 2-3 day hospital stay.
The first weeks involve significant incisional pain as abdominal muscles heal back together. Deep interior healing can also cause pelvic discomfort.
Why might an open hysterectomy be necessary?
- Very enlarged fibroid uteruses.
- Suspected cancer.
- Extensive endometriosis.
- Severe pelvic adhesions.
- Previous pelvic surgeries.
While an open hysterectomy hurts the most initially, the long-term benefits often outweigh the difficult recovery. But less invasive options should be considered first if appropriate.
Tips for recovering from open hysterectomy
- Take it slow – Don’t rush mobility.
- Use pillows for incision support.
- Follow medication schedule closely.
- Increase walks as tolerated.
- Accept help from family and friends.
- Attend physiotherapy for core strengthening.
Be patient as the body recovers from a major surgery. Let your surgeon know if you have any concerns during the recovery process.
Conclusion
Hysterectomy recovery involves pain and discomfort as the body heals. But the intensity and duration varies based on surgical approach. While all hysterectomies hurt to some degree, an open procedure usually causes the most pain while vaginal and laparoscopic hysterectomies generally hurt less. Doctors work diligently to control pain throughout the recovery process. Being prepared for what to expect can help ease worries. With patience and proper care, most women can get back to their normal selves within 1-2 months.