Post-Vacuum Aspiration: Abdominal Pain After Urination

Abdominal pain after urination following vacuum extraction?

Due to the absence of a heartbeat in the child, a vacuum aspiration was performed to terminate the pregnancy at 9 weeks.
However, on the 4th day post-procedure, there was a brief cramping pain in the lower abdomen after urination, which persisted until the 6th day but only at the end of urination.
Should a follow-up appointment be scheduled for examination, or is this a normal transient symptom post-procedure?

Mai Mai, 30~39 year old female. Ask Date: 2020/11/30

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is recommended to return for a follow-up appointment with your physician.
Wishing you good health.

Reply Date: 2020/11/30

More Info

After undergoing a vacuum aspiration procedure due to a missed miscarriage at 9 weeks of pregnancy, it's not uncommon to experience some discomfort or pain in the abdominal area, especially during urination. The symptoms you describe—specifically, a brief sharp pain in the lower abdomen at the end of urination—can be concerning, but they may also be part of the normal healing process following the procedure.

Understanding Post-Operative Symptoms
1. Post-Operative Pain: After a vacuum aspiration, it is typical for patients to experience cramping or discomfort as the uterus contracts back to its normal size. This cramping can sometimes radiate to the lower abdomen and may be exacerbated by activities such as urination.

2. Urinary Symptoms: The sensation of pain during urination can be attributed to several factors:
- Bladder Irritation: The procedure may have caused some irritation to the bladder or surrounding tissues, leading to discomfort when the bladder is full and during the act of urination.

- Pelvic Floor Tension: Following any gynecological procedure, the pelvic floor muscles may be tense or in a state of spasm, which can contribute to pain during urination.

- Infection: Although less common, urinary tract infections (UTIs) can occur post-operatively and may present with pain during urination. Symptoms of a UTI can include burning sensation, increased frequency of urination, and sometimes fever.

3. Healing Process: The body requires time to heal after any surgical procedure. The timeline for recovery can vary significantly from person to person, and while some may feel better within a few days, others may take longer to fully recover.

When to Seek Medical Attention
While some discomfort can be expected, there are specific signs that warrant a return to your healthcare provider:
- Persistent or Worsening Pain: If the pain becomes more severe or does not improve over time, it is essential to consult your doctor.

- Fever or Chills: Any signs of infection, such as fever, chills, or unusual discharge, should prompt immediate medical attention.

- Changes in Urination: If you experience changes in your urinary habits, such as increased frequency, urgency, or blood in the urine, these symptoms should be evaluated by a healthcare professional.

Recommendations
Given that you are experiencing pain that persists beyond a few days post-procedure, it would be prudent to reach out to your healthcare provider for a follow-up appointment. They can perform a thorough evaluation to rule out any complications, such as infection or other issues related to the procedure.
In the meantime, consider the following self-care measures:
- Hydration: Ensure you are drinking plenty of fluids, which can help dilute urine and reduce irritation.

- Pain Management: Over-the-counter pain relief, such as ibuprofen or acetaminophen, may help alleviate discomfort, but consult your doctor before taking any medication.

- Rest: Allow your body time to heal by avoiding strenuous activities.

In conclusion, while some discomfort can be expected after a vacuum aspiration, persistent or severe symptoms should not be ignored. It is always better to err on the side of caution and consult your healthcare provider for peace of mind and appropriate care.

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