Post-Surgery Bleeding After Traditional Hysterectomy: What to Know

Postoperative bleeding after traditional hysterectomy?

Hello, Doctor.
The patient underwent a traditional surgical procedure to remove the uterus, bilateral ovaries, and bilateral fallopian tubes due to atypical complex endometrial hyperplasia at the end of November last year.
Postoperatively, everything was fine except for a small amount of bleeding within the first week.
However, on March 17, a small red mark appeared, about the size of half a fingernail, and today, March 23, there was a small amount of fresh blood on the toilet paper (very little, no clots, and not dark red).
Since it has been about four months since the surgery, I would like to ask: 1.
Is this situation considered normal? Does the patient need to return for an immediate follow-up? 2.
What symptoms would require the patient to return for an immediate follow-up? 3.
Additionally, due to varying information online, I would like to ask the doctor: how many months after surgery is it safe to lift heavy objects?

V52, 50~59 year old female. Ask Date: 2022/03/23

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
Four months post-operation, vaginal bleeding is noted; it is recommended to return to the original surgeon's clinic for examination and evaluation.
2.
How much weight should be lifted? If it is within the range of normal daily activities, there should be no problem.
However, the risk of vaginal prolapse and urinary incontinence is higher in women who have undergone a total hysterectomy, so it is important to perform Kegel exercises regularly.

Reply Date: 2022/03/23

More Info

Post-surgery bleeding after a traditional hysterectomy can be a concerning issue for many patients. It is essential to understand the normal healing process and when to seek medical attention. Based on your description, here are some insights and recommendations regarding your situation.

1. Is this situation normal? Should the patient return for a check-up?
After a hysterectomy, it is not uncommon for patients to experience some light bleeding or spotting, especially in the weeks following the surgery. However, since you mentioned that the surgery was performed four months ago, the appearance of new bleeding, even if it is minimal, should be taken seriously. The small red mark and the light bleeding you observed could be due to several factors, including:
- Hormonal changes: If the ovaries were removed, the body may be adjusting to the loss of estrogen, which can sometimes lead to irregular bleeding.

- Infection or inflammation: Even months after surgery, infections can develop, leading to bleeding.

- Surgical complications: Issues such as adhesions or other complications from the surgery may also cause bleeding.

Given that you have experienced new bleeding after a period of stability, it is advisable to return to your healthcare provider for an evaluation. They may perform a physical examination and possibly imaging studies to rule out any complications.

2. When should the patient seek immediate medical attention?
You should seek immediate medical attention if you experience any of the following:
- Heavy bleeding (soaking through a pad in an hour or less).

- Severe abdominal pain that is not relieved by over-the-counter pain medications.

- Fever or chills, which could indicate an infection.

- Foul-smelling discharge from the vaginal area.

- Any other symptoms that feel unusual or concerning to you.

3. When can the patient resume lifting heavy objects?
After a hysterectomy, it is generally recommended to avoid heavy lifting for at least six to eight weeks post-surgery. This allows the body to heal properly and reduces the risk of complications such as hernias or increased bleeding. However, since you are four months post-surgery, you may be able to gradually resume normal activities, including lifting, depending on your recovery and how you feel. It is crucial to listen to your body; if you experience pain or discomfort while lifting, it is best to stop and consult your physician.

In summary, while light bleeding can be a normal part of recovery, the new symptoms you are experiencing warrant a visit to your healthcare provider. They can provide a thorough evaluation and ensure that your recovery is on track. Always prioritize your health and well-being, and do not hesitate to seek medical advice when in doubt.

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