Post-Operative Concerns: Bleeding and Pain After Uterine Surgery - Obstetrics and Gynecology

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Post-operative concerns, especially regarding bleeding and pain after uterine surgery, are quite common and can often be a source of anxiety for patients. In your case, having undergone a subtotal hysterectomy (removal of the uterus while leaving the cervix intact) via laparotomy, it is important to monitor your symptoms closely.

Firstly, it is not unusual to experience some bleeding after surgery, particularly if you are nearing your menstrual cycle. The presence of fibroids and adenomyosis can lead to irregular bleeding patterns, and the surgical intervention may also temporarily disrupt your normal menstrual cycle. However, if the bleeding is significant or accompanied by severe pain, it is essential to seek medical attention.

The pain you are experiencing in the rectal area could be attributed to several factors. Post-operative pain can radiate to different areas, including the lower abdomen and rectum, especially if there was manipulation of surrounding tissues during surgery. Additionally, if there were any adhesions or if the surgery involved the rectal area, this could also contribute to your discomfort.
The slight vaginal bleeding you mentioned could be a result of the healing process, but it is crucial to differentiate between normal post-operative bleeding and something that may require further evaluation. If the bleeding is bright red, increases in volume, or is associated with clots, it is advisable to contact your healthcare provider.
In terms of recovery, most patients can expect a gradual decrease in pain and bleeding over the weeks following surgery. However, if you notice any sudden changes in your symptoms, such as increased pain, fever, or a foul-smelling discharge, these could be signs of infection or complications that warrant immediate medical attention.

As for your question about whether you should return to your doctor for a check-up, it is generally a good idea to follow up with your healthcare provider if you have any concerns, especially if you are experiencing new or worsening symptoms. They can perform a thorough evaluation, which may include a physical examination or imaging studies, to ensure that your recovery is on track and to rule out any complications such as infection or retained tissue.

In summary, while some post-operative bleeding and pain can be normal, it is essential to remain vigilant about your symptoms. If you feel that something is not right or if your symptoms are concerning, do not hesitate to reach out to your healthcare provider for guidance. They are best equipped to assess your situation and provide the necessary care to ensure a smooth recovery.