Post-Operative Concerns After Uterine Fibroid Surgery: What to Expect

Postoperative Wound after Uterine Fibroid Surgery

Hello, Doctor.
I have a few questions to ask:
1.
I underwent a traditional horizontal incision surgery for uterine fibroids, and I did not need to have my stitches removed.
It has been about eight weeks since the surgery.
Following the nurse's instructions, I used a wound dressing for the first month, then switched to a scar patch for five days and a scar gel for two days, alternating between the two.
Yesterday, while applying the scar gel, I noticed that the incision feels hard and appears quite thick, but this is on the inside of the wound.
In the first few weeks, only the ends of the incision felt hard, while the middle felt fine, and the surface of the skin was smooth.
Is this a normal situation? Could it be that the internal sutures have adhered to something, causing the hardness and thickness? I see that there are no visible stitches on the surface, so I assume the stitches are inside.
Typically, the internal sutures should be absorbable, right? Should I be massaging the wound post-surgery?
2.
Before the surgery, the doctor mentioned that the hard area I felt above the pubic bone was my uterus, which was pushed upward due to the large fibroid.
After the fibroid is removed, will my uterus return to its original position? Because even after the fibroid was removed, the area above my pubic bone still protrudes like it did before the surgery.
3.
After removing a fibroid that was over ten centimeters, what will happen to the space it occupied? Will it affect the positioning of other organs, causing them to sag?
Thank you, Doctor.

p, 40~49 year old female. Ask Date: 2022/11/07

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your description, the wound area needs to be evaluated by a surgical physician.
If the fibroid has been completely removed, the lump should disappear and will not affect other organs.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2022/11/07

More Info

After undergoing surgery for uterine fibroids, it's common for patients to have various concerns regarding their recovery and what to expect in the post-operative period. Here are some insights based on your questions:
1. Post-Surgical Hardness and Scar Formation: It is not unusual for the area around a surgical incision to feel hard or to have a raised appearance, especially in the weeks following surgery. This can be attributed to several factors, including the healing process, the formation of scar tissue, and the presence of internal sutures. In traditional open surgeries, such as a transverse abdominal incision, the body often forms scar tissue as part of the healing process. This scar tissue can feel firmer than the surrounding tissue. The internal sutures used during surgery are typically absorbable, meaning they will dissolve over time, but they can also contribute to the firmness you are feeling. It's important to follow your surgeon's post-operative care instructions, which may include gentle massage of the scar area to help break down any excessive scar tissue and improve flexibility. If you notice any unusual changes or if the hardness persists, it would be wise to consult your surgeon for further evaluation.

2. Position of the Uterus Post-Surgery: After the removal of fibroids, especially large ones, it is expected that the uterus may shift back toward its normal position. However, the extent to which this occurs can vary from person to person. Factors such as the size of the fibroids, the duration they were present, and individual anatomical differences can all play a role in how the body adjusts post-surgery. If you still notice a protrusion in the area above your pubic bone, it may take some time for your body to fully adjust. Additionally, the abdominal wall may have been stretched due to the presence of the fibroids, and it may take time for the skin and underlying tissues to retract. If the protrusion persists or is concerning, a follow-up with your healthcare provider would be beneficial.

3. Impact of Fibroid Removal on Surrounding Organs: When a large fibroid is removed, the space it occupied may initially feel empty, but the surrounding organs typically do not "drop" into this space. The body has mechanisms to maintain the position of the uterus and other pelvic organs. However, it is essential to monitor for any symptoms that may indicate pelvic organ prolapse, such as a feeling of heaviness or pressure in the pelvic area. If you experience such symptoms, it is advisable to consult with your healthcare provider for an assessment.

In summary, while some post-operative changes are normal, it is crucial to maintain open communication with your healthcare provider regarding your recovery. Regular follow-ups can help address any concerns and ensure that your healing process is on track. If you have any unusual symptoms, such as excessive pain, swelling, or changes in your menstrual cycle, do not hesitate to seek medical advice. Your health and well-being are paramount, and your healthcare team is there to support you through your recovery journey.

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