WOMENS-HEALTH Messages for April, 1998: Re: confused

Re: confused

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Tue, 21 Apr 1998 22:37:50 -0500 (CDT)

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In reply to: CHRIS: "confused"

At Tue, 21 Apr 1998, CHRIS wrote: >
>I am 25had hysterectomy on July96 right
>oophorectomy,exploratorylaparotomy,lysis of adhesions,left oophoropexy,
>on Jan8,98. Now my questions I have back and forth to the doctor since
>a month after surgery started pain in right side and when I went to the
>bathroom now the pain is worst and I keep going back and am always told
>it is adhesions and the only thing that can be done is surgery but that
>is not going to happen because the doctor feels it would make it
>worst

As you are experiencing, postoperative pain is a very frustrating and complex problem. Although the overwhelming majority of women who have a hysterectomy do fine, some have problems like you describe, which are most likely (but not always) due to adhesions. When you say you have pain when going to the bathroom, I assume you mean when having bowel movements. This implies scar tissue (adhesions) near the colon, which is quite possible after pelvic surgery, like a hysterectomy.

I cannot tell you whether or not your doctor is giving you good advice without doing an exam (which is currently, and I hope forever, impossible over the Internet)! However, when I see a patient with similar pain, I always do a thorough pelvic and rectal exam. If necessarsy, I refer her for a colonoscopy or other studies of the rectum. Finally, if the pain does not go away over a few months, or if it actually worsens, then laparoscopic surgery may by necessary to cut the adhesions. Before doing this I would suggest a "bowel prep," which cleans out the intestines to help prevent poking a hole in them during surgery. If laparoscopy does not help, or if the patient declines this procedure, then I may suggest seeing a specialist at a chronic pain clinic. They have very advanced methods of dealing with chronic pain. However, I feel that I should leave no stone unturned to diagnose and treat the condition.

If it makes you feel better, please get a second opinion from another gynecologist. Sometimes a fresh look at the problem provides an answer. My partners and I ask each other to see patients when we would like a second opinion, and the advice from another doctor who is hearing the story a first time is often invaluable.

Good luck with everything. I wish you well.

-- Ashley Hill David Ashley Hill, M.D. Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, FL http://home.mpinet.net/dahmd

The above is intended for general medical education, and is not for specific medical advice. I apologize, but I am unable to answer personal e-mail due to time constraints.

Next message: Carrie: "Unusual light period"
Previous message: Angelica: "Estrogen/Weight Gain with Hysterectomy"
In reply to: CHRIS: "confused"

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