WOMENS-HEALTH Messages for November, 2002: Re: pain following uterine suspension

Re: pain following uterine suspension

From: William McIntosh, MD (anonymous@obgyn.net)
Wed, 20 Nov 2002 09:44:37 -0600 (CST)

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At Tue, 19 Nov 2002, Island911 wrote: >
>Dear anyone who can possibly help,
>
>9 weeks ago I had a laparoscopy performed to explore the cause of chronic pelvic pain (primarily mid - cycle) and infertility. Luckily, no endo was found after living with the diagnosis for years, but surgery confirmed a retroverted uterus. Because no other cause for my pain could be identified, a uterine suspension was performed, with 2-0 prolene used in the round ligaments. I have had intense pain since right after the surgery, that is not significantly better now than it was 3 days post - op. I have had urine culture (negative), a 5 day course of cipro (just in case of infection), two ultrasounds and multiple exams. Everyone is fairly clueless at this point and I am being referred to a local pain clinic for workup and management. My concerns are:1) could I just be having an allergic reactio to the suture? I know this is supposedly uncommon with prolene, but I have many allergies in general, and also reacted / still reacting to the vicryl used SQ in the poke hole incisions. 2) Could the knot from the suture (supposedly the only part of the suture material outside the ligament) be rubbing against a nerve? Other possibilities????
>
>The pain is as low as the pubic bones, but primarily radiates to just above my pubic bone, not really central but a little to the sides. I also often get knifelike pains from the upper vaginal/cervical area radiating upwards. The pain is often prickly, worse in early morning and at night but can strike anytime, seemingly regardless of my position or activity. I wake up every morning with horribly crampy pain (having a full bladder definitely makes the pain worse). The only good thing since surgery is the ovarian pain I was having has diminished greatly. These new pains are completley different from anything I have ever experienced, and are greatly affecting the quality of my life.

One of the reasons that uterine suspensions are rarely performed anymore is from this exact cause, severe post-op pain for months. Eventually it goes away, at least most of the time. The pain is mechanical, and is sometimes treated by removal of the suspension. I have had some luck with trigger point injections, somthing the pain clinic may be able to help you with.

-- William D. McIntosh, MD, FACOG

This is for educational purposes only, and is not a substitute for consultation and examination by a licensed medical professional.

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