After Hysterectomy Bleeding, Causes and Symptoms

After hysterectomy bleeding, a woman enters a new phase of life that requires special care and attention. Hysterectomy, a surgical procedure involving the removal of the uterus, can bring relief from various medical conditions, but it also marks a significant transformation in a woman’s body and overall well-being. In this article, we will explore the essential aspects of life after hysterectomy bleeding, understanding the recovery process, managing potential challenges, and embracing a healthier and more fulfilling lifestyle. With the right knowledge and support, this post-hysterectomy journey can be smooth and empowering. Let’s embark on this journey of healing and discovery together.

What is a Hysterectomy?

A hysterectomy is a surgical intervention aimed at removing the uterus, which is the female reproductive organ responsible for nurturing a developing fetus during pregnancy. In some cases, a hysterectomy may also involve the removal of other reproductive organs and The type of hysterectomy performed depends on the reason for the operation and the individual’s health.

Hysterectomies can be divide into different types:

1. Total hysterectomy: The uterus and cervix are remove. The fallopian tubes and ovaries may or not be remove.
2. Subtotal (partial) hysterectomy: Only the upper part of the uterus is remove, leaving the cervix intact.
3. Radical hysterectomy: This is usually done to treat certain types of gynaecological cancer, such as cervical or womb cancer. It involves the removal of the uterus, cervix, surrounding tissue and sometimes the upper part of the vagina.

Hysterectomies can be perform using different approaches:

1. Abdominal hysterectomy: The operation is perform through an incision in the lower abdomen, which gives the surgeon a direct view of the reproductive organs. This approach is often use for a large uterus, cancer, or when other pelvic organs need to be examined or treated.
2. Vaginal hysterectomy: The uterus is remove over an incision in the vagina. No external incisions are made and it is suitable for certain conditions where the uterus is not significantly enlarged.
3. Laparoscopic hysterectomy: Several small incisions are made in the abdomen through which a laparoscope (a thin, lighted instrument with a camera) and surgical tools are inserted. The uterus is then removed in small pieces or through the vagina. This approach has the advantages of smaller incisions, faster recovery and less scarring.
4. Robotic-assisted hysterectomy: Similar to laparoscopic hysterectomy, but the surgeon controls a robotic surgical system to perform the procedure. This approach gives the surgeon greater precision and dexterity.

What is normal after Hysterectomy bleeding? 

1. Vaginal bleeding: It is common to have some vaginal bleeding or spotting for a few days to a few weeks after surgery. This can be similar to a light menstrual period or even slightly heavier.
2. Discharge: Along with the bleeding, there may be a discharge that can range from light pink or brown to yellow or clear. This discharge may contain small amounts of blood and is part of the normal healing process.
3. Duration of bleeding: The length of bleeding can vary. In general, most women experience bleeding for a few days to a few weeks. However, it is important to note that each individual’s healing process is unique and some may experience longer or shorter periods of bleeding.
4. Gradual reduction: Bleeding should gradually decrease over time. It may be heavier at first and slowly decrease. It is important to monitor your bleeding and contact your healthcare provider if you are concerned about the amount or duration of your bleeding.
5. Absence of bleeding: In some cases, such as after a total hysterectomy with removal of the cervix, there may be no bleeding at all. This is because the source of menstrual bleeding has removed.

What Causes after Hysterectomy bleeding?

1. Surgical trauma: Surgical removal of the uterus involves cutting and manipulation of tissue, which may cause minor bleeding. This bleeding is usually controlled during the operation, but some residual bleeding may occur afterwards.
2. Residual menstrual blood: If the cervix is preserve during a hysterectomy, some menstrual blood may remain in the vagina or upper parts of the reproductive system. This blood may be expelle after the operation, causing bleeding or discharge.
3. Dehiscence of the vaginal cuff: In some cases, the surgical incision made in the upper part of the vagina (vaginal cuff) may separate or partially open. This can cause bleeding and requires medical attention to prevent further complications.
4. Infection: Infection at the surgical site or in the pelvic area can cause inflammation and tissue damage, leading to bleeding. Signs of infection may include increased pain, redness, swelling or discharge with a foul odour.
5. Haematoma: A collection of blood at the surgical site or in the surrounding tissues can cause localised bleeding and swelling. This can happen if blood vessels are damaged during surgery or due to poor clotting.
6. Granulation tissue: Sometimes during the healing process, excess tissue called granulation tissue can form in the vaginal cuff. This tissue can bleed or cause persistent discharge.
7. Trauma or injury: Activities or behaviours that put stress on the healing surgical site, such as heavy lifting or sexual intercourse, can cause bleeding. It’s important to follow your post-operative instructions and avoid these activities until you’ve been clear by your doctor.
8. Other factors: Certain medications, such as blood thinners, or underlying medical conditions that affect blood clotting may increase the risk of bleeding after hysterectomy.

How to manage after Hysterectomy bleeding?

The management of bleeding after hysterectomy depends on the severity and cause of the bleeding. While some bleeding is normal during the initial healing process, excessive or prolonged bleeding may require medical attention. Here are some general steps to help manage after hysterectomy bleeding:

1. Rest and elevate your legs: Resting and elevating your legs can help reduce blood flow to the pelvic area, which may reduce bleeding.
2. Apply pressure: If you notice bleeding, apply gentle pressure to the area with a clean cloth or sanitary pad. Bypass utilizing tampons as they have the ability to boost the danger of infection.
3. Ice pack: Applying a cold compress or ice pack to the lower abdomen can help constrict blood vessels and reduce bleeding. 
4. Wrap the ice chuck in a cloth to evade guide call with the skin.
5. Maintain good hygiene: Keep the surgical area clean and dry. Follow your healthcare provider’s instructions about hygiene, such as avoiding douching or using scented products in the genital area.
6. Avoid strenuous activities: Heavy lifting, strenuous exercise, or activities that put stress on the surgical area should be avoid until advised by your healthcare provider.
7. Take any prescribed medicines: Your healthcare provider may prescribe medicines to control bleeding or prevent infection. Take them as directed and finish the full course of medicine.
8. Avoid aspirin or blood thinners: Unless specifically told to do so by your healthcare provider, avoid taking aspirin or other blood thinners as they may increase the risk of bleeding.
9. Stay well hydrated and eat a healthy diet: Adequate hydration and a balanced diet can promote optimal healing and support the body’s natural healing processes.

How to tell if Bleeding is normal or not 

Distinguishing between normal and abnormal after hysterectomy bleeding can be difficult. However, there are some factors that can help you decide whether the bleeding is within the expected range or whether it needs medical attention. Here are some considerations to help you decide whether or not bleeding after hysterectomy is normal:

1. The amount of bleeding: Normal bleeding after hysterectomy is usually light to moderate, similar to a light menstrual period. It may gradually decrease over time. If the bleeding is excessive, soaks several pads or tampons in a short period of time, or if you experience significant blood loss, this may be a cause for concern.
2. Duration of bleeding: Some bleeding or spotting is normal in the first few days after surgery. It is common for the bleeding to continue for a few days to a few weeks, gradually tapering off. If the bleeding continues for a long time, or if it returns after it has stop, it may need to see by a doctor.
3. Presence of clots: Passing small blood clots (less than a quarter) is often considere normal during the healing process. However, passing large or numerous clots may indicate excessive bleeding and should be check by a healthcare professional.
4. Associated symptoms: Check if you have any accompanying symptoms such as severe pain, fever, foul-smelling discharge, dizziness or signs of infection. These may indicate a complication and require medical attention.
5. Personal experience: Your own intuition and understanding of your body can also provide valuable insights. If you feel that something is wrong, or if the bleeding is causing you significant concern, trust your instincts and seek medical advice.

Signs and Symptoms of Abnormal bleeding 

1. Excessive bleeding: Soaking through several pads or tampons in a short period of time.
2. Prolonged bleeding: Bleeding that lasts more than a few weeks or that comes back after it has stopped.
3. Heavy or gushing flow: Bleeding that is significantly heavier than a normal period.
4. Passing large blood clots: Passing blood clots that are larger than a quarter, or experiencing frequent passing of large blood clots.
5. Heavy or prolonged bleeding: Bleeding that shows no signs of improving or that gets heavier over time.
6. Frequent pad or tampon changes: The need to change sanitary products every hour or more often.
7. Bleeding that interferes with daily activities: Bleeding that is excessive or heavy enough to interfere with your normal routine and quality of life.
8. Dizziness or lightheadedness: Feeling light-headed or dizzy, which may be a sign of significant blood loss.
9. Fatigue or weakness: Feeling unusually tired or weak, which may be a result of excessive blood loss.
10. Pale skin or shortness of breath: These symptoms may indicate anaemia, a condition caused by low levels of red blood cells due to excessive bleeding.
11. Severe pain or discomfort: Intense abdominal or pelvic pain that is not relieved by over-the-counter pain relievers.
12. Foul-smelling discharge: The presence of a strong, unpleasant odour from vaginal discharge that may indicate infection.

Conclusion:

After a bleeding hysterectomy, it is crucial for patients to closely follow their healthcare provider’s post-operative instructions to ensure a smooth recovery. Adequate rest, proper wound care, and taking prescribed medications as directed are essential. Patients should monitor for any signs of infection or excessive bleeding and promptly report any concerns to their healthcare team. Gradual resumption of daily activities, including light exercise, should be guided by medical advice. Emotional support and understanding during this recovery period can also play a significant role in promoting healing and well-being. Overall, a combination of attentive self-care and medical guidance is vital for a successful recovery after a bleeding hysterectomy.

*Disclaimer: This article is for informational purposes only and should not substitute professional medical advice. Please consult a healthcare professional for a thorough evaluation of your symptoms and appropriate treatment.

Author Contribution: Reviewed by Dr. Ram Reddy, MD – General Physician, Rajeshwar Rao, Pharm D.