[28F] Experiencing post-hysterectomy complications

Patient Description

A 28-year-old female, who recently underwent a hysterectomy while retaining her ovaries, has been experiencing a range of symptoms since the procedure. These symptoms include hot flashes, headaches, nausea, and significant vaginal, pelvic, and abdominal pain, which she describes as a combination of dull, sharp, shooting, and aching pains. Additionally, she reports a lack of urge or sensation to urinate, requiring her to attempt voiding every few hours. The patient has also been experiencing sudden and intense hot flashes since the day after the surgery, accompanied by waves of nausea, particularly when resting. Despite taking Tylenol three times a day at a dosage of 1,000 mg since the surgery, her headache, described as a dull pain at the back of her head, persists. The patient also notes experiencing dizziness and chills since the surgery but has not observed any changes in vaginal discharge. She has a history of chronic back pain since 2014 and underwent gastric bypass surgery in December 2019. She reports allergies to NSAIDs, aspirin (due to the gastric bypass), and Keflex. Currently, she is managing her pain with Tylenol and has not been engaging in sexual activity since last July, following a C-section 5 weeks prior to the hysterectomy.

Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

Post-Surgical Complications: The timing of your symptoms suggests they may be related to your recent hysterectomy. This could include normal post-operative pain or complications such as infection or injury to nearby structures.
- Treatment typically involves pain management and monitoring for complications. If an infection is suspected, antibiotics may be prescribed.
Surgical Menopause: Even though your ovaries were not removed during your hysterectomy, sometimes the surgery can disrupt the blood supply to the ovaries, leading to a sudden drop in estrogen levels. This can cause symptoms of menopause such as hot flashes and headaches.
- Treatment typically involves hormone replacement therapy (HRT) to replace the estrogen.
Urinary Retention: Your lack of urge to urinate could be due to urinary retention, which can sometimes occur after surgeries involving the lower abdomen.
- Treatment typically involves catheterization to drain the bladder, and then addressing the underlying cause.

What you can do

You should definitely reach out to your healthcare provider as soon as possible to discuss your symptoms. They may want to see you for a follow-up appointment, or they may have specific advice based on their knowledge of your surgery and overall health.

In the meantime, here are a few things you can do:

Continue to take your pain medication as directed by your doctor.
Try to rest and stay hydrated.
Monitor your symptoms closely. If they get worse, seek immediate medical attention.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

Severe pain that is not relieved by your pain medication
Fever
Swelling or redness at the surgical site
Any changes in the color, consistency, or smell of your vaginal discharge
Inability to urinate or very small amounts of urine despite drinking enough fluids

Remember, while I strive to provide accurate information, I'm an AI and not a substitute for professional medical advice. Always consult with a healthcare provider for accurate information.

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10 mo ago

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