Post-Surgery Concerns Regarding Urination and Related Inquiries
At 24, I underwent exploratory laparoscopic surgery in 2021 focusing on my pelvic region, including my ovaries and fallopian tubes, which led to a diagnosis of endometriosis. Following a C-section in 2023, I experienced a resurgence of endometriosis pain, prompting me to have the same procedure again today (03/28). During the operation, the medical team identified just two lesions tied to my endometriosis, which were cauterized. They informed me that these lesions likely weren't the root cause of the significant pain I was experiencing. Instead, the discomfort appeared to stem from a complication where my colon had adhered to my uterus, which they successfully separated during the procedure. This complication necessitated a second incision, resulting in one cut at my belly button and another on the left side of my abdomen. Additionally, they placed a Liletta IUD to assist with menstruation and to prevent any potential pregnancy. While I’ve been experiencing slight bleeding since the IUD insertion, I don't find it alarming. Since I was still under anesthesia when the results were shared, my mother received the information and later conveyed it to me. Due to the complexity, she didn't recall every detail, so I reviewed the findings myself once they were made available. The documents indicated the separation of my uterus and colon and the removal of the two lesions, but they also noted, "Cautery of a vessel in the left uterosacral ligament was necessary for hemostasis." I’ve gone to the restroom twice since the surgery, and I’ve noticed a tenderness in my uterus while urinating. I cannot recall if I experienced this sensation during my previous surgery, which raises some concern for me. The discomfort isn’t intense but definitely noticeable. I have several pressing questions: 1. What does the note regarding the cauterization of a vessel in the left uterosacral ligament mean? What might lead to this situation? 2. After getting an MRI due to lumps in my left thigh, I learned I have varicosities there, and the surgical notes merely indicated "mild pelvic varicosities." Could there be a connection between these varicosities? 3. Is there a chance that separating my uterus and colon could lead to complications down the line, especially in relation to future pregnancies? 4. What could be the underlying reasons for the adhesion between my uterus and colon? 5. Given the discomfort during urination, should I be concerned enough to reach out to my doctor on Monday or even visit the ER? Ideally, I'd like to avoid an ER visit and wait until Monday if this is not pressing. I’ll also address all my questions during my follow-up appointment on (04/09). Thank you for any guidance you can provide!
Answers (1)
3/29/2025, 1:40:43 PM
OpenHealth AI
Thank you for sharing such detailed information about your recent surgeries and current concerns. It's understandable to feel apprehensive after undergoing complex procedures, especially when experiencing new sensations or discomfort. Let’s address your main questions and provide guidance on what to do next.
Key Points:
- The cauterization of the vessel in the left uterosacral ligament was necessary for controlling bleeding.
- There may be a connection between the varicosities and your pelvic conditions, but more specific assessment is needed.
- Separation of the uterus and colon can have implications for future pregnancies, but it often improves symptoms.
- Adhesions can arise from previous surgeries, infections, or endometriosis.
- The tenderness during urination is likely related to the recent surgery, but it’s important to monitor this.
Explanation:
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Cauterization of the Vessel: The left uterosacral ligament supports the uterus and has blood vessels. Cauterization here means they used heat to seal a bleeding vessel during surgery, which is a standard practice to minimize blood loss. It’s typically reactive to bleeding that might occur during the procedure.
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Pelvic Varicosities: Varicosities are enlarged veins, often present in the pelvis. There's limited evidence to firmly establish a direct connection, but increased pressure in pelvic veins can be associated with conditions like endometriosis. It's worth discussing with your doctor to understand if and how they might be related.
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Future Pregnancy Complications: Generally, separating the uterus from the colon aims to relieve pain and avoid complications. While every surgical intervention carries some risks, many women go on to have successful pregnancies after similar procedures. It's best to follow up with your doctor for a comprehensive evaluation.
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Reasons for Adhesions: Adhesions can form from surgical trauma, endometriosis, or infections. In your case, they likely developed as a consequence of your endometriosis and previous surgeries, which is not uncommon.
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Post-Surgery Discomfort: Tenderness during urination can be quite common following surgery, especially in the pelvic area. However, if the discomfort worsens, is accompanied by fever, severe pain, or changes in urination (like blood in urine), or if you feel unwell, then seeking immediate attention would be appropriate.
Next Steps:
- Monitor Symptoms: Track the tenderness and any changes in your urinary habits. If symptoms escalate (increased pain, fever, or other concerning signs), consider contacting your healthcare provider sooner.
- Pain Management: Use over-the-counter pain relievers such as ibuprofen or acetaminophen if needed for discomfort, as long as it is safe based on your medical history.
- Follow-Up: Prepare your questions for your follow-up appointment on 04/09 to ensure all your concerns are addressed comprehensively.
I hope this guidance helps you feel more secure as you navigate your recovery. Please take care and let me know if there’s anything more specific you’d like to discuss or clarify.
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