Hysterectomy Pain Management Q&A
Baptist Gynecologic Oncologist Answers Your Questions About Hysterectomy Pain
On April 24, Baptist hosted a Facebook Live event about hysterectomies and hysterectomy pain management. Dr. Joseph Santoso, gynecologic oncologist at Baptist Cancer Center, participated in the conversation. We sat down with him to discuss your follow-up questions about managing pain after a hysterectomy.
Q. What sets Baptist apart in hysterectomy care and pain management?
A. Hysterectomy is the most common surgery for women—about 500,000 hysterectomies are performed each year in the United States. Hysterectomies are typically managed with a strong painkiller like morphine, and with that, patients usually stay three to five days in the hospital.
However, we propose a different approach. At Baptist, our preventive pain approach involves using other medications to reduce pain with morphine as a backup. As a result, most of our patients can typically go home the next day after surgery.
Q. Why does Baptist prefer to manage hysterectomy pain with other pain relievers?
A. Conventionally, morphine follows a hysterectomy to help with pain control, but morphine also comes with side effects, such as constipation, nausea and vomiting, and even a rash and itching throughout the body. It also is addictive, as we’re seeing now with the opioid crisis. So, although morphine is probably one of the best pain medications, it comes with some serious side effects.
The distinctive way we’re managing hysterectomy pain at Baptist Cancer Center involves giving patients non-narcotic pain medication even before they have pain. We block the pain receptors using very basic medications—Tylenol and Gabapentin—before patients go into surgery. During the surgery, we give local anesthetic on the skin incisions, and we also give anti-nausea medicine.
When patients wake up, they feel some soreness but not excruciating pain. We continue with this regimen. This preventive pain approach improves patient comfort and provides better pain control. In the background, we still have strong painkillers like morphine, but most patients use this very little. When patients go home, they are given some narcotic pain medication just in case, but most people don’t use much at all.
Q. How should I tend to my incisions?
A. In our surgery, incisions are closed with sutures, glue and staples. The glue is waterproof, so you can take showers or a bath. Keep the area clean and dry with soap and a soft towel.
Q. I feel fatigued and exhausted after my hysterectomy. Is something wrong with me?
A. Not at all. After surgery, some patients describe the feeling of being hit by a truck. The best thing is to listen to your body. However, when you’re resting too much, you increase the risk of postoperative blood clots, which can be life-threatening. One of the things I advise my patients to do is move the ankle up and down to improve circulation.
Q. Do you recommend exercise following a hysterectomy?
A. Yes. Be as active as possible. The best doctor that my patient has is herself. I want her to be active, but if she starts to have pain from lifting or walking too much, then the doctor within her will tell her to slow down or stop. Rest when your body is telling you to rest, and move when the body says, “I’m ready to move.”