Back Pain After Myomectomy: Any Blunder In The Surgery?

Myomectomy refers to the surgical removal of uterine leiomyomas or fibroids, keeping the uterus intact. It is a major surgical procedure. A small number of complications may arise after a myomectomy. Back Pain after myomectomy is one of them. 

Levels of estrogen and progesterone promote the growth of the uterine lining at the time of the menstrual cycle. This prepares the uterus for pregnancy. Over multiplication of the lining may generate fibroids. This is because the uterine lining contains more receptors for the mentioned hormones. 

So if you want to learn more about the cause of complications, read down below.

woman having back pain after myomectomy
Photo by Alex Green from Pexels

Back Pain and Myomectomy

Post Abdominal surgeries and back pain is a pretty common scenario. These may last even after three to four months after the surgery. Organs in our abdomen are held together by fascias and multiple muscles. 

Major muscles of the abdomen are pierced at the time of Open Myomectomy. In Laparoscopic Myomectomy, the rectus muscles are pierced. All in all, the front of the abdomen is tensed and worked up.

After the completion of the surgery, back pain is one of the common complaints. The skin starts to repair right after the surgery. The tension in the back and front of the abdomen remains for about three to four weeks.

The scar tissue gently tugs the skin and the abdominal contents. As a result, back pains are felt.

Along with the classic back pain, you can have bowel disorders, swelling of feet, burning pain in the operated region. 

Things to Do if You Have Back Pain after myomectomy

  • Three to twelve months after the surgery, patients have been prescribed a Neurontin group of medicines. This medicine group helps limit back pain, pain in the legs, and tension in nerves.
  • Pain management techniques
  • Physiotherapy after surgery.
  • Be careful to sleep on your back.
  • Light exercises
  • Walking
  • Control your diabetes
  • Avoid stress

Other complications after Myomectomy

Apart from back pain, some other complications often arise after a Myomectomy. After proper extraction of the fibroids or leiomyomas, these may occur at ladies of reproductive age.  

Possible side effects after a Myomectomy are given below:

  • Hemorrhage
  • Injury to the uterus 
  • Damage to organs of the urinary system
  • Infection
  • Blood clots
  • Formation of scar tissues within the uterus.
  • Shoulder ache
  • backache

How Body Changes after Myomectomy

The complications mentioned above are relieved as soon as a woman undergoes myomectomy. Despite going through this surgery,  some physical changes after myomectomy are invariably seen in women like:

  • Weight gain
  • Regular menstruation
  • Relief to pelvic pain
  • Pigmentation in body folds
  • Improved fertility
  • Reduction of the extra belly

Menstrual Cycle and Myomectomy

Several metabolic activities are disrupted after a myomectomy. These can initiate back pain or any other local pain. Patients can face similar problems at the time of the menstrual cycle. One of the familiar changes that we see after a myomectomy is the restoration of a healthy menstrual cycle. 

The uterus is kept intact in myomectomy. Hence the menstrual cycle rather starts to reinstate. It is usual to have brown or reddish-brown vaginal discharge and spotting in the first menstrual cycle after myomectomy. 

Menstrual Irregularities

Menstrual irregularities are a common sight after myomectomy. The period can be delayed or early too. Do not be worried or anxious if you are not having your periods the month after your myomectomy. 

As such, it is okay to have a lower belly ache or even back pain.

Ovulation

In general, fibroids do not interfere with ovulation. But submucosal fibroids do. Other than that, fibroids hinder the conceptual ability of a woman. 

Cramps/Back Pain after myomectomy

Cramps in your abdominal region, legs, and back are often felt after a myomectomy. But the pain post-surgery isn’t supposed to last long; if your cramping lasts for over six weeks, consult with your gastroenterologist.  

Bleeding

It is normal to have vaginal bleeding after 1-2 weeks of surgery. Gradually the discharge and bleeding will decrease. 

Myomectomy and Pregnancy

Every woman aspires to become a mother as soon as she steps into her reproductive age. Motherhood is like a blessing to them. But like every cherished thing comes a lot of sacrifice and hardship. Similar is the case of mothers with a myomectomy. 

A woman undergoes this surgery to remove the unwanted fibroids from her uterus without hampering her reproductive ability. Within three to six months of her surgery, she is suggested to conceive. Before that, the uterus is fragile and delicate from the surgery. Noteworthy, women with multiple fibroids can also conceive. 

Getting pregnant too soon can endanger the child as well as the mother. Uterine adhesions, unwanted miscarriages, preterm birth, cesarean section, uterine rupture, abnormal placentation are the risks involved. 

Delivery after Myomectomy

If the surgery didn’t enter the uterine cavity, the vaginal trial of labor is safe after Myomectomy. Vaginal delivery after Laparoscopic Myomectomy can be accomplished using management protocols safely. It is a similar procedure to vaginal birth after cesarean section. 

The rather lodged opinion goes in favor of doing a cesarean section. It is because of fewer chances of opening the uterine cavity apart. 

Pain: Before and After Myomectomy

Before Surgery

A sharp pain strikes in the lower abdomen, right ribs, and back for fibroids. This aloft as soon as the patient bends down or sidewise. The flow of urine is disrupted and causes the kidney to swell. This clinical condition is called hydronephrosis. It is characterized by painful urination and frequent excretion of urine solely due to fibroids. 

After Surgery

It takes about 4-6 weeks fully to recover after a myomectomy. The abdominal stitches heal and repair in this duration. Abdominal cramps are felt and followed by a slight pain in the incision area.

Apart from that, the bothersome back pain after myomectomy and feelings are relieved with a myomectomy. A patient is advised to avoid heavy weight lifting, pushing and pulling heavy objects, and sexual intercourse for about six weeks after the surgery. 

You have to be extra careful to ignore any major injuries to the freshly done surgery area while you are sleeping. Women after myomectomy are prescribed to sleep on one side or flat on their backs. To steer clear from injuries, do not sleep on your stomach. 

Pain relief

Bring the following into immediate effect after having excruciating pain from fibroids:

  • Non-steroidal anti-inflammatory drugs like ibuprofen
  • Warm compression
  • Massage gently
  • Green tea

Myomectomy Operative Notes

Myomectomy can be performed by two procedures, namely Open Myomectomy and Laparoscopic Myomectomy. There are significant effects on how your surgery is being done and myomectomy. 

Open Myomectomy

Here, an incision is given along the bikini line through the abdomen. It is the preferred option for extracting very large sizes of fibroids from the uterus. As the incision is made, the stitches may initiate back pain.

This happens because of the opening of the abdominal cavity. For such cases, patients are suggested to walk after a few days post-surgery. This will pull the stitches back to normal and restore the skin.

Laparoscopic Myomectomy

A narrow tube is inserted near your belly button and carefully taken to your uterus. The camera on the tube leads the surgeon to take out the fibroids via medical instruments.  Here, the chances of back pain are comparatively less. The reason behind this is, the abdominal cavity is not fully opened here.

Risk factors during the surgical procedure:

  • Intraoperative complications
  • Excessive blood loss
  • Myometrial hematoma
  • Morcellation accidents
  • Uterine rupture

Overweight and Myomectomy

Obesity triggers a lot of ill health. Be it, diabetes or high blood pressure, or even cardiac diseases, obesity is always one of the major factors behind it and back pain after myomectomy.

Being overweight can instigate the occurrence of fibroids. The growth of fibroids is set off by estrogen. An obese woman has raised an amount of estrogen and is more susceptible to developing fibroids.

 Along with that, being overweight women can toil at the time of myomectomy. Backache, shoulder pain, joint pain, and headache are some basic problems at this time. 

Hysterectomies or Myomectomies help to reduce the chronic lower abdominal pain and heavy bleeding from fibroids. As the matter is resolved with the surgery, the woman’s body finds more energy to be physically active and focus on her health. This leads to weight loss concerning her motivation. 

Health Care after Myomectomy

After any surgery, it is vital to emphasize the health care of the individual. Below is some advice to be followed:

  • Take bed rest
  • Do not wear yourself out
  • Walk everyday
  • For four to six weeks, avoid weight lifting
  • Refrain from any strenuous activities
  • Shower
  • Do not be worried if you have staining. It’s normal!
  • Avoid sexual intercourse

Now that you know what to do, we hope you’re feeling better. Don’t forget to consult your doctor before getting a diagnosis.

FAQs

Why do I have back pain after myomectomy?

The abdominal contents of the body are attached to the spine by muscles and fascia. Low back pain happens after a Myomectomy. This is because the healing of scar from surgery pulls down and tenses the back. It presses on the nerves in that particular region and initiates a colicky pain. 

It is advised to rest and not do excess physical activities right after the surgery has been performed. 

woman walking to avoid back pain after myomectomy
Photo by Daniel Reche from Pexels

How quickly fibroids grow back after Myomectomy?

The possibility of regrowth of fibroids is pretty skin. However, new generations of fibroids can increase in 33% of cases within five years of their removal. 

Minor fibroids can double up in 2 years and take a bigger shape. To stop the fibroids from growing back, try and do the following:

  • Follow the Mediterranean diet
  • Cut off alcohol
  • Fight off low blood pressure
  • Monitor and control estrogen levels
  • Avoid smoking
  • Increase Vitamin D intake

How soon can I walk after Myomectomy?

Soon after two weeks of your surgery, you should be walking for about 10 mins every day. Refrain from doing so if your doctor has prescribed otherwise. 

This will help in reducing the tension of the back and easing the backache that occurs from the stitch. In doing strenuous exercise, try to step back and do it after six weeks from the surgery. 

Do fibroids make your stomach big?

Fibroids vary in terms of sizes and quantities. Plenty of them can be in small sizes. You may also have one big fibroid that can make you go through hell. 

Fibroids do make your stomach big. Although it might look like this is out of bloating, fibroids can make you look pregnant. The heavy menstrual bleeding and pain keep the fibroids active. They, in turn, pressurize the bladder and cause frequent and repetitive urination. The same goes for the rectum. These things can make your stomach look big. 

Conclusion

No matter what, it is more suitable to undergo a Myomectomy than to bear the unbearable pain of fibroids. Back pain after myomectomy is little suffering in this big pool of solace. 

Irrespective of having complications, in the long run, it is better to have the fibroids removed. You can have a healthy child without having to worry whether your fibroids help to accommodate him in your uterus or not!!

Nuha Adila

I am a health enthusiast who finds fitness as a top priority in life. I like to keep a track of what I eat despite my profound attachment to any spicy food. Being a medical student, looking out for healthier food and lifestyle options has become a habit. And music inspires me while I write.

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