Vaginal cuff not healing after radical hysterectomy

I would please like to know if anyone else has had any problems with their vaginal cuff healing after their radical hysterectomy. I am having a rough time of my body healing.
I had a radical hysterectomy on March 22 and was given the ok to have sex 6 weeks later. I waited 8 weeks and it has turned into a nightmare. During intercourse, I had no pain but immediately afterwards...I started cramping really really bad and bleeding. I went to the ER and ended up in emergency surgery for a vaginal cuff repair,
Well, 12 weeks after that repair (and having NO sex) I started cramping again and bleeding out of nowhere. I went to the ER and ended up in emergency surgery AGAIN. My vaginal cuff which was supposibly healed up was once again open and my bowels were pushing out. So they cut out more of my vagina and sewed it back up again with longer lasting sutures.
That was 2 weeks ago. I had my 1st post-op appt today and all is well so far. I am still closed up with sutures. But I am on strict restrictions. No lifting, pushing, pulling, bending, running, jumping or exercise and I am suppose to lay down as often as I can to prevent my bowels from pushing against the sutures and causing it to re-open. I cannot have sex for 6 months now. And if I dont heal this time, they are going to put permanent sutures inside me and I will never be able to have sex again.
Is there anyone else out there that has had anything similar happen to them and is there hope that maybe I will heal this time?!

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I'm so sorry this is happening to you. It is very scary! I've talked w/you before about what happened to me...It has been over 3 months since my surgery to repair my vag. cuff. I just got the ok to have sex again, and I have twice but I am so scared that it will happen again. Good luck to you and I hope you heal this time!

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No, i dont think I had any dead or necrotic tissue, at least they didnt tell me I did. And both of the repairs were done vaginally. My dr thought she might have to go cut my stomach this last time to put my bowels back but she was able to do it vaginally.
I dont think they really know the reason why Im not healing other than my bowels are pushing against the sutures and causing them to re-open.
Good luck on Monday...I hope they can help you with the least invasive procedure possible.
Oh, also, I have never had to have chemo or radiation. All pathology reports came back negative after my radical hysterectomy.

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I cannot believe I found this! This happened to me TWICE! I had my hyst in jan, I was sick for months then in April had peritonitis from a torn vaginal cuff. Then in July had it happen again. I also had the da vinci robot. I wonder if that is the common denominator?

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Hi there, I was SOO glad to find your blog during my search for more info re: my very similar hysterectomy experience. I've had endometriosis & female probs since H.S. & decided to have a complete hysterectomy to relieve some of the probs & bc ovarian cancer runs in my family. I am a teacher, so I had the DAVINCI robotic hysterectomy the wk after school let out (1st wk of June). Surgery went well & I was laid up ALL summer trying to ensure I would be able to return w/ no probs. I started bouncing back w/ energy & felt well for about 2 wks. I returned to wk the begin. of Aug. for 1 wk of training, etc., had my kiddos for the 1st half day of school, and then, over the w.end, my hub & I had sex for the 1st time since surgery (almost 9 wks later, but rcvd clearance after 6wks). I had SEVERE cramping and pain & started bleeding. I convinced myself that it was prob "normal" since we'd waited so long despite the fact that my husband said he "felt 3 different "textures" & it didn't seem right". Got NO sleep that night, but was hellbent on going to work the following a.m. since NO ONE calls in & misses the FIRST day of school (right??). I got out of bed & peed all over myself with NO warning & was still bleeding. Again, I swore I was going to at least go until they could get someone to sub for me, but knew I couldn't drive. Every time I stood up (hunched over from pain, mind you), I peed. My husband finally told me he was going to call the school if I didn't,...so I called. I went to my OB-GYN & saw the NP. She said s.thing wasn't where it belonged, but she wasn't sure, so she got a Dr. (my Dr. was off that day). That OB-GYN said the same thing, but doesn't perform robotic hysterectomies, so she called one of the Drs who helped perform my surgery & he came back off his lunch break within 10 min (I should've known something was bad at that point). He said my cuff had split open & my intestines & bowels had dropped into my vaginal opening & were coming out. I was transported via ambulance for emergency surgery. After the surgery, my husband expressed concern & asked if my vaginal "wall" had been shortened bc he felt it go through the cuff quickly, but my Dr. insisted it wasn't shortened & was a little peeved by his inquiry. I've gone to this OB for well over a decade & have always liked him & never had any probs, but this complication was the FIRST of its kind for him & I think it REALLY messed with his ego (he'd already watched the video from the Davinci surgery before I was discharged from the hospital bc he was concerned that he'd missed something,...which I respected). SO, I use up ALL my sick days recouperating,....LITERALLY laying in bed (which has pretty much been NON STOP since early June less 2 wks), I don't know my parents, students, class routine, etc. at work, have NO stamina, & am terrified that I'll return to work, wear myself out w/ the kids, and will have NOTHING to fall back on bc I have NO sick days remaining & my sick leave bank days don't kick in until you've missed either 5 or 10 consequtive days w/ a Dr. note. SO, I go for my follow up appt. & express the pros & cons of returning this next wk (It will have been a little over 6 wks) & explain the spasms, cramps, nausea, little if any "advance notice" & hot flashes I'm still having w/ bowel movements, including the fact that I haven't left the house more than once a week bc it wears me out & I wind up in bed cramping the remainder of the wk afterwards. Not to mention that I've had flibytus (sp) from vein damage from all the collapsed veins, an ER stint from bad antibiotic reactions, etc....this definitely hasn't been a walk in the park for me! He started a "Look,....I've babied you,...." & then apparently picked up on my cocked jaw & tried to recover with ",....I mean,...with good cause, bc of your rare situation,..." but decided I'd be fine to return to work on Monday. I've never had a problem holding my own with anyone, much less a Dr.,...but it threw me for such a loop bc my husband lectured me repeatedly to please, please, please be honest & let the Dr. know everything (bc I always say "I'm fine" & don't want to whine). I was shocked & hurt that he'd imply that I was trying to sit home leisurely with no real cause. I waited a few days before telling my husband bc I knew he'd go nuclear (& he did), & I told him that all that ran through my mind was "Look dude, this has been a HUGE inconvenience for me,...I have NO sick days to cover me if I get the flu, pnemonia, a cold, or just need a day off to go to Dr. appts., etc., I've been trapped in bed since JUNE with NO summer break, much less summer fun, I've been inactive, feel like I'm 92 (yet am only 41), don't know my students, parents, or routine at work, and I'M not the one who performed the first friggin' surgery,...YOU did!...AND, how do you know how long it should take for me to recover? You gave me the green light for everything almost 3 wks prior to the cuff split AND you've NEVER had this happen with any of your patients,...how do you have ANY benchmark for what is "normal" recovery for me??SERIOUSLY!!!" It infuriates me the more I think about it, bc I feel like I'M the one that got the raw deal out of all of this & he's acting like I'M being a baby?? I'm livid (seriously, get over yourself already,...it's not about YOU). If I return to work & can't handle it, I'll have to go w/out pay even w/ a Dr. note for either 5 or 10 days before pay will kick in again. I'll be returning for 1 wk & then we have a wk off for Fall Break. My husband wanted me to wait until after fall break bc it'd give me 2 more wks to recouperate & build my energy lvl back up. I really don't mind trying to go back (I'm beyond stir crazy & definitely haven't been able to do a.thing fun while I've been off), but now I'm trapped & have no safety net if I can't handle it. I don't think he understands that I'm on my feet, on the floor, etc. ALL day. I teach little kids, I can't sit at my desk, cancel class, or tell the kids I need to rest,...it just doesn't work like that. I think it's an ego thing w/ him & he just wants the whole situation to go away,...so,...the sooner he can say I'm fine, he can clear his conscience & forget about it. Especially since the other Dr.s in his practice are aware of it,...I just can't see what else it could be. I hate that I'm so upset with him, bc I've always respected him, but I felt like he stepped WAY over the line with the baby comment & I'm sorry, but you'd think he would've been ultra sensitive to my healing & lack thereof since I clearly don't heal like most people, and considering the massive inconvenience it's had on MY life. Sometimes I think they forget that someone else is involved in their world! Can you tell me how long you've had to miss from all of your complications? I haven't heard a.thing about the silver nitrate that some have talked about (does it help?). Several have also said it DOES shorten the vaginal wall (is this true? He told my hub that it doesn't). Has anyone found anything that helps with all the bowel problems that accompany this procedure? Apparently, my intestines & bowels were "bruised" from the trauma of being exposed to air (who would know?), so I'm STILL struggling with the spasms, sharp pains, & dizziness that accompanies it all. It sounds like several of you have also had similar probs with your Dr.s,...what to do?? I'll HAVE to say something to address the comment bc it has been eating at me, but I don't see him again for anotehr 6 wks,...oh,...plenty of time to stew!! LOL

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Unfortunately, sounds like this has become a nightmare for you also. Ive been through this TWICE now and Im going to give you some advice that your Dr wont give you bc he's gonna pretend everything is ok now and not tell you what you really should do.
I believe you should be ok to go back to work as long as you are able to keep the pain under control and I think all your cramping and pain you are still having is from damage done by not being repaired quickly enough. I am still having some pain but having a 10month old to keep up with takes my mind off of me and onto him. BUT having been through all this...I wouldnt run, jump, bend over and pick things up or anything that could push the bowels back through the vaginal cuff. And as sad as it is, I wouldnt have sex for at least 6 months of being fully healed.
I have went through 3 Drs during my nightmare and I finally found one that told me like it is. That this is very rare and that it was probably caused by not being sewed up well enough the first time. She has also put me on restrictions that I wasnt even put on after the hysterectomy. No running, jumping, lifting anything over 10 lbs, no bending over, sittups..etc for 6 months. AND the hardest to swallow...no sex for 6 months.
I am 8 weeks out from the second vaginal cuff repair and am completely healed but she told me to follow her restrictions bc it can still happen 6 years down the road. And I am scared silly to not follow this advice. She has also told me that if my vaginal cuff does re-open again...chances of me ever healing or going back to normal are slim to none. That means always worrying about my bowels falling out of me and not having sex EVER again.
I sure hope you feel better soon and I am soo sorry that anyone else has had to go through this.

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Ladies, I found your comments while I was researching why not to bend over after hysterectomy recovery. I am 4 weeks post-op and don't feel right, although I have no actual prolapse (yet). Your comments scare me. I haven't had sex yet and hope I don't start having problems then. My stitches were cauterized yesterday. I found some great information that may help you find doctors that will help you. Their explanations may help you understand your condition better. http://www.gyndr.com/genital_prolapse_surgery.php
These guys are a gyn practice in Chattanooga, TN. That's a long way for me, but if I had your problems, I would consider the travel if no one in your area seems to have a grip on your problems. Best wishes. Were you told not to bend over post-op? I wasn't, and I wasn't told a lot of other things either. Patient education was sorely lacking both from the hospital and my clinic. Infuriating!

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Thank you for this information:)

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Hi, this happen to me too. I had a hyster in June, after having sex with my husband in September I started having really painful cramps and I felt I needed to have a bowel movement but couldn't. Went to the hospital and was told the incision had come open of the vaginal cuff. Its been a month now and I'm still having pain with bowel movements but have been told everything is healing fine. At this point it's hard for me to believe anything they say. They say we will never know why this happen. If that's true then it could happen again. Why did this happen? Are they covering something? Please email me if you have anymore info about what could of went wrong or what I can do in healing. Thank You

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I saw a female gynecologist in another city for a second opinion on my case. When I told her that some people in a forum I am using said their husbands went right through them the first time they had sex, she said, "They had laparoscopic hysterectomies". I got somewhat the impression the top is perhaps glued shut, and she didn't quite go quite that far, but said if they do stitch they don't go as far through. Apparently they can't suture the cuff as deeply as with traditional hysterectomy. It made me feel better about my choice to stick with my elderly gynecologist for the surgery just before his retirement (he operated on me nine days before his last day), who did the old fashioned vaginal hysterectomy, instead of waiting for a younger MD in his practice to do da Vinci surgery. But I feel compelled to let you in on this piece of information, since I doubt you'll hear it from your doctors. I am sorry about this whole situation for you and I will say (again) that I am angry with the lack of information provided by the medical community to patients about something that will deeply impact their future. I am still appalled with the paternalism in not telling prospective surgical candidates that they risk pelvic prolapse from hysterectomy if they don't carefully follow guidelines of not lifting, bending, vacuuming, sweeping, reaching, sitting for prolonged periods, etc, during the recovery process. Do they think that what we don't know won't hurt us? I would say that it's more that we are not giving informed consent, since we are not informed. I hope all goes well with all of you. I appreciate the full explanation given by the gynecologists in Chattanooga, TN in describing the role of ligaments and fascia in pelvic prolapse and how this works during surgery for hysterectomy and pelvic prolapse problems. That is the only site I have found so far with such quality information. Best wishes to you all.

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I did a little research on the subject of vaginal cuff after laparoscopic hysterectomy for you. Here is some food for thought:

http://www.ncbi.nlm.nih.gov/pubmed/19622999

http://www.uptodate.com/patients/content/topic.do?topicKey=~TmVAAFh7EO46ghV

- please note that a 4 percent rate is considered high risk by medical standards. Anything less than 1 percent is acceptable risk. So, they know they are doing something with unacceptable risk? And not telling us?

This one is very interesting. Please not the paragraph just above the box labeled "Figure 6":
http://www.femalepatient.com/html/arc/sig/cut/articles/032_10_037.asp
- apparently they do suture, but the electrocautery is perhaps the problem? The doctor I saw last week didn't elaborate, but she may have been thinking this.

http://www.youtube.com/watch?v=FnFW23fgtNo

http://www.ncbi.nlm.nih.gov/pubmed/20506682?dopt=AbstractPlus

Here is another doctor who may help you:
http://www.reproductivecenter.com/texas.html

http://en.wikibooks.org/wiki/Radiation_Oncology/Toxicity/Vagina

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WG6-5137K59-6&_u ser=10&_coverDate=09%2F24%2F2010&_rdoc=1&_fmt=high&_orig=search&_origin=sea rch&_sort=d&_docanchor=&view=c&_searchStrId=1512775883&_rerunOrigin=google& _acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=6b3e75d8f2c05073b6 11d00e07333b48&searchtype=a

Petunia, I am thinking about you. One of my closest friends is a techer.

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I'm sorry, I should have included all of you. All of you deserve the same regard. It's just that Petunia's case sounds the most harrowing and her doctor sounds like a jerk. I mean is a jerk. It's almost as if he's covering for something and feeling guilty. Or he could just be frustrated. But probably not the most skilled surgeon? BTW, the spelling for your vein inflammation is phlebitis. I am a medical transcriptionist but a housewife at this time (and working toward my nursing degree).

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