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Suggest Remedy For Pain At Laparoscopy Incision Sites

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Posted on Mon, 15 Sep 2014
Question: I have pain in both incision sites on left side where laparoscopy was used to do hysterectomy and bladder sling for prolapse bladder and uterus. cervix was removed I am having pain under left rib and ribs themselves. it feels like a flexing or cracking in the ribs when breathing or laughing or cough and sneeze etc. very painful. I also have a rash around only the 2 incision sites on left side out of 5 cuts made.They are red, raised and have a spotty rash around them. no fever or signs of feeling bad other than continued discharge of brown fluid that has a foul odor. I'm 2 weeks post op. Is this normal post op healing or do I need to go see the hospital for treatment. Considering this was a major surgery with organ removal and a bladder sling placed I believe dr said he treated cytocele and rectocele and hysterectomy was the terms used. No mesh it was a sling for the bladder. Only staying 1 night in hospital and after surgery no immediate problems showed as I was discharged in good health 2 weeks ago. I'm 32 yrs old.
doctor
Answered by Dr. Dr. Rakhi Tayal (19 minutes later)
Brief Answer:
Brownish discharge can be due to infection.

Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
The discharge of brownish fluid with a foul odor is a worrisome finding 2 weeks post op. By now your stitches should have healed without any discharge. Absence of fever is a good sign. The persistent pain on the left side is a normal finding which can happen due to mild inflammation or partial healing of the internal stitches. The pain that you can feel on the left side is likely to subside with rest and the pain killers that you are already taking.
But I would advise you to go for a follow up visit to your surgeon to get a culture sensitivity of the discharge done. The raised rashes around the area are suggestive of inflammation. Infection needs to be ruled out. Doing a hot fomentation with a hot water bag will help in reducing the symptoms.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Rakhi Tayal (19 hours later)
I went as directed by the OB dr this morning for a follow up to my hysterectomy surgery 2 weeks ago on the 5th. As I explained to previous dr I had hysterectomy via laparoscopy in the procedure it was determined I had prolapse issues and during the surgery they ended up also placing a bladder sling in and fixing what they referred to as rectocele and cytocele. Sorry if misspelled. Apparently the uterus had prolapse into vagina but was placing pressure on both bladder and rectum since was in doing surgery he didn't want me having hysterectomy and recovery to end up with incontinence. So everything was addressed and fixed during the 1 surgery. Cervix was also removed. I have sutures running up and down vaginal canal to strengthen and seal the hernias repaired. I believe on the rectum side but also the front side as well. The issue was brown discharge leaks constantly thru day with a foul odor. It's a small amount at a time. Like a 5-7ml amount of fluid. It has been since surgery. I also have no fever or signs of infection anywhere else. The 5 incision sites have sealed fine. The 2 on left are more raised and red than the 3 others and are also more painful. I have increased pain in left side also in ribs and under ribs Esp laughing, cough or sneeze. My pain level hasn't seemed to decrease much from discharge of surgery which was only a 1 day outpatient surgery stay and was sent home with no apparent issues or complications other than normal post op instructions for no lifting or bathing/swimming. Showers were fine. Nothing into vagina for 12 weeks or sex. I have followed all instructions and take minimal medications and deal with the pain due to I have small infants at home I care for and don't want anything to impair my judgment so advil or tylenol is only used. Pain is out of 1-10 roughly depending on day about a 7. Is any of this normal?
CT SCAN showed nothing and blood work taken via arm showed nothing also. No vaginal exam was done other than a quick visual look. No swabs or culture sensitivity was done to determine infection like other dr suggest. Should I seek a second opinion? Is this something that can become worst than an infection when dealing with a major surgery like this?
doctor
Answered by Dr. Dr. Rakhi Tayal (44 minutes later)
Brief Answer:
Foul smell of discharge is worrisome.

Detailed Answer:
Hello.
Thanks for writing again. in detail.
This makes the picture more clear to me.
The mild blood stained vaginal discharge is a normal finding. Such mild oozing will gradually subside in next few weeks as the internal stitches and the uterine stumps will heal. Please do not worry. The only finding that worries me is the foul odor. This smell can be indicative of an infection. But any infection is usually associated with pain and fever.
You need to closely monitor your body temperature, have plenty of fluids orally and watch out for any burning during micturition. If the foul smell persists or there is an associated itching then a vaginal swab culture is recommended.
The pain on the left side and under the ribs is normal. This will gradually subside. Do take care of your diet- should be rich in proteins and Vitamin C to boost your immunity and for faster healing.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Rakhi Tayal (52 minutes later)
Would the fever perhaps not be showing due to the constant every 4-6 hours on tylenol and advil?
doctor
Answered by Dr. Dr. Rakhi Tayal (6 hours later)
Brief Answer:
It is possible.

Detailed Answer:
This is also a possibility. But these pain killers are needed to combat the pain. Vaginal swab culture is needed in case the foul smell persists. Try to keep the area clean and dry.
Regards.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Dr. Rakhi Tayal

OBGYN

Practicing since :2001

Answered : 14039 Questions

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Suggest Remedy For Pain At Laparoscopy Incision Sites

Brief Answer: Brownish discharge can be due to infection. Detailed Answer: Hello, Thanks for trusting us with your health concern. The discharge of brownish fluid with a foul odor is a worrisome finding 2 weeks post op. By now your stitches should have healed without any discharge. Absence of fever is a good sign. The persistent pain on the left side is a normal finding which can happen due to mild inflammation or partial healing of the internal stitches. The pain that you can feel on the left side is likely to subside with rest and the pain killers that you are already taking. But I would advise you to go for a follow up visit to your surgeon to get a culture sensitivity of the discharge done. The raised rashes around the area are suggestive of inflammation. Infection needs to be ruled out. Doing a hot fomentation with a hot water bag will help in reducing the symptoms. Please feel free to discuss further. I will be glad to answer the follow up queries that you have. Wishing you good health. Regards. Dr. Rakhi Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal