Setting Up for Success after Endometriosis Excision Surgery

In Endometriosis, Pain, Pelvic Health, Pelvic Pain by Jennifer KeeseeLeave a Comment

By Jennifer Keesee, DPT, PHRC Westlake Village & Jandra Mueller, DPT, MS, PHRC Encinitas

 

Congratulations on taking the next step in your healing journey! You’ve found a great doctor and decided to proceed with endometriosis excision surgery. If you’re like me, after many years of managing endo symptoms, you’re probably excited to address the root cause. If you have been wondering how to prepare, what to wear, or how you will feel, you are not alone. You may find yourself asking “what if they don’t find anything” or “is this really the right decision?” As you’ve probably learned, excision surgery is the gold standard for diagnosing and treating endometriosis, your fears are real, they likely WILL find something, and many patients do feel better mentally and physically afterward.

 

It is important to remember that recovery looks different for each person. Most patients recover from the surgical pain within the first couple of days to weeks after surgery; however, it takes six to twelve weeks for tissues to fully heal. Don’t be discouraged if your first few menstrual cycles are painful or different, this should gradually improve over the next three to six months.

 

Here is what you can expect in the first couple of days to weeks following your excision surgery, and this will vary depending on all that was performed during your surgery: 

  • Pain in your abdomen, shoulder, or pelvis which partially is from the gas they use in the laparoscopy – this pain should subside within a few days
  • Irregular spotting or bleeding
  • Constipation, gas, and bloating
  • Difficulty urinating
  • Fatigue, drowsiness
  • Nausea 
  • Soreness at incision sites 
  • Difficulty sitting, standing up, or walking 

 

Here are some tips to set yourself up for success after a laparoscopy:

 

Medication

  • Follow the pain medication schedule provided by your surgeon. Take it regularly, this means setting an alarm to take medication at night for the first couple of nights. There is nothing heroic about not needing pain medication, and staying ahead of the pain can make a huge difference in keeping your pain levels low. 
  • Take a stool softener recommended by your surgeon. Pain medication often causes constipation so keeping your stool soft will help you to avoid straining. This may help reduce pain and minimize stress to your healing tissues and pelvic floor muscles. A squatty potty can help with this too! Check out this blog for the right way to poop.

 

Rest

  • You may feel better after a couple days, stick to the activity limitations your surgeon provided as your tissues are healing. You may not feel better for a couple of weeks, stay the course, as your tissues are healing. 
  • Some common activity restrictions include avoiding: stairs, intercourse, orgasm, lifting heavy weights, and moderate to strenuous exercise. 
  • You may find that purchasing a wedge pillow can provide more comfort during the times you are laying in bed and not moving around as much.

 

Diet and Hydration 

  • Eat foods that are easy to digest (soup, toast, bananas, etc.) and avoid foods that are more difficult for you to digest. Stay well hydrated by drinking plenty of water or clear liquids (at least 64 ounces).
  • You may want to consider an electrolyte beverage such as organic Gatorade (it does not have the high fructose corn syrup) or electrolyte tablets for your water, especially if your appetite remains low. 

Movement

  • Walking, especially after meals, can improve digestion, decrease gas, and prevent blood clots. We recommend ten to twenty minutes at a low intensity. Generally if you can walk and talk, this would be low intensity. 
  • Light movement, can help ease tension and pain.

 

Abdominal binder

  • Your surgical center may provide an abdominal binder. This can help support tender incision sites, especially when sneezing, coughing, or laughing and prevent irritation from clothing. As your recovery progresses, the support from the binder can also be a reminder to take it easy.

lap surgery pt2

Other Tips:

  • You may find it helpful to join an endo community group such as Nancy’s Nook, or you may have a local group on Facebook. Reading through some of the experiences there may help to provide information from the local doctors or may remind you of important questions to ask your doctor at your pre-op appointment. 
  • Call your doctor if you experience anything that seems like it may not be part of the normal healing process. For example, those with endo can have a lot of sensitivities and if you feel you are reacting to any medications or adhesives, it is important for them to know. 
  • Talk to your doctor beforehand about what they suggest for management afterwards. Will you need hormonal birth control, if so, which type? Is an IUD an option? If you suffer from vestibulodynia, a systemic form of birth control may not be the best choice for you, check out this blog for more information. What do they expect long-term? How do fertility treatments work if needed in the future – if this is a concern you have. 

 

Resources:

Excision of Endometriosis via Center for Endo

Nancy’s Nook Endo- WHy Excision is Recommended

Pelvic Pain Explained: Endometriosis + Resource List – books, support groups, videos, provider lists, etc.

Pelvic Pain After Endometriosis Surgery (video)

Everything You NEED to Know About Endometriosis (video)

Getting to Know Your Vulva (video)

 

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Are you unable to come see us in person in the Bay Area, Southern California or New England?  We offer virtual physical therapy appointments too!

 

Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page

Melissa Patrick is a certified yoga instructor and meditation teacher and is also available virtually to help, for more information please visit our therapeutic yoga page

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