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Neurology (Expert Forum)
Nerve pain in vaginal/urethra after hysterectomy
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Nerve pain in vaginal/urethra after hysterectomy
by otessa, Nov 06, 2006 12:00AM
Hi,
I had a TAH on 7/21/06. At 4 weeks I was pretty much off meds for pain. At week 5 or so, I thought I had a UTI and went to the gyn. They treated it, but the culture came back negative. I was back the next week and was treated for a yeast infection. That didn't help. I won't call what I have pain, it's more of an irritation. The closest thing I can liken it to is when you have a UTI and you feel like you need to urinate all the time. But I don't have one. It's almost constant and the only thing that helped was sitting on a hot heating pad and Lortab. Now they won't prescribe Lortab any more and I don't know what my next step should be. The irritation seems to be where my urethra is and in the lower part of the vagina. It's very strange and doesn't seem to want to go away. I've had a CAT scan also...all clear, no adhesions, no hematomas from surgery. Any ideas?
Thanks!
Otessa
I had a TAH on 7/21/06. At 4 weeks I was pretty much off meds for pain. At week 5 or so, I thought I had a UTI and went to the gyn. They treated it, but the culture came back negative. I was back the next week and was treated for a yeast infection. That didn't help. I won't call what I have pain, it's more of an irritation. The closest thing I can liken it to is when you have a UTI and you feel like you need to urinate all the time. But I don't have one. It's almost constant and the only thing that helped was sitting on a hot heating pad and Lortab. Now they won't prescribe Lortab any more and I don't know what my next step should be. The irritation seems to be where my urethra is and in the lower part of the vagina. It's very strange and doesn't seem to want to go away. I've had a CAT scan also...all clear, no adhesions, no hematomas from surgery. Any ideas?
Thanks!
Otessa
Doctor's Answer
by CCF-Neuro-M.D.-SH, Nov 14, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The most likely explaination of your symptoms are non-neurologic, including bladder sphincter spasms (that can be helped by Detrol) or undiagnosed inflammation/infection.
However, the symptoms you describe may also be related to nerve damage in the peroneal area, amongst other things. I do not know the procedure that was done for the TAH, but with vaginal approach TAH the nerves could be stretched and cause a transient pain. In rare cases the nerves may have permanent stetch damage/injury, which can be diagnosed on a pelvic EMG. Other possible causes include multiple sclerosis (an MRI of the brain can help with this) and a viral infection such as herpes simplex, etc. I would suggest starting a medication for neuropathic pain such as Elavil, neuronitn, cymbalta, etc to replace the Lortab (neuropathic pain medication takes 2-3 weeks to work, but is more effective in the long term. I would also suggest the pelvic EMG and MRI of the brain with and without contrast.
I hope this has been helpful.
The most likely explaination of your symptoms are non-neurologic, including bladder sphincter spasms (that can be helped by Detrol) or undiagnosed inflammation/infection.
However, the symptoms you describe may also be related to nerve damage in the peroneal area, amongst other things. I do not know the procedure that was done for the TAH, but with vaginal approach TAH the nerves could be stretched and cause a transient pain. In rare cases the nerves may have permanent stetch damage/injury, which can be diagnosed on a pelvic EMG. Other possible causes include multiple sclerosis (an MRI of the brain can help with this) and a viral infection such as herpes simplex, etc. I would suggest starting a medication for neuropathic pain such as Elavil, neuronitn, cymbalta, etc to replace the Lortab (neuropathic pain medication takes 2-3 weeks to work, but is more effective in the long term. I would also suggest the pelvic EMG and MRI of the brain with and without contrast.
I hope this has been helpful.
Ask them for more details on what the surgery found and see if it may have been worked on, or if the catheter they used may have irritated the uretherer somewhat.
I would suggest using cranberry juice or the tabs (avail at supermarket healthfood sections) to keep your urine in good shape and keep yourself hydrated.
Fiona