Post C-Section Woe: Infertility and Pain

But another cause has been discovered by Dr. Mousa Shamoni of University of Siena, Italy, and presented at the Annual InVitro Fertilization and Embryo Transfer Conference. That is scaring of the cervix after a C-section. These women may have scars that actually close the cervix, or scars that partially close the cervix, or pockets of fluid near the old c-section scar. Once these scars occur, the natural uterine fluids and/or menstrual blood then doesn't have the natural passageway out and can accumulate in the uterus. This can lead to obstructions that will prevent normal sperm passage, it can lead to problems with implantation, and chronic abnormal periods or pain. Whether it can cause out right infection is so far speculation. But since between a 1/3 and 50% of women at any given hospital are born by c-section today it's becoming more and more frequent. We know a lot about what internal scaring can cause in women who still have periods after having an endometrial ablation. Women who have endometrial ablations rarely have abnormal bleeding and fluid accumulating in the uterine cavity and the cause is what has become known as the post endometrial ablation syndrome. Transvaginal Pelvic Ultrasound can see these scars in some cases, and other cases need hysteroscopic surgery to determine the problem. And often the scars can be removed with the hysteroscopy. Dr. Ivan Valencia from Quinto Equador gave resounding support to this newly discovered medical problem, and now he estimates that 60-70% of C-sections cause these scars he calls isthmoceles. Something new to gab with your gyno about if you plan a c-section or have had one.

Comments

  1. A reader wrote about a common complaint which is temporary numbness after abdominal surgery. What would not be common is numbness that does not resolve, although that does occur as well. gynecologists, surgeons, and plastic surgeons have a lot of experience with the healing process post surgery, which can take a long time...as in months. Nerve symptoms can occur from swelling, nerve stretching or the cutting of nerves, but swelling and stretching symptoms virtually always resolve. Most women will have excellent healing with no bothersome symptoms after the lower abdominal incision. Women who were not at their ideal weight or who carry their weight in their abdomen or have issues of localized fat collection have more complaints as to the cosmetic look and feel of their abdomen after healing. That can be addressed as well with targeted therapies such as weight reduction, training, non-invasive treatments such as coolsculpting, or surgery. Those therapies do not specifically address nerve issues.
    I found your blog looking for info about muscular pain after a c-section. I didn't actually have a c-section, but there's nowhere near as much info out there about myomectomies and I know there is a similarity in the incisions of an abdominal myomectomy (like the one I just had) and a c-section.

    As I said, I just had an abdominal myomectomy for some seriously large fibroids (11cm, 7cm, 6cm, intramural, two of them in the fundal area.).

    I'm 5 weeks post-op right now and I'm concerned about how numb my stomach is. I have heard a lot of women talk about numbness after myomectomies and c-sections, but they always seem to be refering to the area around their incisions. I was prepared for the skin around my incision to be numb. What I wasn't prepared for is the numbness I currently have - The complete absence of surface sensation on my skin from about a half inch below my belly button to about halfway down my pelvis. The numbness also extends right to left - taking about the length of my incision but all the way from my belly button almost to my pelvis.

    Needless to say, this is WAY more than being numb around my incision! I feel mutilated! I asked my surgeon initially about this and he said that they cut small nerves leading to the skin and this numbness is normal, and will take about 6 months to a year to resolve - is this true? Or am I permanently injured from this and will I never feel my lower stomach again? I'm concerned because again, most women I have spoken to have only had numbness around their incision, not their entire lower stomach. I'm really shaken up by this - I feel like a part of me has been almost amputated or something.

    While I am numb on skin level, I have pain that is nowhere near my incision, that feels muscular - on the right side right above where my leg connects to my torso. When it is at its worst, I also get some tingling in my foot on that side.

    I guess my question is:
    1) Is there a specialty in the GYN field that addresses nerve issues? If the nerves have been cut, can they be fixed? What kind of specialist would I see for such a thing?
    2) Am I possibly overreacting, or is this numbness way above what is normal for this surgery?
    3) Is there any chance of such a thing indeed healing in 6 months to a year, and me regaining normal feeling in my abdomen?

    Thanks for any comments you may have to give me. I know this doesn't constitute any sort of professional relationship and that you are just giving me insight, not medical advice.
    I'm just greatful to pick your brain and experience if you'll allow that.

    ReplyDelete

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