What causes mild abdominal pain after hysteroscopic surgery, and what should be done?

Nov 05, 2025 Source: Cainiu Health

Dr. Zhang Lu

Introduction

In general, mild abdominal pain after hysteroscopic surgery may be caused by uterine contraction and recovery, postoperative pelvic fluid accumulation, postoperative endometritis, intrauterine adhesions, or postoperative pelvic inflammatory disease. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve symptoms through general measures, medication, or other treatments under a doctor's guidance. After surgery, personal hygiene should be maintained, underwear should be changed frequently, and bathing in a tub should be avoided.

In general, mild abdominal pain after hysteroscopic surgery may be caused by uterine contraction and recovery, postoperative pelvic effusion, postoperative endometritis, postoperative intrauterine adhesions, or postoperative pelvic inflammatory disease. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve symptoms under a doctor's guidance through general management, medication, and other approaches. Specific analyses are as follows:

1. Uterine contraction and recovery: After surgical stimulation, the uterus needs to contract to return to its normal shape, which may cause mild abdominal pain lasting usually 1–2 days. Resting in bed, applying a warm compress (such as a hot water bottle) to the lower abdomen, avoiding strenuous activity, and drinking warm water appropriately can help relieve discomfort from uterine contractions.

2. Postoperative pelvic effusion: Small amounts of fluid may remain in the pelvic cavity during surgery, irritating the peritoneum and causing mild abdominal pain, typically without other obvious symptoms. Patients can benefit from gentle ambulation to promote fluid absorption, avoid prolonged sitting or lying down, and maintain a light, easily digestible diet to reduce pelvic burden.

3. Postoperative endometritis: Bacterial infection due to surgical manipulation can lead to inflammation of the endometrium, causing abdominal pain, possibly accompanied by increased vaginal discharge with an unpleasant odor. Patients should follow medical advice to take anti-infective medications such as cefixime dispersible tablets, metronidazole tablets, or levofloxacin hydrochloride capsules.

4. Postoperative intrauterine adhesions: Damage to the endometrium during surgery may result in adhesions, obstructing menstrual blood flow and causing abdominal pain that often worsens with the menstrual cycle. Medications such as estradiol valerate tablets, progesterone capsules, or enteric-coated aspirin tablets may be used as directed by a physician to promote endometrial repair.

5. Postoperative pelvic inflammatory disease: Reduced immunity after surgery may allow bacteria to ascend and infect the pelvic organs, leading to inflammation. Abdominal pain is typically persistent and may be accompanied by fever and soreness in the lower back or sacral area. Patients should follow medical instructions to use anti-inflammatory medications such as ceftriaxone sodium injection, doxycycline tablets, or clindamycin phosphate injection.

After surgery, personal hygiene should be maintained, underwear should be changed frequently, and tub bathing should be avoided. A diet rich in protein and vitamins—such as lean meat, eggs, and fresh fruits and vegetables—is recommended to support recovery and reduce postoperative discomfort.

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Can a transvaginal ultrasound be performed ten days after hysteroscopic surgery?

Whether a transvaginal ultrasound can be performed ten days after hysteroscopic surgery depends on the extent of endometrial injury. Generally, if the injury is mild and recovery is quick, a transvaginal ultrasound can usually be done normally after ten days. However, if the injury is severe and requires a longer recovery period, the timing of the ultrasound will be delayed until full recovery is achieved, after which it may be performed under a doctor's guidance.

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Can I get an IUD inserted immediately after a hysteroscopy procedure?

Whether an intrauterine device (IUD) can be inserted immediately during hysteroscopic surgery depends on the extent of surgical trauma and the individual's health condition. Generally, immediate IUD insertion is not problematic if the surgical trauma is minimal, recovery is quick, and there are no underlying abnormalities; in fact, it may help control postoperative bleeding. However, if the surgical injury is extensive, recovery is slow, or there is an existing infection, inserting an IUD immediately may impair recovery and exacerbate the infection.

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What are the symptoms of the first menstrual period after hysteroscopic surgery?

In general, symptoms of the first menstrual period after hysteroscopic surgery may include earlier or delayed menstruation, reduced menstrual flow, irregular periods, abnormal menstrual color, and pain. In addition, other symptoms such as amenorrhea may also occur. If you experience severe discomfort, please seek medical attention at a hospital promptly for targeted treatment to avoid delaying your recovery.