A hysterectomy involves the removal of the uterus, and pain is an expected part of recovery. While discomfort is often felt centrally in the pelvis, specific pain localized to the right side of the abdomen can be concerning. This right-sided sensation can arise from various sources, including temporary surgical side effects, issues involving adjacent organs, or structural complications. Understanding the potential origins of this localized pain is helpful, but this information is not a substitute for professional medical guidance.
Expected Causes of Postoperative Discomfort
The immediate pain experienced after surgery results from tissue manipulation and the body’s natural healing response. Even with a central incision, surrounding muscle and deep fascia tissues are stretched and moved, leading to radiating soreness. This general muscle discomfort may manifest as a persistent ache concentrated on the right side of the abdomen.
The uterus and its supporting structures are secured by various ligaments that extend into the pelvis, which must be clamped, cut, or manipulated during the procedure. For example, the broad ligament, which supports the uterus and extends laterally, must be severed. Trauma to these strong tissues can cause pain referred to the surrounding abdominal wall. Nerves in the pelvic region may also be stretched or irritated, contributing to localized or neuropathic pain that feels like burning or a sharp ache near the incision or in the right lower quadrant. This type of discomfort is typically managed effectively with prescribed pain medication and should steadily decrease during the first few weeks of recovery.
Digestive and Urinary System Contributions
Temporary disruption of the digestive system is a common source of acute, sharp, right-sided pain after abdominal surgery. Gas pain is frequent, especially following laparoscopic procedures where carbon dioxide is pumped into the abdomen. This trapped gas irritates the diaphragm and peritoneal lining, often causing pain that travels to the shoulder tip. It can also press against the right side of the colon, leading to localized abdominal discomfort.
Constipation is another frequent issue, often caused by anesthesia and prescription pain medication used during recovery. Stool buildup in the large intestine, particularly in the ascending or transverse colon, causes bloating, cramping, and pressure often felt strongly on the right side. Maintaining hydration and using stool softeners are recommended to mitigate this pain.
The bladder’s close proximity to the uterus means it is often manipulated during the hysterectomy, increasing the risk of urinary tract irritation or infection (UTI). While primary UTI symptoms include burning or frequency, inflammation can cause referred pain to the lower abdominal area, sometimes localizing to the right side of the pelvis. This pain is usually accompanied by other urinary signs and requires medical assessment for confirmation.
Delayed or Less Common Structural Complications
If right-sided pain persists or develops weeks to months after the initial recovery period, the focus shifts to less common structural changes. Adhesions, bands of internal scar tissue, are a natural part of healing after pelvic surgery. While often harmless, adhesions can sometimes tether or pull on organs like the small bowel, a retained ovary, or the abdominal wall on the right side. This can cause chronic or intermittent sharp pain, especially noticeable during digestion or specific movements.
A localized infection or abscess, a collection of pus, can form deep within the pelvic cavity or at the incision site, causing persistent, localized right-sided pain. This is often accompanied by systemic symptoms like a fever or an elevated white blood cell count. Deep wound infections typically appear about a week after surgery and require immediate medical evaluation.
A hernia is another possibility, resulting from a weakness in the abdominal wall near the surgical incision. This structural defect allows internal tissue or a loop of the bowel to push through, causing a bulge and pain that worsens with straining, coughing, or lifting. Nerve damage or irritation, where pelvic nerves become trapped or inflamed, can also lead to chronic neuropathic pain on the right side that feels sharp, burning, or electrical.
Warning Signs Requiring Medical Attention
While mild to moderate pain is expected, certain symptoms alongside right-sided pain suggest a complication requiring immediate medical assessment. Sudden, severe pain that is significantly worse than previous discomfort and unresponsive to medication should be reported without delay.
Immediate medical attention is necessary if you experience:
- A new, high fever or shaking chills, which may indicate a serious infection.
- Persistent nausea and vomiting, or the inability to pass gas or have a bowel movement for several days, signaling a potential bowel obstruction.
- Any change in the incision site, such as increasing redness, swelling, foul-smelling discharge, or heavy bleeding.
- Signs of a potential blood clot, such as unexplained pain, swelling, warmth, or tenderness in the calf of the leg.
Any concerning symptoms must be discussed with your surgeon or primary care physician to receive a definitive diagnosis and appropriate treatment.