Do we REALLY need to obey pelvic rest instructions?
June 22, 2016 4:40 PM   Subscribe

13 days ago, I had a laparoscopic surgery to treat some endometriosis-related concerns. YANMD, but you are also not what I find when I Google this ("pelvic rest" seems to turn up pregnancy-related concerns only). Short version: my partner and I want to do. it. soon. But the printed instructions my doctor gave after surgery say no.

Two weeks out, is it a terrible idea to have intercourse? As far as I know, the incisions/work were exclusively around my abdomen (nothing transvaginal) and recovery has been relatively uncomplicated. My partner and I are exceedingly, almost obsessively, clean. It's not like we're throwing fecal matter hither and yon.

And yet, my doctor's printed post-op instructions were to follow pelvic rest (no tampons, intercourse) for six weeks. Six weeks! It seems excessive for the level of invasiveness of the procedure.

So my question is about your experiences (horror stories welcome, if I need to be scared out of the notion) about recovery after a laparoscopic or other abdominal/pelvic procedure, particularly w/r/t doin' it.
posted by witchen to Health & Fitness (20 answers total) 1 user marked this as a favorite

So, I don't have experience with laparoscopic surgery in that area, but I do have experience with stitches being taken out too early and wounds opening back up.

I'm guessing you don't want that to happen to your lady bits. I would take the doctor's advice seriously. You might feel fine, but your tissues are likely still healing and fragile right now.
posted by burntflowers at 4:44 PM on June 22, 2016 [8 favorites]

Creativity opportunity.
posted by amtho at 4:47 PM on June 22, 2016 [20 favorites]

Hi there, I (formerly) worked as a bench researcher regarding wound healing. That work was mostly on bone injury and healing, but included a lot of soft tissue stuff. And, uh, yeah, two weeks is not very long? You need more than two weeks for all the biological mechanisms of wound healing to really wrap up solid,long-lasting, strong tissue. If you are curious about some of those mechanisms, here's a (free) paper, btw.

In any case, you can and should call your doctor for their take. They may tell you that people have reported differing degrees of success with sex against medical advisement. They may also tell you True Tales of Less Successful Experiences. Which you might need to hear right now because nothing grinds down horniness like medical emergency mental flashcards.
posted by late afternoon dreaming hotel at 4:55 PM on June 22, 2016 [22 favorites]

I've had laproscopic surgery on my stomach (so, pretty far away from the lady bits and maybe not relevant). I was told I could get back to it whenever I wanted. I couldn't imagine wanting to, not for at least a month. My abs really hurt from all the bits and pieces they stick through those tiny incisions. Laughing and rolling over were painful enough.
posted by kitten magic at 5:06 PM on June 22, 2016 [1 favorite]

The issue here isn't cleanliness/sterility-- two weeks in, the wounds should have healed superficially. The problem is that the increase in intrabdominal pressure might lead to separation of the wound, which would not be very fun to deal with. (That said, activities like lifting 8-20 lbs and even abdominal crunches did not increase intraabdominal pressure more than standing up from a seated position does, apparently.)

IANAD and have no anecdata to relay here, but two weeks isn't a super long time in terms of surgical wound healing, and even after six weeks, only 80% of the original strength is achieved. Do I think your guts will spill out? Probably not, since laparoscopic incisions are small. But I'd wait until at least four weeks to be safe. Guidelines exist for a reason. Find other ways to have fun for now.
posted by gemutlichkeit at 5:13 PM on June 22, 2016 [5 favorites]

No ! Don't do this! There's a huge difference between 13 days and 6 weeks. Call your doc if you want to have transvag sex sooner but holy Christ, don't put your uterus through that.
posted by pintapicasso at 5:14 PM on June 22, 2016 [12 favorites]

So, the fact that the abdominal port incisions are small doesn't tell us anything about what was actually done inside. Remarkably extensive surgical procedures can be performed laparoscopically, and no one but your surgeon can tell you how extensive or difficult your procedure was. There is a big difference between cauterizing a few tiny endometrial deposits as compared to say, removing a huge endometrioma that was scarred down to your bladder. If you are questioning the need for pelvic rest, the person to talk to is your surgeon, not the internet.
posted by TheLittlestRobot at 5:38 PM on June 22, 2016 [23 favorites]

This is an anecdotal story and I have zero idea if your procedure relates to my friend's if at all. She was similarly told no sex for X weeks. She thought this just meant intercourse, so she decided to have some oral fun with her partner. Well, her orgasmic contractions created terrible, searing pain, because the muscles were pulling on the wound in a way her body was not cool with. So there's a cautionary example on the extreme end.

(and man, outside of actual violence and such I can't imagine a much worse turn of events.)
posted by MillMan at 5:53 PM on June 22, 2016 [16 favorites]

SO VERY MUCH what TheLittlestRobot just said. Those tiny skin incisions are irrelevant; very extensive internal procedures can be done laparoscopically. Definitely consult your surgeon before proceeding!
posted by jesourie at 6:11 PM on June 22, 2016 [2 favorites]

NOoooooooooooooooo. I have had a laparoscopy for endometriosis. Can confirm you should very much not not not do this. I know you feel fine right now. Check with your doctor, too.

Please, no.
posted by jbenben at 6:24 PM on June 22, 2016 [4 favorites]

I will say that we didn't wait that long, but there is no way to know from here whether or not the surgeries and recoveries were in any way similar, so I wouldn't take this as medical advice at all.
posted by Dip Flash at 6:38 PM on June 22, 2016 [1 favorite]

Two weeks out, is it a terrible idea to have intercourse? As far as I know, the incisions/work were exclusively around my abdomen (nothing transvaginal) and recovery has been relatively uncomplicated. My partner and I are exceedingly, almost obsessively, clean. It's not like we're throwing fecal matter hither and yon.

It ain't just about the cleanliness. I had similar surgery, and my then-boyfriend and I tried fooling around only one week later and he went down on me - and I tell you what, the muscle contractions that accompany orgasm made my incision hurt a mofo - like I'd pulled stitches or something. We laid off nookie altogether for the rest of the six weeks my doctor had told me to do after that because we were kinda freaked out.

You don't know what-all may have been affected on the inside and what point things may be at when it comes to stitching itself back together again. It's best to play it safe.
posted by EmpressCallipygos at 7:17 PM on June 22, 2016 [5 favorites]

I know, it's hard to really comprehend the extent of what is going on inside, because you have no outward signs. But "minimally invasive" doesn't mean they didn't rummage around plenty good in there. Trust me, I know from experience. (Have had uterine related lap surgery an unfortunate number of times.) I mean, yes call and confirm with the surgeon if you like, but I'd say they are not kidding about the six weeks. Seriously, follow the instructions. Give yourself time to heal.

Good luck and hang in there!
posted by hurdy gurdy girl at 7:35 PM on June 22, 2016 [1 favorite]

No, listen to your doctor. Sorry.
posted by Toddles at 7:37 PM on June 22, 2016

I'm 100% on "do it all." The reason doctors give advice like that is due to liability, and the reason that advice satisfies their liability concerns is because that's how the least number of problems happen. This is permanent stuff.
posted by rhizome at 7:53 PM on June 22, 2016

Damn! Okay. I am just rounding the corner on feeling better and more like myself (can laugh, cough, and sleep on my stomach comfortably) and started to rationalize out loud that we might be able to "get back to normal" in other ways too. But my desire to return to work and not go through this again...well, I guess that outweighs the other desires. Damn damn damn.

Thanks for the advice and reality checks, truly.
posted by witchen at 7:58 PM on June 22, 2016 [1 favorite]

I had a hysteroscopy for fibroids and like you chafed at the six week ban on penetrative sex. In fact, we didn't wait, after about 4 weeks. No pain at the time, and sex was great. . . sweeter for the ban, and all was right with the world.

Until about a week later I started having vague abdominal pain that eventually, about 10 days later, had me exhausted and with the weirdest, most painful abdominal pain I have ever experienced. I couldn't really straighten up completely, and was walking sort of hunched over to spare my middle. I could not understand what was happening, and finally, after about a week where I wasn't getting better, went to the ER with what I thought must be appendicitis. Tests ensued, including a CT scan, bloodwork and several painful abdominal exams. The pain I felt has a special description in medicine - it's called "exquisite pain" when you can't tolerate even the most gentle palpation. The docs thought I had appendicitis too, until I mentioned the hysteroscopy.

Can you guess what the diagnosis was? Pelvic inflammatory disease. I kid you not. The infection that can scar your fallopian tubes and impact fertility. Plus it hurt. It really, really hurt. The proper antibiotics solved the infection, and fortunately we were not planning more kids, but it had never occurred to me that there was a risk of infection. I would hate for something like this to happen to you. Hell, I hate that it happened to me!
posted by citygirl at 8:00 PM on June 22, 2016 [9 favorites]

You should probably listen to your doctor and everyone else here, but you asked for anecdotes. I had laproscopic surgery for endo 2 years ago. Incisions in abdomen only, etc. The official printed literature said wait, but my surgeon said, "if you're feeling better you can try. If it hurts, stop." (It's possible that her relaxed reaction was related to particularities of my case, I have no idea.) I had a very rapid recovery and was feeling fine a few days post-surgery, so we gave it a try before one week was up, very carefully. It was totally fine. I wouldn't have made a habit of it, but partner was traveling shortly thereafter so it wasn't an issue. I was back at work 1 week after the surgery, if that helps as a benchmark for how I was feeling.
posted by oneaday at 2:00 AM on June 23, 2016

IANYD, however, I am an OB/Gyn who performs laparoscopies, and I would talk to your surgeon. If it was just a diagnostic laparoscopy without extensive lysis of adhesions then you would be totally fine to gently ease back into your usual activities. However, just as with stories above, if there was scar tissue that needed taking down, if there was something that necessitated enlarging your port site, if then it would be prudent to wait. The paperwork is generic and assumes most invasive procedure so that we don't tell folks who really should wait not to!

A phone call to your doc might take a day or two to get through, but they should be able to tell you in a few minutes from glancing at your op report.

posted by eglenner at 9:03 AM on June 23, 2016 [3 favorites]

As these answers suggest, everyone's experience is difference. (And the concern about the pull of an orgasm is real!) I would also caution, though, that just because your only incisions were abdominal that doesn't mean that your vagina went unscathed during the procedure. Speculums and ultrasound wands can be used roughly when you're not conscious to object, and depending on where your lesions were they may have operated quite close to your vaginal walls. How have things felt during your post-op check-ups? Was your doctor able to examine you internally without pain?

I ask because when I had laparoscopic surgery to treat endometriosis, I had an excruciating follow-up exam. I mean, when the doctor inserted the speculum I actually screamed. Nothing was wrong, I was just still exquisitely sensitive.

Be gentle with yourself!
posted by CtrlAltDelete at 9:25 PM on June 24, 2016

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