Bladder and bowel changes after a hysterectomy | CION Cancer Clinics

Bladder problems in the first weeks after a hysterectomy are common and usually settle. The bladder sits directly in front of the womb, so it is moved, bruised and handled during the operation, and the catheter used during surgery irritates it further.

What has actually changed inside

The womb was a neighbour to both the bladder in front and the bowel behind. Removing it means the bladder loses some of its support, the tissues around it are swollen, and the small nerves that tell you when the bladder is full may be bruised. For a simple hysterectomy those nerves are mostly left alone. For a radical hysterectomy, done for cervical cancer, more tissue beside the cervix is removed and the nerves are more affected, so bladder changes are more common and last longer.

What is usual and what is not

Needing to pass urine often, a weak stream, a little leaking when you cough, and a feeling that the bladder has not emptied are all usual in the early weeks. Burning, cloudy or smelly urine, a fever, or being unable to pass urine at all are not, and are covered in the red-flag box below. Bowel changes, mostly constipation and wind, come from the anaesthetic, the painkillers and the handling of the bowel, and are covered further down.

For most women after a simple hysterectomy, bladder and bowel habit return to their own normal within a couple of months. Two groups need a longer view.

After a radical hysterectomy

Because the nerves beside the cervix are partly removed, the bladder may not signal fullness properly for months. You may be taught to pass urine by the clock, or to empty the bladder with a small catheter for a time. This usually improves, but it improves slowly, and it is not a sign that something went wrong.

After radiotherapy to the pelvis

Radiotherapy irritates the bladder and bowel lining during treatment and for some weeks after. Some women have looser motions, urgency or needing to pass urine at night that lasts longer. Your radiation oncologist manages this, and there are treatments for each of these.

What this page cannot tell you

It cannot tell you which operation you had, whether your nerves were involved, or whether a symptom is settling or getting worse. Keep a simple note of how often you pass urine, whether you leak, and when the bowels open. Bring it to the check-up. Symptoms that are named get treated; symptoms that are put up with do not.