Bleeding, Fever or Pain After Endometrial Cancer Surgery: Which Signs Need a Call

It is day four. The hospital blanket has been swapped for your own duvet, the discharge letter is somewhere on the kitchen table, and at 2 a.m. you notice a fresh streak of pink on the pad. Is that the ordinary healing everyone warned you about, or the thing the nurse meant when she said “ring us if anything changes”? You reach for your phone, then put it down, not wanting to be the patient who calls about nothing.

Almost everyone who has surgery for endometrial cancer meets this moment. The operation is usually a total hysterectomy, removal of the uterus and cervix, often with the ovaries, tubes and some lymph nodes; the recovery leaflet covers bleeding, fever and pain in a few brisk lines; and real life produces symptoms that sit somewhere in between.

This guide is about exactly that gap: after hysterectomy for cancer, when to call, when to go straight in, and when to let your body get on with the slow business of knitting itself back together.

After hysterectomy for cancer: when to call, and why the question is different from routine surgery

A hysterectomy for heavy periods and a hysterectomy for endometrial cancer can look identical on the operating list. They do not feel identical afterwards, and the calling thresholds are not quite the same either.

Three things change the picture. First, cancer surgery often removes more tissue: the ovaries and fallopian tubes as well as the uterus, and frequently lymph nodes from the pelvis or the sentinel nodes, the first nodes that drain the uterus. More dissection means more raw surface that can ooze, collect fluid or become infected. The NHS notes that lymph node removal carries its own longer-term risks, including lymphoedema of the legs (NHS).

Second, many people with endometrial cancer are in their 60s or older, carry other conditions such as diabetes or high blood pressure, or live with a higher body weight. None of those is a failing, but each alters how infections show themselves and how quickly small problems become larger ones.

Third, the waiting. Between surgery and the pathology result there are usually a few weeks, and it is easy for every twinge to feel like news about the cancer. It almost never is. Early postoperative symptoms are about healing, not about disease, and knowing that can take the edge off a 2 a.m. decision.

The general rule your team will give you is simple: call for anything new, worsening or worrying. That is honest advice, but it hands the judgement back to you at the moment you feel least equipped to make it. The rest of this article fills in what “worsening” and “worrying” actually look like for bleeding, fever and pain, so the call you make is an informed one rather than an apologetic one.

What actually happens during surgery for endometrial cancer

Understanding the operation makes the symptoms afterwards far less mysterious.

Endometrial cancer starts in the lining of the uterus. The standard operation is a total hysterectomy with bilateral salpingo-oophorectomy, which is medical shorthand for removing the uterus, the cervix, both fallopian tubes and both ovaries. The NHS describes this as the main treatment for most womb cancers, sometimes followed by radiotherapy or chemotherapy depending on the stage and type (NHS).

The surgeon reaches the uterus in one of three ways. Laparoscopic or robotic surgery uses several small incisions in the abdomen, each usually under an inch, with a camera and long instruments; the uterus is then removed through the vagina. Open surgery uses one longer incision, either horizontal along the bikini line or vertical. A purely vaginal approach is occasionally used. The Mayo Clinic notes that the route chosen depends on the reason for surgery, the size of the uterus and the surgeon’s assessment (Mayo Clinic).

Whichever route is used, the top of the vagina is stitched closed where the cervix used to be. That stitched edge is called the vaginal cuff, and it matters enormously for the bleeding section below, because it is the one internal wound you cannot see.

Lymph nodes may be sampled at the same time. In many centres a dye or tracer is injected so that the sentinel nodes can be identified and removed selectively rather than taking a whole chain. The pathology from those nodes, together with the uterus itself, determines the final stage and whether any further treatment is recommended. That report takes time, which is why the first follow-up appointment is often a couple of weeks after you go home.

Who goes home quickly, and who is usually asked to stay a little longer

The length of a hospital stay is not a verdict on how well the operation went. It is a judgement about safety, and it varies more than people expect.

The NHS puts the typical stay after a hysterectomy at between one and five days, with shorter stays after keyhole surgery and longer ones after an open operation (NHS). Some units run same-day or next-day discharge for uncomplicated laparoscopic cases. Others keep everyone overnight as a matter of routine. Neither approach is wrong; both reflect local resources and the team’s confidence that you can manage at home.

People who usually go home sooner have had a minimally invasive operation, are passing urine without a catheter, can eat and drink, are walking to the bathroom, and have pain that is controlled with the medicines they can take by mouth. Someone at home who can help for the first few days makes discharge much easier.

People who are usually asked to wait include those who had an open incision, those whose bowel has not yet woken up after the anaesthetic, anyone with a fever or a rising heart rate on the ward, anyone who needed a blood transfusion, and people with conditions such as diabetes or heart disease that the team wants to see settle first. If a catheter is still in place, or a drain was left in the pelvis, you will generally stay until those are out or a plan is made to remove them at home.

None of this predicts your long-term outcome. The pathology report does that, and it is not ready when you leave. What discharge timing does affect is how much of your early recovery happens under your own roof, which is why the calling rules matter so much in that first week.

Bleeding after hysterectomy for cancer: what is normal in the first six weeks

Some bleeding is expected, and the pattern tells you more than the fact of it.

The NHS advises that vaginal bleeding and discharge can continue for up to six weeks after a hysterectomy, usually lighter than a period and gradually fading in colour from red to brown to yellowish (NHS). The source is the vaginal cuff, that stitched edge at the top of the vagina, plus small amounts of old blood and fluid working their way out of the pelvis. Dissolvable stitches at the cuff loosen over the following weeks, and a small burst of fresh spotting around week two or three, sometimes with a fragment of stitch, is a common and normal event.

What is not normal is volume and direction. Bleeding that soaks a sanitary pad in an hour, that is heavier than the heaviest day of a period you used to have, or that contains clots larger than a grape, is a same-day call. So is bleeding that had stopped and then restarts as bright red flow rather than a few streaks. The MedlinePlus discharge instructions for hysterectomy list heavy vaginal bleeding as a reason to contact your surgeon promptly (MedlinePlus).

Watch the company the bleeding keeps. Light bleeding with a bad smell suggests infection at the cuff. Bleeding after straining on the toilet or after lifting something heavy points to pressure on healing tissue. Bleeding that comes with light-headedness, a racing pulse or fainting is an emergency, because it suggests the loss is more than the visible amount.

Use pads, not tampons, until your team clears you; a tampon sits directly against the cuff. Keep a simple note of how many pads you use and what they look like. When you do call, that detail is exactly what the nurse will ask for.

Vaginal cuff dehiscence symptoms: the rare complication worth knowing by name

Dehiscence means a wound coming apart. Vaginal cuff dehiscence is the top of the vagina opening along its stitch line, and although it is uncommon, it is the complication that turns an ordinary “bit of bleeding” call into an urgent one.

The cuff is under more strain after a cancer operation than after a benign one, because more tissue has been removed around it and, in some people, radiotherapy later thins the tissue further. The Cleveland Clinic lists opening of the vaginal incision among recognised hysterectomy complications, alongside infection and bleeding (Cleveland Clinic). It most often becomes apparent weeks rather than days after surgery, frequently after the first attempt at intercourse, a heavy lift, a bout of coughing or straining on the toilet.

The symptoms people describe are a sudden gush of watery or bloody fluid from the vagina, a feeling of pressure or something “giving way” low in the pelvis, new pelvic or lower abdominal pain, and occasionally a sensation of tissue at the vaginal opening. In the most serious cases a loop of bowel can pass through the opening, which is why any sense of a bulge is an emergency.

This is not a wait-until-Monday situation. A cuff that has opened needs to be examined and usually repaired, and the sooner that happens the simpler the repair tends to be. If you have any of these symptoms, particularly after sex or a strain, go to an emergency department rather than waiting for a clinic call back.

Prevention is mostly about patience. The NHS advises waiting until scars have healed and vaginal discharge has stopped before having sex, typically four to six weeks, and avoiding heavy lifting for several weeks (NHS). Your surgeon may extend those timelines if the operation was complex or if radiotherapy is planned; follow the specific advice you were given rather than the general figure.

Fever after hysterectomy: the number that matters and what it cannot tell you

Fever is the symptom that gets people calling, and rightly so, but it deserves a more precise look than “any temperature is bad”.

Most discharge leaflets, including the MedlinePlus instructions for hysterectomy, ask you to contact your surgeon for a temperature of 38°C (100.4°F) or above (MedlinePlus). That threshold is not magic. It is the level at which a raised temperature is unlikely to be explained by a warm room, a hot drink or the normal inflammatory response to surgery, which can nudge the reading up slightly in the first day or two.

The number is only half the story. A temperature of 38.2°C in someone who feels tired but otherwise well, is drinking normally and has a clean wound is a same-day call. A temperature of 37.9°C in someone who is shivering, confused, breathing fast, passing very little urine or has mottled skin needs emergency care regardless of the thermometer, because those are the features of sepsis, the body’s overwhelming response to infection (NHS). Older adults and people on certain medicines may develop serious infection with little or no fever at all.

Where does postoperative fever come from? In the first two days, the lungs are the usual culprit: shallow breathing after anaesthesia lets small airways collapse. From roughly day three onwards, the likelier sources are the urinary tract, particularly after a catheter; the skin incisions; the vaginal cuff; and collections of blood or lymph in the pelvis that have become infected. Blood clots in the leg can also cause a low-grade fever.

Buy a thermometer before surgery if you do not own one, check your temperature if you feel hot, cold or unwell rather than on a schedule, and write the reading down. “I felt feverish” is hard for a nurse to act on. “38.4 at 3 p.m., 38.6 at 7 p.m., and I have shaking chills” is a decision made.

Wound infection or normal healing: how to tell the difference

Every incision goes through a stage that looks alarming and is entirely normal. The trick is knowing which direction things are moving.

The CDC defines a surgical site infection as one occurring within 30 days of an operation, in the skin, the deeper tissue or the organ space where surgery took place (CDC). That 30-day window is worth remembering: a wound that looks fine at your two-week check can still develop a problem afterwards, and you should not assume that a late change is nothing.

Normal healing includes a faint pink rim a few millimetres wide along the incision, mild swelling, bruising that turns yellow-green over a week or two, numbness or tingling around the scar, and a small amount of clear or slightly blood-stained fluid on the dressing in the first days. Itching as the skin closes is common. A firm ridge under a laparoscopic port site is scar tissue, not a lump to worry about.

The signs of infection are about change and spread. Redness that is widening day by day, particularly if it is hot to the touch and tracking away from the incision; swelling that is increasing rather than settling; thick yellow, green or foul-smelling fluid; an incision edge that has separated; and pain in the wound that is worsening after day three or four instead of easing. Any of these, with or without fever, is a same-day call.

People with diabetes, a higher body weight or a vertical open incision are at somewhat higher risk of wound problems, and teams often arrange earlier wound checks for that reason. If a small opening develops, it is usually managed with dressings rather than more surgery, but it needs to be seen. Photograph the wound in good light each morning; a sequence of pictures shows direction of travel far better than memory.

Pain after a hysterectomy for cancer: the pattern that is expected and the pattern that is not

Pain is expected. The question is never whether you have it but how it is behaving.

In the first few days most people describe a deep ache across the lower abdomen, sharp pain at the incision sites on movement, and, after keyhole surgery, a distinctive pain in the shoulder or under the ribs. That shoulder pain is referred from gas used to inflate the abdomen during surgery irritating the diaphragm; it usually fades within a couple of days and is helped by walking and changing position. Cramping like period pain is common as the pelvis settles.

The expected trajectory is downhill: each day a little better than the one before, with occasional bad afternoons after doing too much. The Mayo Clinic notes that most people feel gradually better over the recovery period, though fatigue can last longer than pain (Mayo Clinic).

Pain that breaks that pattern needs attention. Pain that is escalating from day to day after the first 72 hours, pain that has moved to a new place, pain that wakes you from sleep, or pain accompanied by a rigid or swollen abdomen, vomiting, fever or an inability to pass gas or stool is a same-day call. Severe, sudden abdominal pain is an emergency.

Pain medicines after this surgery are typically a combination of a simple analgesic such as paracetamol (acetaminophen), an anti-inflammatory where appropriate, and a short course of a stronger opioid for breakthrough pain. How those are used, tapered and stopped is a decision for your prescribing team, not a general article; what you can do is take them as prescribed rather than waiting for pain to peak, and tell the team if the plan is not working. Uncontrolled pain is itself a reason to call, because it stops you breathing deeply and walking, and both of those protect you from complications.

Leg swelling, chest pain and the clot question

Of every complication after pelvic cancer surgery, a blood clot is the one that can move fastest from minor to life-threatening, which is why it earns its own section.

A deep vein thrombosis, or DVT, is a clot in a deep vein, usually in the calf or thigh. If a piece breaks off and lodges in the lung it becomes a pulmonary embolism. The CDC notes that major surgery, cancer, reduced mobility and older age each raise the risk, and that after surgery the risk stays elevated for weeks rather than days (CDC). Endometrial cancer surgery ticks several of those boxes at once, which is why most patients are given compression stockings and a blood-thinning injection in hospital, and some are asked to continue an anticoagulant at home. How long that continues is a decision for your team based on your individual risk.

The signs of a DVT, as described by the NHS, are pain, swelling or tenderness in one leg (rarely both), warmth over the area, and skin that looks red or darkened (NHS). The swelling is usually one-sided and does not go down overnight. Calf pain that started after you got home, without an obvious cause, should never be dismissed as a cramp.

The signs of a pulmonary embolism are sudden breathlessness, chest pain that is sharp and worse when you breathe in, coughing up blood, a racing heart, light-headedness or collapse. These are reasons to call emergency services, not the surgical ward.

Prevention is unglamorous: walk every hour you are awake, even if only around the room; keep drinking fluids; do ankle circles when sitting; wear the stockings if you were given them; and use any anticoagulant exactly as prescribed for the full duration your team specified. Long car journeys and flights in the early weeks deserve a conversation with your team before you book them.

Urinary problems after hysterectomy, bowel changes and the symptoms people hesitate to report

Bleeding, fever and pain get the headlines. Bladder and bowel symptoms get whispered about, if they are mentioned at all, yet they are among the more common reasons for a call in the first fortnight.

The bladder sits directly in front of the uterus and is moved aside during surgery. Afterwards it can be sluggish. A weak stream, needing to strain, a sense of incomplete emptying, or going often in small amounts are frequent in the first week or two and usually settle. Burning, cloudy or smelly urine, or urine that looks bloody, more often signals a urinary tract infection, particularly after a catheter; the MedlinePlus discharge instructions list painful urination as a reason to contact your provider (MedlinePlus). Being unable to pass urine at all for eight hours or more, with a full, uncomfortable bladder, is urgent.

Two rarer bladder problems deserve a mention because they are easy to miss. Continuous leaking of urine from the vagina, rather than the occasional dribble with a cough, can indicate a fistula, an abnormal channel between the bladder or ureter and the vagina, and needs prompt assessment. Pain in one flank with fever may indicate a blocked or injured ureter, the tube from kidney to bladder, which runs close to the surgical field.

Bowels are the other quiet casualty. Anaesthetic, opioid pain relief and inactivity together produce constipation in most people. Trapped wind can be genuinely painful. Fluids, gentle walking, fibre and any stool softener your team suggests usually solve it. What is not routine is a swollen, tense abdomen with vomiting and no passage of gas or stool; that pattern can indicate a bowel obstruction or injury and is a same-day call, an emergency if there is fever or severe pain.

Nothing in this section is too small or too embarrassing to mention. Nurses on gynaecology wards discuss bladders and bowels all day; you will not surprise them.

Lymph node removal, pelvic fluid and swelling that appears later

If lymph nodes were removed, some of your recovery will look different from the standard hysterectomy leaflet, and a couple of symptoms that would otherwise be alarming have a benign explanation.

Lymph is the clear fluid that drains from tissues through a network of vessels and nodes. Cutting through that network during node dissection means lymph can leak into the pelvis for a while. Most of it is absorbed. Sometimes it collects into a pocket called a lymphocele. Small lymphoceles cause no symptoms and are found only on scans. Larger ones can cause a dull, one-sided pelvic or groin ache, a feeling of fullness, pressure on the bladder or, if they press on a vein, leg swelling. If a lymphocele becomes infected it produces fever and worsening pain and needs draining. A new one-sided pelvic ache in weeks two to six is worth a call, not a panic.

Lymphoedema is longer-term swelling, usually of one or both legs, sometimes the lower abdomen or genital area, because the remaining lymph channels cannot keep up. The NHS lists it among the recognised consequences of lymph node removal in womb cancer treatment (NHS). It may appear months after surgery, or after radiotherapy. Early signs are a heavy or tight feeling in the leg, socks leaving deeper marks than usual, or a shoe that fits on one side only. Early referral to a lymphoedema specialist matters because compression and skin care work best when started early.

The important distinction is between lymphoedema and a clot. Lymphoedema tends to develop gradually, is soft and puffy, and is painless or mildly uncomfortable. A DVT tends to develop over hours to days, is often painful and warm, and may involve visible veins. If you cannot tell, treat it as a possible clot and seek same-day assessment; an ultrasound settles the question quickly.

A small watery or blood-tinged discharge that continues a little longer than the usual six weeks can also be lymph finding its way out through the cuff. Mention it at follow-up; it is rarely serious, but your team should know.

Endometrial cancer surgery recovery week by week: what the first six weeks usually look like

Recovery rarely runs in a straight line, but it does run in a recognisable shape. The NHS gives six to eight weeks as the typical recovery period after an abdominal hysterectomy, with a shorter time after keyhole surgery (NHS). Within that window, here is what most people describe.

Days one to three: the hardest stretch. Pain is at its peak, you are tired in a way sleep does not fix, your bowels have not restarted, and getting out of bed requires strategy. Shoulder-tip gas pain is common after laparoscopy. Fever in this window is most often from the lungs; deep breathing and short walks are the treatment. Any temperature at or above 38°C still warrants a call.

Days four to ten: the danger of overdoing it. Pain eases, energy returns in bursts, and people start to do too much. This is when wound infections and urinary infections most often declare themselves, and when a constipation crisis tends to arrive. Bleeding should be light and fading. A bad day after a busy one is normal; a bad day after a quiet one is a reason to call.

Weeks two and three: stitches at the vaginal cuff begin to dissolve, and a brief return of spotting is common. Many people have their first clinic review and receive the pathology result in this window. Fatigue often lingers well past the point where pain has gone.

Weeks four to six: most restrictions begin to lift. The NHS advises not driving until you are comfortable wearing a seatbelt and can perform an emergency stop, which may take three to eight weeks, and waiting for sex until scars have healed and discharge has stopped, typically four to six weeks (NHS). Late complications, including cuff problems and lymphoceles, can appear here. Any new bleeding, pain or discharge in this period still deserves a call, even if you feel otherwise well.

Beyond six weeks: if adjuvant radiotherapy or chemotherapy is planned, it usually begins once surgical healing is confirmed. Your calling rules then shift to the oncology team’s guidance.

Which signs need a call: a quick reference for after hysterectomy for cancer when to call

When you are tired and worried, a short table beats three paragraphs. This one sorts the common symptoms into three tiers: expected, call the same day, and go to emergency care. It summarises the guidance above and the sources cited throughout; it does not replace the specific instructions your own team gave you, which take precedence.

Symptom	Usually expected	Call your team the same day	Seek emergency care
Vaginal bleeding	Light, fading over up to 6 weeks; brief spotting when stitches dissolve	Heavier than a light period; bright red flow restarting; clots; bad smell	Soaking a pad an hour; bleeding with dizziness, fainting or racing pulse
Vaginal discharge	Brownish or yellowish, no strong odour	Foul smell; green or thick; new watery gush	Gush after sex or strain with pain or a sense of something bulging
Temperature	Slightly raised first 24–48 hours, feeling well	38°C (100.4°F) or above at any point	Fever with shivering, confusion, fast breathing, mottled skin or very little urine
Wound	Faint pink rim, mild swelling, bruising, itching, numbness	Spreading redness, heat, thick or smelly fluid, edges separating	Rapidly spreading redness with fever and feeling very unwell
Abdominal pain	Aching that improves daily; gas pain in shoulder after keyhole surgery	Worsening after day 3; new location; pain not controlled by prescribed medicines	Sudden severe pain; rigid or swollen abdomen with vomiting
Bladder	Weak stream, frequency, mild stinging in first days	Burning, cloudy or bloody urine; continuous leaking from the vagina	Unable to pass urine for 8 hours with a full, painful bladder
Bowel	Constipation, trapped wind	No bowel movement several days despite measures; persistent vomiting	Swollen tense abdomen, vomiting, no gas or stool, with fever or severe pain
Legs	Mild puffiness in both ankles, settles overnight	One leg swollen, painful, warm or discoloured	Leg symptoms plus chest pain, breathlessness or coughing blood
Breathing and chest	Mild breathlessness climbing stairs in week 1	New cough with fever	Sudden breathlessness, sharp chest pain, collapse

If a symptom sits between two columns, choose the more urgent one. Nobody on a gynaecology oncology team has ever regretted a patient calling early.

What people often get wrong about recovery after endometrial cancer surgery

Some of the most dangerous delays come from beliefs that sound sensible.

“Bleeding means the cancer is back.” It almost never does in the first weeks. Early bleeding comes from the cuff, from dissolving stitches or from old blood clearing out. Recurrence, when it happens, is usually detected months or years later and rarely announces itself through early postoperative bleeding. Bleeding still needs assessment for volume and infection, but not for that reason.

“No fever means no infection.” Older adults, people with diabetes and anyone on steroids or certain other medicines can have a significant infection with a normal temperature. Feeling unusually unwell, confused, off your food or short of breath matters as much as the thermometer.

“Pain relief is a sign of weakness, and it is safer to take less.” Under-treated pain keeps you still and breathing shallowly, and both raise the risk of clots and chest infection. Take what was prescribed, as it was prescribed, and discuss any change with the team that wrote it.

“Keyhole surgery is minor surgery.” The incisions are small; the operation inside is exactly the same. The cuff heals at the same speed whichever route was used, and lifting restrictions apply just as strictly.

“Antibiotics were given in theatre, so infection is covered.” A single dose at the time of surgery lowers the risk of wound infection. It does not protect you for the following 30 days.

“The nurses are too busy for small worries.” Ward teams and cancer nurse specialists plan for exactly these calls. A five-minute conversation on day five is far less work for everyone than an admission on day nine.

“Once the six weeks are up, I am done.” The surgical recovery may be, but follow-up, any further treatment and watching for late effects such as lymphoedema continue. Keep the contact numbers.

Questions to ask your care team before you go home

The best time to sort out when to call is before you need to. Discharge day is busy, so write these down and bring them with you.

• Which number do I call in working hours, and which outside them? Is there a 24-hour line for cancer patients specifically, or do I use the ward?
• What temperature reading do you want me to call about, and should I check it routinely or only when I feel unwell?
• How much bleeding is acceptable for my operation, and for how long? Was anything done to the cuff that changes the usual advice?
• Were lymph nodes removed? If so, what symptoms of lymphocele or lymphoedema should I watch for, and who do I contact about leg swelling?
• Am I going home on a blood-thinning injection or tablet? For how long, and who do I call if I miss one or notice bruising or bleeding?
• What is my pain relief plan, how should it be stepped down, and who adjusts it if it is not working?
• Do I have dissolvable stitches, clips or glue? Who removes anything that needs removing, and when?
• When can I shower, bathe, drive, lift a full kettle, a toddler, a shopping bag? What weight is the limit, and for how many weeks?
• When can I have sex, and does planned radiotherapy change that advice?
• When will the pathology result be available, and how will I hear about it?
• If I need to be seen urgently, do I come to this hospital or go to my nearest emergency department, and what should I tell them about my operation?
• Who is my named contact, such as a clinical nurse specialist, for questions that are not urgent?

Ask for the answers in writing where possible. A single page with the numbers, the temperature threshold and the lifting limit stuck to the fridge will do more for your peace of mind than any amount of reading at 2 a.m.

When to call your doctor

Everything above comes down to this page. Keep it where you can find it.

Call your surgical team or cancer nurse specialist the same day if you have:

• a temperature of 38°C (100.4°F) or higher, or shivering and chills
• vaginal bleeding heavier than a light period, bright red bleeding that restarts after stopping, clots, or bleeding that lasts beyond six weeks
• vaginal discharge that smells offensive, is thick and green or yellow, or a sudden watery gush
• an incision that is spreading red, hot, leaking thick or smelly fluid, or opening
• pain that is getting worse after the first three days, has moved to a new place, or is not controlled by your prescribed medicines
• burning, cloudy or bloody urine, difficulty emptying your bladder, or urine leaking continuously from the vagina
• no bowel movement for several days despite fluids and any softeners you were given, or repeated vomiting
• one leg that is swollen, painful, warm or discoloured
• a new cough, or feeling generally more unwell than the day before

Call emergency services or go to the nearest emergency department if you have:

• sudden breathlessness, sharp chest pain, coughing up blood, or collapse
• bleeding that soaks a pad in an hour or comes with dizziness, fainting or a racing heartbeat
• a gush of fluid or bleeding from the vagina with a feeling of pressure or something bulging, especially after sex or straining
• severe or sudden abdominal pain, a rigid or swollen abdomen, or vomiting with no passage of gas or stool
• fever with confusion, rapid breathing, mottled or bluish skin, or passing very little urine, which are features of sepsis (NHS)
• being unable to pass urine for eight hours with a full, painful bladder

Tell whoever you speak to that you have recently had a hysterectomy for endometrial cancer, the date, whether lymph nodes were removed and whether you are on a blood thinner. Those four facts change what they look for first.

Every decision about investigation, treatment and any change to your medicines rests with the team looking after you. Your job is only to notice, to describe, and to pick up the phone a little earlier than feels comfortable.

Frequently asked questions

How much bleeding after hysterectomy for cancer is normal?

Light bleeding or discharge that fades from red to brown to yellowish over up to six weeks is expected, according to NHS recovery guidance. A brief return of spotting around weeks two to three, when dissolvable stitches at the vaginal cuff loosen, is also common. Bleeding heavier than a light period, clots, bright red flow that restarts after stopping, or bleeding with a bad smell should prompt a same-day call to your surgical team.

What temperature counts as a fever after hysterectomy?

Most discharge instructions, including those on MedlinePlus, ask you to contact your surgeon for a temperature of 38°C (100.4°F) or higher. A slightly raised reading in the first day or two while feeling well is usually the body’s normal response to surgery. Shivering, confusion, fast breathing or passing very little urine with any temperature are signs of possible sepsis and need emergency care regardless of the number.

What are the symptoms of vaginal cuff dehiscence?

The typical picture is a sudden gush of watery or bloody fluid from the vagina, new pelvic or lower abdominal pain, and a feeling of pressure or something giving way, often after first intercourse, a heavy lift or straining. Any sensation of a bulge at the vaginal opening is an emergency, because bowel can pass through the opening. This complication is uncommon but needs prompt examination and usually a repair, so go to an emergency department rather than waiting.

How long does endometrial cancer surgery recovery take?

The NHS gives six to eight weeks as the typical recovery after an abdominal hysterectomy, with a shorter period after keyhole surgery. Pain usually eases steadily after the first few days, while fatigue often lingers longer. Driving typically resumes when you can wear a seatbelt comfortably and do an emergency stop, often three to eight weeks. If lymph nodes were removed or further treatment is planned, your team may adjust these ranges.

Is shoulder pain after keyhole hysterectomy a reason to call?

Usually not on its own. Shoulder-tip pain after laparoscopic surgery is referred pain from gas used to inflate the abdomen irritating the diaphragm, and it typically settles within a couple of days with walking and position changes. Call if shoulder pain is accompanied by chest pain, breathlessness or coughing up blood, because those are signs of a possible clot in the lung, which is an emergency.

How do I know if my incision is infected or just healing?

Healing incisions have a faint pink rim, mild swelling, bruising, itching and some numbness, all of which improve over days. Infection shows as redness that spreads and feels hot, swelling that increases, thick yellow, green or smelly fluid, edges separating, or wound pain that worsens after day three or four. The CDC notes surgical site infections can appear within 30 days of surgery, so late changes still count. Daily photographs help you and your team judge direction.

Can I have a blood clot without any leg symptoms?

Yes. Some clots in the leg cause little or no swelling, and a pulmonary embolism can be the first sign, presenting as sudden breathlessness, sharp chest pain worse on breathing in, a racing heart, or collapse. The CDC notes clot risk stays elevated for weeks after major surgery, especially with cancer and reduced mobility. Use any prescribed blood thinner for the full course your team set, walk hourly, and treat chest symptoms as an emergency.

What urinary problems after hysterectomy need a call?

A weak stream, frequency or mild stinging in the first days often settle on their own. Burning, cloudy or bloody urine, especially after a catheter, may signal infection and warrants a same-day call, as MedlinePlus discharge guidance advises. Continuous leaking of urine from the vagina, or flank pain with fever, needs prompt assessment for a fistula or ureter problem. Being unable to pass urine for eight hours with a painful, full bladder is urgent.

Does bleeding after hysterectomy for cancer mean the cancer has come back?

In the early weeks, almost never. Postoperative bleeding comes from the vaginal cuff, dissolving stitches or old blood clearing from the pelvis. Recurrence, when it occurs, is usually identified months or years later through follow-up rather than through early bleeding. Bleeding still needs assessment for volume, infection or cuff problems, so report it, but the pathology report and your follow-up plan, not early spotting, are what inform the cancer picture.

What is lymphoedema after endometrial cancer surgery and when does it appear?

Lymphoedema is long-term swelling, usually of one or both legs, caused by lymph fluid building up after lymph nodes are removed or treated with radiotherapy. The NHS lists it among recognised consequences of womb cancer treatment. It often develops months later and starts as heaviness, tightness or socks leaving deeper marks. It differs from a clot, which is usually sudden, painful and one-sided; if in doubt, seek same-day assessment. Early specialist referral improves management.

References

• NHS: Hysterectomy, recovery
• NHS: Womb cancer, treatment
• MedlinePlus: Hysterectomy, abdominal, discharge
• CDC: About surgical site infections

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.