Post Op Info

Sub-urethral Sling Insertion

When you return from theatre you will have an intravenous cannula and a catheter in most cases. If you have only had a sling inserted and no other prolapse surgery the following applies. If you have had additional prolapse surgery such as a vaginal repair see the Pelvic floor repair notes.

If well you will be discharged from hospital after you have had 3 successful attempts at passing urine leaving less than 100 ml in your bladder. This will be measured by means of ultrasound by the nurses on the ward.

You can expect to notice the following:

• Mild vaginal bleeding.
• A weaker urinary stream and often you will have to change position while passing urine to adequately empty the bladder. We recommend that you double void i.e. pass urine, go for a walk and go back to the toilet to make sure that the bladder is empty.
• Mild pain in the lower legs, and the inside of the thighs.

You must please report if you have:

• Heavy vaginal bleeding
• An offensive vaginal discharge
• Difficulty passing urine
• Worsening pain
• Pain in the calf of one leg (possible thrombosis)

It takes 3 weeks for the tissue to start gaining strength and from week 3 to week 6 to fully heal. It is important that you follow the guidelines to allow this to happen.

As far as activities go,

• You should be restricted to staying at home for the first week after surgery doing minimal housework.
• After one week you can return to work as long as it does not mean that you have to lift heavy weights (more than 3 kg on each arm) or drive a car.
• driving the car can commence after 3 weeks.
• Normal exercise can commence after 6 weeks.
• Sexual intercourse can commence after 6 weeks.

Please avoid the temptation to self-explore the vaginal wounds as there are sutures there and this may often make you worry unnecessarily.

 

Endometrial Ablation

Having had the Endometrial Ablation you would usually be allowed to go home on the same day of the operation. You will notice that you will have some cramping abdominal pain which is a reaction of the uterus to the surgery as well as mild to moderate vaginal bleeding.

Over the next 2 to 3 weeks you will have a blood stained watery discharge which may be quite profuse.

We would like you to report if the following occur:

• Very heavy vaginal bleeding
• An offensive smell to the discharge
• Worsening abdominal pain

We would encourage you to:

• Take one week off work
• Avoid heavy exercise and intercourse for 3 weeks
• Not drive a car until day 2
• No swimming for 3 weeks

 

Hysteroscopy

As you are aware, Hysteroscopy is a relatively minor procedure where the cavity of the uterus is examined with a telescope. The procedure is normally performed as a day procedure and there is occasionally additional surgery such as resection of a uterine fibroid or endometrial ablation performed.

Most patients will awake from the anaesthetic feeling quite comfortable. At the worst they may have low grade cramping abdominal pain and a watery blood stained discharge. This will continue for a few days. Patients are normally allowed home on the same day.

We would like you to report if you have:

• Heavy vaginal bleeding
• Worsening abdominal pain
• An offensive vaginal discharge

We ask that you do not:

• Have sexual intercourse for two weeks after the procedure
• Perform heavy physical activity for one week after the procedure
• Bath or swim for one week after the procedure

 

Laparoscopy

Laparoscopy or key-hole surgery involves a variable amount of operating. Most patients will wake feeling quite comfortable with some bloating of the abdomen and pain in the shoulder due to diaphragmatic distension from the gas that is used during the procedure. Generally patients will be allowed to go home on the same day.

You should expect to have:

• Pain at the port sites
• Pain in the shoulder from diaphragmatic irritation
• Bloating in the abdomen
• Vaginal discharge and bleeding from associated Hysteroscopy and Tubal Dye studies

Activities to be restricted:

• No intercourse for 2 weeks
• No heavy exercise for 2 weeks
• No driving a car for 3 days
• No work for 3 – 7 days

We ask you to report if you get worsening pain, worsening abdominal distension, heavy bleeding or an offensive discharge.

The dressings would normally stay on for 5 days after the operation when they could be removed and the sutures usually do not require removing because they are either absorbable or the wound has been closed using sterile strips.

Results will be generally discussed with Dr Luiz when you come in for a wound check.

 

Laparoscopic Hysterectomy

Most Patients who have undergone a Laparoscopic Hysterectomy will return to the ward with an intravenous cannula and no catheter. They will be provided with analgesia in the ward and usually discharged the next day or 2 days after the operation.

We would ask that the patients who have undergone this procedure report the following:

• Fever, worsening abdominal pain, heavy vaginal bleeding
• Offensive vaginal discharge or any bladder or bowel dysfunction

Once home, we would encourage you to:

• Take your dressings from the abdominal incisions off after 5 days
• Keep your bowels acting regularly
• To do minimal activities for the first two weeks and thereafter to slowly reintroduce activities such as walking
• driving a car can commence after 3 weeks
• Sexual intercourse and heavier physical activities can occur after 6 weeks

 

Pelvic Floor Repair Surgery

There are number of different types of Pelvic Floor Repair Surgery, but they all require the same post-operative recovery. The post-operative recovery is based on the initial need to get your bladder and bowel functioning once again and then to allow time for the tissues to heal and strength to be regained.

When you return from surgery you will generally have a drip in your arm, a catheter in the bladder and cotton wool wadding in the vagina to act as compression. The first day after surgery the cotton wool wadding will be removed. Once we are certain that you pelvic floor has relaxed sufficiently, we can remove the catheter. This usually occurs in the third day after you bowels have acted. On the fourth day you should be allowed home.

We would ask that once you go home that you report the following:

• Heavy vaginal bleeding ( fresh blood or more than a period, phone if uncertain)
• An offensive vaginal discharge
• Inability to pass urine
• Worsening constipation
• Worsening abdominal or vaginal pain
• Signs of Thrombosis of the leg, which would be a painful swollen calf

Your activities are designed to ensure that the above healing can occur. We would ask that you follow this fastidiously:

• For the first 2 weeks after surgery you are limited to very light house work such as making a cup of tea or a light meal. Under no circumstances should you lift any heavy weights.
• encourage you to drink plentiful fluids and pass urine on a regular basis.
• You should pay attention to your bowels, ensuring that they are working regularly.
• Driving a car can commence at week 3 if you have had very minor pelvic floor surgery, but in most cases we would not encourage driving until week 6.
• Physical exercise should only be introduced after 6 weeks, but pelvic floor exercises can commence after 3 weeks.
• Sexual intercourse should only commence after 6 weeks.