Urogynecologic Surgery

You’ll receive details and instructions during your pre-admission testing appointment or during your pre-operative phone call with one of our Urogynecology nurses. In general, you can expect these steps in preparation for your surgery:

• Recovery After Your Procedure: Recovery times vary, but most people are ready to leave the recovery area after about an hour and a half. Some people go home the same day of surgery. In other cases, you may need to spend the night in the hospital. Ask your doctor if you aren’t sure which applies to you.
• What to Bring to the Hospital: If your doctor thinks that you’ll need to spend the night in the hospital, you should be prepared. We suggest that you bring a small bag including toiletries, comfortable footwear and any other personal items you may need. However, please don’t bring this bag with you when you report for surgery. Leave it in the car, and have someone bring it to you once we take you to your hospital room.
• Preparing for Your Return Home: Ask your surgeon if you need to restrict any activities after surgery. What that information, you can make plans for any help you may need. For example, you may be restricted from lifting items (or children) weighing more than a certain amount. You also won’t be able to drive as long as you’re taking prescription pain medicine.

Learn what to expect while you’re in the hospital directly following your urogeyncologic surgery. Get general tips on what to expect after surgery.

Post-Surgical Nausea or Vomiting

After your surgery, you may have some nausea or vomiting. This is not unusual. Our recovery nurses will try to keep you as comfortable as possible. Other symptoms related to surgery and anesthesia can include these or others:

Please tell your recovery room nurse how you feel. Treatments are available for most common symptoms. 

Constipation After Surgery

Constipation is a common complication after surgery. Even if you always had regular bowel movements before your procedure, constipation could become a problem during your recovery.

It’s important to follow these instructions unless your doctor instructs you otherwise. Straining because of constipation can affect the success of your surgery. Stool

Softener, Laxative & Suppository

Start taking a stool softener twice each day as soon as you return home after surgery. We usually include a prescription for Colace in your discharge papers. You also can purchase Colace over the counter at most pharmacies. (Docusate is the generic version of Colace.) Colace softens the bowel movement, making it easier to pass. You can start taking 100 mg twice day, and you may increase to a maximum of 200 mg twice daily if needed. Colace is not habit-forming.

For the first week or so, take the laxative Miralax as well so you don’t become constipated. Miralax is a powder, and you can mix it into any liquid. Your goal is to have regular bowel movements that are easy to pass. Start with Miralax once a day. If your stools are very watery, switch to every other day.

As you go back to your usual diet and routines in the next week — and after you stop taking narcotic pain medicines — your bowel function should return to normal on its own. You can slowly reduce the amount of Miralax you are taking until you no longer need it.

If you don’t have good results from the Colace and Miralax, you may need to replace Miralax with a stronger laxative. Milk of Magnesia can be effective. It’s a harsher laxative, and you should take it only for a short time. Take Milk of Magnesia with a large glass (at least eight ounces) of very warm water for best results.

If you are still constipated after using the above methods, you may have some hard stool in your rectum, acting as a plug. To relieve the blockage, gently place a rectal suppository — such as Dulcolax — into your rectum. You may repeat the dose once, according to the package instructions. If you still don’t have a movement after the second suppository, please call our office for advice at 617-667-4070.

Please follow these instructions as you recover from your procedure. Around 20% (2 out of 10 patients) will have significant swelling which does not allow them to properly empty their bladder after their urogynecologic surgery. If you’re going home with a urinary catheter to drain your urine, we’ll instruct you on care of these devices. If you have any questions, or if you are having problems, please call us at 617-667-4070.

Activity

After surgery, your body needs time to heal. It’s normal to feel more tired than usual. As you recover, it’s important to increase your activity gradually, as outlined below. Expect to be back to your usual level of activity in about six weeks.

• Plan to stay at home for the first week after surgery.
• Do not lift, push, pull or carry anything that weighs more than five pounds until your doctor says it is OK. This is usually after about six weeks. Gradually increase your activity each day over the next few weeks, as your energy increases. You can climb stairs once or twice a day, and walk at a slow pace as much as you want, if you feel comfortable doing so.
• You may take a shower, but no tub baths until your doctor approves.
• You may ride in a car as a passenger. You may drive when you feel comfortable and you aren’t taking a prescription pain medicine.
• It’s OK to travel out of town or travel by air three weeks after surgery.

Until your doctor says it’s OK (usually after about six weeks), please do not:

• Do any heavy housework, such as vacuuming, washing floors or carrying laundry or trash
• Have sexual intercourse
• Participate in exercise classes
• Swim

Pain Management

After any type of surgery, you may have some pain. It’s very important to your recovery to keep your pain well controlled. This is not just for your comfort. Controlling your pain will help you move more easily, breathe deeply and cough effectively. All of these things are essential in preventing complications such as pneumonia, blood clots and psychological stress.

Here's what to expect related to pain management after having urogynecologic surgery:

• Your doctor may select one or more types of oral (taken by mouth) medicine to help you control your pain.
• In most cases, you can take a prescription, narcotic medicine as well as a non-prescription medicine such as ibuprofen (Motrin). The narcotic medicine is for moderate to severe pain as your doctor advises. You can then use ibuprofen in between doses as needed. If the pain is milder, ibuprofen alone may be enough to manage the pain effectively.
• Use your medicine as your doctor prescribes to make sure you stay reasonably comfortable. This is important for your recovery.
• Narcotic pain medicines can cause constipation. Be sure to read the detailed instructions above about preventing constipation.
• If your pain doesn’t improve or gets worse after taking pain medicine as your doctor has prescribed, please call your doctor for advice.

Incision Care

It’s important that you care well for your incision at home. Here are some tips:

• You may wash the incision area — including the vaginal area — with soap and water. (Remember, no tub baths until your doctor says it is OK.) After showering or gently washing the area, pat the incision dry with a clean towel.
• A dressing is not usually needed, but you may use one to protect your clothing from any discharge.
• If you have an incision in your abdomen, you may have Steri-Strips (thin paper strips) in place over the incision. Sometimes the strips become loose and fall off. This is normal — you don’t need to replace them.
• We won’t need to remove your stitches. They will dissolve on their own in about six weeks.
• If we used skin clips, a member of your care team will remove them before you leave the hospital or at your first post-operative visit with your surgeon.
• The area around your incision may itch, bruise or feel numb. You may have a pulling sensation in the area. This is all normal.
• If your incision becomes hot, red, swollen or very painful, or if you develop a fever of 101°F or higher, please call your doctor.

Vaginal Bleeding, Discharge & Urinary Issues

Here’s what you can expect:

• Right after surgery, you may have slight vaginal bleeding, which changes to a dark brown discharge. There may be a foul odor to the discharge. This is all normal and may last four to six weeks after surgery. The bleeding shouldn’t be heavier than a normal menstrual period.
• Use sanitary pads only. Do not use tampons.
• Please call the office right away if you have heavy bleeding — soaking a pad every hour.
• Your doctor may ask you to use an estrogen cream in your vagina beginning a few weeks after surgery.
• Urine leakage may occur, even if you didn’t have this issue before surgery. This may be caused by swelling and should improve as the swelling goes down.

Urinary Catheter Care

You may go home with a catheter to drain your urine. If so, your nurse in the hospital will show you how to take care of it.

If you have a urinary catheter, be sure to take the antibiotic you receive until your care team removes the catheter. If you run out of antibiotics while the catheter is still in place, please call your doctor for a new prescription.

When To Call Your Doctor

Call us right away at 617-667-4070 if you have any of these symptoms:

• Temperature of 101°F or more
• Pain that is not under control with the medicine you were given
• Pain that is getting worse instead of better
• Heavy vaginal bleeding or discharge (soaking a pad every hour)
• Your incision is hot, red, swollen or painful, even after taking pain medicine
• An increase in bleeding from your incision