Urogynecology Surgery Post-Operative (Post Op) Care & FAQ

Our fellowship-trained, double board-certified urogynecologists are experts at pelvic floor reconstruction and regularly treat our patients by performing life-changing surgery. As part of the surgical process, we are committed to ensuring that your post op experience goes smoothly and allows you to recuperate as quickly as possible.

Many women struggle with slowing down after surgery and want to resume normal activities as quickly as possible. We like to remind our patients that surgery recovery is an opportunity for self-care. It is crucial to allow your body the time it needs to heal. Other priorities can wait – this is the time when you should focus on yourself and your well-being.

Below we have provided information and a few recommendations that will answer frequently asked questions. We hope this will help you understand and manage common experiences that women report after reconstructive pelvic surgery. Not all symptoms can be predicted, nor does each woman have the exact same experience. Should you have any additional questions, please do not hesitate to contact us.

Urogynecology surgery post op FAQ

How long will I stay in the hospital for surgery recovery?

Several factors determine if you will have an ambulatory surgery (go home the same day) or if you will be admitted overnight. These factors include:

1. The type of surgery you have.
2. The duration of your surgery.
3. How well you recover post-operatively.

Insurance companies differ in their approval for admission and the length of stay in the hospital. However, we may also recommend a shorter or longer stay depending on your medical history or how you respond to surgery.

Our goal is to help you in meeting your post-surgical milestones of comfortably walking, eating and going to the bathroom, while also ensuring that you heal well and have good pain control. Our team will communicate with you regularly and inform you of your anticipated day of discharge. Planned discharge time is typically at 11 a.m.

What are my limitations after surgery?

We recommend that you do not drive for 1-2 weeks after surgery. To ensure the safety of yourself and others, we encourage you defer driving until your pain is well controlled without the need for narcotic medications.

Routine activities such as walking, climbing stairs at home and showering are encouraged to help you get back to your routine as quickly as possible. For at least 8-12 weeks post-operatively to allow for adequate wound healing, you should avoid lifting objects in excess of 10 pounds (remember a gallon of milk is 8.36 pounds!), strenuous physical activities such as running and jumping, and mopping and vacuuming (thank us when you tell your family this one). Check with your provider at your 2-month follow-up visit to discuss recommendations specific to you.

Will I go home on a blood thinner?

You may be discharged home on a blood thinner (for example, Lovenox) to prevent post op blood clots. The length of time you will be on the blood thinner depends on your medical history and the type of surgery you had. It may be between 7-14 days.

How do I care for my incisions?

Depending on your surgery, you may have incisions on your abdomen, over your pubic bone or in your vagina. We typically use absorbable sutures for your incisions, which means they will dissolve over time and no additional care is required. Internal vaginal sutures can remain in place for up to 6-8 weeks after surgery.

For small incisions, a special surgical glue may be used to close the opening. It will gradually peel off over time and can take 3-4 weeks to completely peel off. To ensure proper healing, we recommend that you:

• Shower (NO BATHS) for 6-8 weeks after surgery.
• Wash incision site gently and avoid rubbing the incision.
• Pat the incision site dry with a clean towel.
• Avoid placing anything in your vagina (until you are seen by your provider and cleared at your 8-week follow-up visit).
• Avoid applying CBD oil (from cannabis plants) to surgical incision sites or anywhere near the surgical area.

Will I go home with a urinary catheter?

Many research studies have shown that the types of surgeries we perform increase patients’ risks of having difficulty with emptying their bladder. However, the vast majority of our patients are able to urinate successfully and go home post op without a catheter.

Following your surgery, we will assess your ability to urinate. If you are not able to provide adequate urine output, instructions on how to manage this will be reviewed prior to your discharge.

Alternatively, if you don’t want an indwelling catheter, you will be taught self-catheterization.

When can I resume sexual intercourse?

Intercourse should be avoided until your surgical incisions are healed. Your provider will perform a follow-up evaluation 8 weeks after your surgery. If your vagina is well-healed at that time, your provider will give you permission to resume intercourse.

When should I resume my vaginal estrogen?

Do not put anything in your vagina for at least two weeks after your surgery. All patients should be seen by their physician before they restart their vaginal estrogen.

Do I need any special preparations for my return home after surgery?

We recommend that you prepare your home so you arrive back to clean sheets, towels and pajamas.

When should I schedule follow-up appointments with my doctor?

You should already have two appointments scheduled after surgery: a 2-week follow-up with your surgeon (if she is unavailable, a nurse practitioner may see you) an and 8-week follow-up appointment with the nurse practitioner. If these appointments have not been scheduled, please schedule them as soon as possible. In certain instances, we want to see you before these planned appointments. Any changes in the follow-up schedule will be communicated to you directly before you are discharged from the hospital.

Common surgery post op symptoms

Vaginal bleeding

The sutures used for surgery are absorbable, which means that over time they will disappear and are replaced by scar tissue. As this occurs, light vaginal bleeding and spotting are normal and expected to occur. This usually resolves within one week but may last up to six weeks.

We recommend purchasing menstrual pads. This will avoid unnecessary staining of your underwear or clothes from vaginal bleeding. You can expect saturation of 1-4 pads daily.

Constipation

Constipation is also a common symptom. You can experience post op constipation, even if it wasn’t a problem before your surgery. Constipation can also be significantly worsened by use of the narcotic medications that are routinely prescribed to help alleviate your pain.

It is important that you avoid constipation as it can have negative effects on many pelvic floor symptoms and may worsen your post op pain. Your goal is to have one soft bowel movement daily or every other day.

Tips for avoiding constipation:

• Use your narcotic pain medications sparingly and only with moderate to severe pain.
• Take fiber (such as Metamucil) to bulk up your stools and take MiraLax 17 grams once a day to keep bowel movements regular.
• If you have not had a bowel movement by postsurgical day 3, we recommend taking milk of magnesia 1-2 tablespoons twice a day until a bowel movement occurs.
• If you feel like you cannot evacuate your rectum or stool is still stuck in your rectum, use a glycerin or dulcolax suppository.

If you have chronic constipation or your postoperative constipation symptoms are not improved with Metamucil, Miralax and 4 doses of milk of magnesia, then please call our clinic.

Loose stools/diarrhea

Diarrhea is defined as 4 to 6 watery or loose stools a day. Changes in diet, medication or excess fluid in the body can all contribute to diarrhea after surgery.

Tips for managing diarrhea:

• If you are having loose bowel movements, stop taking the Miralax. Continue taking the fiber supplement.
• If you are STILL having loose bowel movements after discontinuing the Miralax, take one Imodium before each meal.
• If you have watery, explosive diarrhea, please contact your physician.

Pain

After surgery, you may experience mild to moderate pain that typically comes and goes. You will be prescribed pain medication to take by mouth. This medication should relieve your pain so that you are comfortable.

Daily use of nonsteroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen, Motrin, Advil and Aleve, and/or Tylenol (an analgesic) help decrease pain and reduce inflammation associated with the post-operative state. We recommend that you alternate taking NSAIDs with Tylenol on a schedule around the clock for the first 3-5 days after surgery unless you have been told that you have a medical condition that prevents you from using them. This can also help reduce the amount of narcotic pain medication you need to take.

As your pain improves, you can reduce the use of these over-the-counter medications and take them only as needed when you encounter pain. If you have a medical reason why you cannot use NSAID medications, we recommend only using acetaminophen (Tylenol).

The recommended dosages for the commonly used postoperative pain medications are:

*Take as needed for moderate to severe pain or pain unrelieved by NSAIDs.

Medication safety tips:

• Your total daily acetaminophen dosage should not exceed 4,000 mg.
• If you are taking a narcotic that also has acetaminophen, then you should NOT take any additional acetaminophen.