Surgery: What to expect

Most women who have urogynecological surgery do very well and feel better afterward. Follow your surgeon’s instructions regarding when it is safe to resume various activities, as well as when and how to contact the doctor’s office.

About Surgery

Urogynecological surgeries include a range of operations in the pelvic area, often designed to repair pelvic organ prolapse or urinary incontinence. Surgeons who perform these types of surgeries include urogynecologists, urologists, gynecologists, and female pelvic medicine and reconstructive surgeons.

To get you ready for the procedure, your surgeon will ask about your general health and the prescribed and over-the-counter medicines and supplements that you are taking. Also, discuss the surgeries you have had in the past. If you have had problems with anesthesia, make sure your surgeon knows. A number of tests may also be required, such as blood tests, EKG, and a chest x-ray. You may also need bladder tests done before the surgery.

Having surgery can seem like a complicated process with many unknowns. Open and honest communication with your surgeon is the key to having a positive experience. Write out your questions, and take notes during the appointment with your provider. Make sure you have all your questions answered ahead of time and know-how to contact your surgeon with questions or problems after the procedure.

The Day of Surgery

These surgeries are typically performed under general or spinal anesthesia. You will need to go to an outpatient surgery center or to the hospital to have these operations.

Not all surgeries require an overnight hospital stay. Depending upon the type of surgery and your health, you may be able to go home the same day. Ask if you should plan on a hospital stay.

The morning of your operation, dress simply and leave all of your jewelry and valuables at home. When you arrive at the hospital:

  • You will meet many people who may ask the same questions several times, such as confirming what surgery you are having. This is to double-check for safety purposes.
  • The anesthesiologist will talk with you. Some women have general anesthesia, which means they are asleep breathing through a tube in their throat during the procedure. Or, the surgeon may recommend a spinal block together with an IV medicine to make you drowsy.
  • The nurse will place an IV into your arm. You may also be given other medicines for pain or anxiety.
  • You will then be moved into an operating room.

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After the operation, you will be in a recovery room for a few hours. When you wake up, a catheter will be in your bladder and you may have gauze material in the vagina. The gauze will be removed and your bladder will be tested to see if it is ready to empty on its own before you leave the hospital.

As many as 50 percent of women have trouble emptying the bladder immediately after this surgery. These symptoms are usually temporary. If you have trouble urinating, you will go home with a catheter to drain urine from your bladder. Or you may have to do self-catheterization. You will receive instructions from your nurse. Ask your surgeon when you can stop using the catheter.

Recovering from Surgery

It may take up to 6-12 weeks to get back to your usual activity level. Right after surgery, walking is recommended to help your body get back to normal. As you feel up to it, gradually take longer walks each day.

Most women experience some pain following surgery. Your provider will discuss using pain medicines to help reduce your discomfort. Read the pain medicine directions carefully. Some cause drowsiness. Follow the precautions included in the patient education material provided by the pharmacy. It may help to write down each time you take pain medicine as pain medicines work better if taken at the scheduled intervals.

Your appetite may be poor the first few days after the surgery. Try to eat several small meals during the day. If you feel nauseated, eating bland foods may be helpful.

Constipation is very common after this type of surgery. Discuss with your surgeon the use of a stool softener.

While you are recovering, showers are OK. However, don’t take a long bath until your provider gives you the OK to resume getting in the tub.

During the first six weeks, it is normal to experience light vaginal spotting or light bleeding. It’s OK to wear a pad until it subsides, but do not use a tampon or douche. If the bleeding gets heavy or you have itching, foul odor, or large amounts of discharge, call your surgeon’s office.

Once you feel your reflexes are back to normal, you can start driving. However, make sure you are strong enough to do an emergency stop. Talk with your surgeon. Also, don’t drive while you are still taking narcotic pain medicines—they can make you drowsy.

Ask your surgeon when you need to return for a postoperative visit. At this visit, the doctor can let you know when it is safe to have sex again. When you get that OK from your doctor, you’ll still need to take it slow. At first, you might experience some discomfort with sex. Vaginal dryness may be a problem. Many women find a vaginal lubricant helpful for this symptom.

After surgery, call the surgeon’s office with any concerns, if you are not feeling a little better every day, or if you have a sense something is wrong. Also, write down a list of questions and take your notes with you to your follow-up appointment.

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