Preparing for Your Surgery
All patients are required to schedule a preoperative visit with the surgeon to review the intended procedures, discuss possible risks and outcomes, fill out the necessary paperwork, and re-review your medications and allergies. This is also your opportunity to ask us any questions or concerns regarding your surgery. This visit is typically separate and in addition to any other consultation or testing that you may have with the office. You will be required to pay your insurance co-pay at the time of this visit. We ask that you schedule this appointment at least one week in advance of surgery.
If you take Aspirin or other blood thinning products (eg. Plavix) we will typically ask you to discontinue this 7 to 10 days prior to your surgery
The Night Before Surgery
It is critical that you do not eat or drink anything, including water, after midnight.
You will be instructed whether you should take any of your medications before coming to the hospital.
Your Hospital Stay
Most of our surgeries are performed either as an outpatient (ambulatory) or a one night hospital stay. Our surgeons have been following the Enhanced Recovery Protocol (ERAS) for all major abdominal surgeries. ERAS is a multimodal, perioperative clinical pathway designed to achieve early recovery after surgery. ERAS is focused on reducing the stress response to surgery and maintaining homeostasis, with a focus on decreasing perioperative complications. The protocol incorporates the following: early feeding and ambulation, same day as surgery, early discontinuation of IV fluids, and minimizing the use of opiate pain medications by maximizing the use of nonnarcotic pain relievers.
Please keep in mind that some of our hospitals are teaching institutes, and therefore, resident physicians and medical students may be involved in your care. We respectfully ask that you be receptive to their participation in your care.
You will be given written instructions at the time of discharge. Should you have any questions following your discharge, do not hesitate to call one of our nurses. You may receive a call from a nurse 2 or 3 days after your surgery to see how you are doing.
It is your responsibility to schedule a follow up appointment with one of our doctors 2 to 4 weeks after your surgery. Please call the office to schedule this within a few days of your discharge. In general, you do not have to pay your insurance co-pay for the first visit. However, there are some exceptions to this rule.
A second and sometimes third postoperative visit will typically be necessary for follow up care. In general, you will be required to pay your copay, especially when these visits occur outside the typical window of included care.
Postop Instruction for SUI Surgery
Postop instructions following a Pubovaginal sling fro SUI (AKA TVT Sling)
Expect light vaginal bleeding for 3 to 5 days. It will be heaviest on the day of surgery or the following day. If the bleeding seems excessive, please call your doctor right away
Your bladder should empty normally, although your stream may be slightly slower. If you are only voiding small amounts, voiding very frequently, or experiencing a lot of pressure just behind your pubic bone, you may be experiencing urinary retention, and should call immediately.
Expect some bruising and soreness abound the pubis. Typically the two small incisions located there may ooze slightly, and be tender to touch. If the pain is severe, or radiates down into the groin or labia, call.
You may shower the day after surgery, and remove any dressing or bandaid on the day after surgery. Do not take a bath, hot tub, or swim in a pool for 1 week
You may use tampons if you are experiencing your menses, even the day of surgery
You may drive a car the day after surgery.
You may perform your typical daily activities, such as walking, bathing, taking the stairs as needed without restrictions, EXCEPT:
No exercise for one week. No sexual intercourse for three weeks
Pat the incisions dry. They do not need to be covered. If the skin edges were closed with glue, this will dissolve in a few days. Report any significant drainage or redness (other than bruising)
Motrin (Advil, Ibuprofen) should be sufficient for most pain. You may take 400mg to 600mg every six hours as needed. Over the counter motrin is 200mg per tablet. However, you may also have been given a prescription for something stronger such as dilaudid or Percocet, if you need it.
Avoid taking aspirin or vitamin E for at least one week after surgery, unless instructed otherwise.
Avoid heavy lifting (more than 20 lbs) for two weeks. Avoid most strenuous activity for that period of time as well.
You may exercise lightly after one week, but avoid strenuous core exercise for two weeks.
Call your doctor immediately if:
- You experience heavy vaginal bleeding.
- Redness, swelling, drainage or increased pain from the incisions or vagina.
- Develop abdominal pain that is progressively getting worse.
- Notice pus coming from the incisions or vagina.
- Experience an unexplained fever of over 101 degrees.
- Feel lightheaded or faint.