Dr. Randell's Postoperative Instructions
With any type of surgical procedure there is a possibility of post-operative pain. There are many benefits to keeping your pain under control, which include being able to move easier, breathe deeper, and cough more effectively. All of these things are essential to your recovery because they can prevent complications such as pneumonia, blood clots, and psychological stress. Dr. Randell may select one or more types of oral medications to help control your pain.
Usually a narcotic pain medication (e.g., Percocet) and ibuprofen (or other non-narcotic pain medication if allergic to or cannot tolerate ibuprofen) are prescribed to manage your pain. You will recieve your prescriptions upon discharge from the hospital. It is recommended that you use the narcotic pain medication for moderate to severe pain as directed by Dr. Randell. For break-through pain, it is recommended that you use ibuprofen between your doses of narcotic pain medication to manage pain effectively. If you have mild to moderate pain, ibuprofen alone may be enough to manage your pain. If you are in pain, do not hesitate to use your pain medication. You cannot drive while taking narcotics. Keep in mind that narcotic pain medication is constipating so follow the directions for bowel management as listed below. Please go to the emergency room if your pain does not improve or worsens after taking your pain medication.
The incision (vaginal area included) may be washed with soap and water. Do not soak in water. After showering or washing gently, pat the incision dry with a clean towel. A dressing is not usually necessary, but may be desirable to protect your clothing, as there may be a fluid or bloody drainage. You may have vaginal discharge and bleeding that can last until your stitches are dissolved, in about six weeks. Your bleeding should decrease after several days. If you have had an abdominal incision, steristrips may have been placed over the incision. Please remove the steristrips one week after surgery. Laparoscopic incisions are covered with glue. You can use use a washcloth to remove the glue in 2-3 weeks after surgery. Stitches do not need to be removed; they will dissolve in about six weeks. If skin clips were used, they will be removed before you go home or at your first post-operative office visit. Itching, bruising, a pulling sensation, and or numbness around the incision is normal. If your incision becomes hot, red, swollen, persistently painful and/or has pus, please go to the emergency room.
It is especially important after surgery to maintain good bowel habits, as constipation requiring strong bearing down efforts may cause a problem with your stitches. You can use an over the counter stool softener and laxative. Drinking plenty of water, walking, and increasing fiber in your diet or with fiber supplements (i.e. Fibercon, Metamucil) are helpful. If constipated, you may try Milk of Magnesia or Dulcolax. You may also use a suppository or an enema. Please go to the mergency room if these methods do not result in a bowel movement within 48 hours.
VAGINAL BLEEDING AND DISCHARGE:
Initially you may have slight vaginal bleeding, which is usually followed by a dark brown discharge. This may last up to four to six weeks after surgery. The bleeding should not be heavier than a normal period. Use sanitary pads only; tampons are not permitted. A vaginal discharge with a foul odor may occur after your surgery. This is common and will take several weeks to subside. Please go to the emergency room if you are saturating a pad every hour. Urinary incontinence can occur post-operatively even if you did not have a problem with leaking prior to surgery. This is normal post-operatively due to inflammation. It will improve as the inflammation decreases. If it doesn't improve, please call the office.
If you go home with a Foley catheter, you will have a leg bag for daytime and/or a larger drainage bag for overnight use. You will need to return to the office to have the catheter removed.
Please keep your incisions clean and dry. Avoid sexual intercouse for six weeks or until Dr. Randell says it is ok to resume sexual activity. If you have had a hysterectomy, we do not recommend heavy lifting for six weeks. If you have had a myomectomy, you should not get pregnant for three months. Please go to the emergency room for any post-operative issues or complications, including without limitations, fever greater than 101degrees, leg pain, severe abdominal pain, chest pain, or shortness of breath.