A nurse is caring for a client who is 1 day postoperative following gynecologic surgery

• Vaginal surgery
• Abdominal surgery
• L.A.V.H. & L.A.S.H.
• D&C / D&E
• Thermal ablative procedures
• Bowel prep prior to surgery
• Robotic hysterectomies

Post-op instructions for vaginal surgery

• Avoid heavy lifting, strenous activity, driving for 7-10 days and until off narcotic pain meds
• You may bath or shower
• Avoid intercourse, douching or tampons until seen by your surgeon postoperatively
• Stool softeners and/or milk of magnesia for constipation
• Call the office if you experience fever greater than 100.5, heavy vaginal bleeding or sudden sharp pain in your calf or thigh.

Post-op instructions following abdominal surgery

• Out of bed and active but without exertion and avoid heavy lifting (20 pounds or more).
• Avoid driving for 7-10 days and until not using narcotic pain meds.  You may be a passenger in the car prior to this point.
• Use stool softeners and/or milk of magnesia if you are constipated.
• Showering and bathing is fine.
• Just pat dry over the incision.  If you have staples left in place, please call the office for removal  on post-op day 5-7.  If you have Dermabond, the glue will begin to flake off in 7-10 days (you may peel it off at this point.)
• Avoid intercourse, douches and anything else vaginal until advised by your physician.
• Call the office to schedule a routine post-op appointment in 2-4 weeks depending on what your physician advised you.
• Call the office sooner if you experience:
  • A fever > 100.5 degrees
  • Heavier vaginal bleeding
  • Heavy drainage from the incision
  • Redness around the entire incision
  • Severe and sudden pain in the calf or thigh

Post-op instructions for l.a.v.h. and l.a.s.h. procedures

• Avoid heavy lifting, strenuous activity and driving for 7-10 days
• Avoid intercourse, tampons and douching until seen by your surgeon postoperatively
• Use stool softeners and/or milk of magnesia if constipated
• You may shower or bath
• The skin glue on your incisions will flake off in 2 weeks at which point you can peel off the rest.  The sutures underneath will dissolve on their own.
• Call your surgeon if you experience heavy vaginal bleeding, fever greater than 100.5 degrees or sudden sharp pains in a calf or thigh.
• Otherwise, make a post-op appointment for 2-4 weeks after surgery.

Post-op instructions for D&E or D&C

• You may have bleeding for 7-10 days. Pads or tampons are fine.
• Pain meds as prescribed by your MD
• Follow-up 2-3 weeks after the procedure
• Avoid intercourse for 2 weeks
• Call the office for heavy vaginal bleeding or temperature greater than 100.5 degrees

Post-op instructions for thermal ablation procedures

• Expect to go home the day of surgery with pain meds and instructions to rest the remainder of the day
• Non-steroidals (ibuprofen) often work better than narcotic pain relief
• You can drive, work, or exercise the following day as long as you are no longer taking narcotic pain meds.
• You can expect to have a vaginal discharge for up to 14 days.  Initially, it may be red or pink and gradually turn lighter and watery.  You may use pads or tampons but remember to change both frequently throughout the day.
• Avoid intercourse until the discharge lessens and becomes normal for you.
• A postoperative visit is best scheduled 2-3 months after the procedure to better evaluate the menstrual cycles post-ablation.
• Call your MD for heavier than expected vaginal bleeding or drainage.  Also call for abdominal pain and/or fever.

Post-op instructions following abdominal surgery

Occasionally, depending on the physician and the type of surgery you will undergo, you may be asked to perform a "bowel prep".

The purpose of this is to evacuate as much stool from the lower GI tract as possible to make your surgery easier for the surgeon and also to minimize the risk of infection in the event of a bowel perforation which is an uncommon but well known risk of abdominal surgeries.

To perform a bowel prep follow the instructions below unless your physician has outlined another method.

• The day prior to surgery limit intake to clear liquids and broths
• The afternoon or early evening prior to surgery use one bottle of magnesium citrate which can be purchased at the pharmacy.
• Be prepared to stay at home immediately following the ingestion of the magnesium citrate as it works quickly.
• The later part of the evening or first thing in the morning prior to leaving for the hospital, use 1-2 Fleets enemas to be certain the lower part of the GI tract is completely clear. For some vaginal surgeries your MD may also ask that you simply use 1-2 fleets enemas prior to presenting to the hospital rather than the entire bowel prep outlined above.

Post-op instructions for robotic hysterectomies

• Avoid heavy lifting or straining for the first 2 weeks
• Do not drive until off ALL pain meds
• Stool softeners if GI function slow to return and milk of magnesia if no bowel movement by day 3 or 4 after surgery
• Showers or baths are fine
• Pad dry the incisions
• You will need 2 postop appointments. The first one will be 1-2 weeks after surgery to have the incisions inspected. The second visit is 6 weeks after surgery to have your first postop vaginal exam. Prior to that appointment avoid anything placed in the vagina.
• Call the office for fever above 100.4, heavy vaginal bleeding after day 3 or 4, drainage from the incisions, and/or severe and sudden pain in the calf or thigh.