For your convenience, we have made some of our more commonly used patient urological surgery instructions available for review online. Please contact our office if you have questions about any of the information presented here.
Vaginal Surgery Post-operative Information
You have just undergone vaginal surgery. This may be any combination of the following:
Transobturator Tape (TOT)
The transobturator tape sling procedure is intended for the
treatment of stress incontinence. There are 3 incisions: 2 groin
incisions and 1 vaginal. The groin incisions are approximately ¼ inch and have a Steri-strip (band-aid, butterfly) covering them. The vaginal incision is about 1 inch in length.
The Pubovaginal Sling
A slightly more involved surgery intended for the treatment of stress ncontinence. There are two incisions: one 1 inch vaginal incision and one “pfannenstiel” (smiley face) incision in the lower abdomen.
Cystocele Repair
This is performed by extending the incision along the
front wall of the vagina and repairing a bladder hernia.
A medical grade plastic mesh is often used to support the repair.
Rectocele Repair
This is performed through an incision in the back wall of
the vagina to repair a rectal hernia. A medical grade leather is often used to support the repair.
Vault Suspension
This is performed to support the innermost part of the vagina if it is protruding after hysterectomy. This can be done via vaginal or abdominal incision (staples if present are due for removal at 10 days).
What to know:
Vaginal packing should be removed 24 hours after surgery. If you had a TOT and went home after surgery, you will need to do this yourself. If you spent the night, the resident staff will do this on morning rounds. Please make a mental note when this is removed, as it should NOT be left in place. After removal, spotting is normal (like the very beginning or end of your period) for about two weeks.
Sutures. All vaginal sutures are dissolvable. You may notice a brownish or yellowish discharge as they dissolve.
Foley catheter. The foley catheter which was placed in the operating room will be removed 2-24 hours post-operatively depending on the surgery you had. When you first urinate, it may burn. A “peri” bottle with warm water used EXTERNALLY only can help. After you empty your bladder, a bladder scanner will be used to check residual volume.
No tub baths for 10 days. You may shower on the day following your surgery. The “peri” bottle for EXTERNAL use can help with feeling fresh.
Medications. You will be given a prescription for a short course of:
Antibiotics to prevent infection.
Narcotic pain medication mixed with Tylenol – when you no longer need it, switch to Tylenol alone but do not combine the two. Maximum dose of Tylenol is 4 grams per day in 650-1000 mg doses every 4-6 hours.
Stool softeners – titrate to effect.
No heavy lifting (greater than 5 pounds) for about 6 weeks.
Exercise. You may resume treadmill walking and upper body weight lifting in 2 weeks. Full exercise is permissible at 6 weeks.
Sexual intercourse. No sexual intercourse for 6 weeks or until the spotting has stopped which ever is later.
Driving. Driving may resume in one week if you are feeling 100% like yourself. If you are still taking pain medication, you must not drive “under the influence.”
Work. If you have a desk job, you may resume work in one week. However, if heavy lifting is involved, follow the instructions in number 6. Disability papers should be given to the nursing triage team. Please remind them of your occupation (e.g. shelf-stocker versus desk work). Please fill out as much as you possibly can regarding dates of first appointments, date of surgery, etc. The minimum time off is 1 week, maximum 6 weeks. Lifting will be forbidden for 6 weeks – if light duty is possible, be clear about this. Please put your preference for time off on a post-it note and we will do our best to accommodate.
Problems. If you have increasing pain, difficulty urinating, fever, excessive bleeding, or foul-smelling discharge please call the Urological Institute at 518-262-3341.
Follow-up.
Please call the Urological Institute 518-262-3341 for a post-operative appointment with measurement of post-void residual 1-2 weeks after surgery.