Gynecology Questions

What If I Have Medical Conditions Such As Diabetes or High Blood Pressure?

• If you have diabetes or other pre-existing medical conditions, especially to do with your heart or lungs, let your doctor know.
• We typically will ask for a “Medical Clearance” from your doctor to ensure that you are in good health before undergoing surgery. We will also have you meet with our Anesthesia team prior to your surgery date to review your medications and health records.

Which of My Medications Should I Stop Taking and Which Should I Take the Morning of My Surgery?

• Always make sure your medication list is updated every time you visit with us. (Especially all over the counter and herbal medications). Medications such as aspirin have to be discontinued in advance, sometimes weeks before your scheduled surgery.
• When you meet with the Anesthesia team during your preassessment visit, he or she will review which medications need to be held and which can be taken on the day of surgery. If you have any questions or concerns, please call our office PRIOR to your surgery date.

What If I Smoke? Do I Really Need to Quit Prior to Surgery?

• It is highly encouraged to quit smoking 2 to 6 weeks before surgery. Smoking may cause breathing problems during surgery and has been shown to delay the healing and recovery process.

What Is the Point of Bowel Prep?

• In some cases, a laxative or enema is indicated to empty the bowels before surgery. Our nurses will review these instructions in detail with you. Please call our office if you have any questions.

I Am Sick the Week of My Surgery, Do I Need to Cancel?

• If you have any unexpected medical problems before your scheduled surgery, such as a fever, cold, cough or flu please contact the office immediately as your surgery may have to be rescheduled.

Post-Op Questions:

What Effects Will I Feel From the General Anesthesia After My Surgery?

• If you have had a general anesthetic, you may have a sore throat for the first 24 hours due to the airway placed in your windpipe.
• Due to the sedation during surgery, you may experience dizziness, drowsiness or lightheadedness.

How Do I Take Care of My Incision When I Get Home?

• Try to keep your incision clean and dry. You may shower after 24 hrs from your surgery. Do not soak or bathe.
• If you have steristrips (adhesive strips) over your incision, they can be removed once they start to peel off.
• Signs or symptoms to call the office about:
  • any redness or warmth around the incision
  • any drainage or pus from the incision
  • if the incision is starting to open
  • if the incision is exquisitely tender
  • if you have a fever
• If you have staples in your incision, make an appointment to have them removed within 7 days following your surgery or as directed by your physician. Some stitches will dissolve and others have to be removed in our office.

What Can I Eat When I Get Home?

• You may return to a normal diet as quickly as you are comfortable doing so.
• If nauseated, start slowly with clear liquids (jello, tea, broth) and advance gradually to more solid foods.
• Typically you will not be sent home unless you are tolerating a regular diet. Once you are home, if you are not tolerating any food or water, call your doctor immediately.

What Should My Level of Activity Be When I Go Home?

• In the first 24 hours after your surgery: do not drive or operate power equipment and do not engage in activities that require coordination for the ability to respond quickly.
• You may walk, ride in a car, climb stairs after your surgery.
• Rest the first day home. You may resume light activity the next day. You may feel weak or tired for a few days after your surgery. Increase your activity as tolerated.
• Do not do any heavy lifting or vigorous exercise for a week or two if you had a laparoscopy; for 4-12 weeks if you had a hysterectomy or prolapse surgery (as directed by your surgeon). There are no restrictions on activity after a D&C or ablation.
• You may drive when you can control the car fully and are not taking any narcotic pain medication.
  • Please abstain from sexual intercourse until your two-week follow-up appointment where further activity instructions will be given.
• No tub baths, hot tubs or swimming until you see your doctor for your 2-3 week postoperative check. Showers are okay.
• Activity, such as walking, can help bowel function return to normal and decreases the chance of postoperative blood clots.
• Avoid tampon use until you see your doctor for your 2-3 week postoperative visit. No touching.
• You may return to work when you are released to do so by your surgeon.

Is Vaginal Bleeding Normal After My Surgery?

• You will have some vaginal spotting or bleeding after your procedure.
• If you had a LEEP you may have a dark coffee grind discharge after that and may pass some tissue in 1-2 weeks.
• If you had cryotherapy, you may most likely have a clear vaginal discharge for 4-6 weeks (and may well not have any bleeding or spotting).
• If you had a thermachoice ablation, the discharge is usually clear and watery for approximately 2 weeks.
• If you had a hysterectomy, light spotting is normal for up to six weeks while the suture line heals. Some women experience a gush of blood followed by spotting for several hours. This is usually due to a clot or small collection of blood forcing its way through the suture line at the top of the vagina. If you have bleeding that requires pad changes more frequently than every 2 hours or less that persists, please come into the office to be evaluated.

When Can I Resume Sexual Intercourse?

• If you had a colposcopy and a biopsy, then you are advised to abstain from intercourse, tampon use, baths, and swimming for 1 week.
• If you had a LEEP or cryotherapy, then you are advised to abstain from intercourse, tampon use, bath, and swimming for 4 weeks. After a LEEP, avoid vigorous physical activity (heavy lifting, etc) for 48 to 72 hours.
• If you had a hysterectomy, then you are advised to abstain from intercourse for at least 6 weeks, but wait until you are instructed by your doctor.

I Was Given a Prescription for More Than One Pain Medicine, Which One Should I Take?

• We typically will give you a prescription for high dose Motrin and a narcotic (Tylenol #3 or Tramadol). If your pain is moderate, start with the Motrin. Take as directed on the prescription bottle. If your pain is severe, you may take the second prescribed medication as directed on the bottle. If your pain is uncontrolled with both, please call the office to discuss further management with the doctor.
• Things to remember – narcotics are constipating and may make your bowel movements painful. Please no driving or drinking alcoholic beverages while taking pain medication.

Why Am I Experiencing Constipation After My Surgery?

• It may take some time for your bowels to normalize after major surgery. In addition, taking narcotics for pain medication can also add to constipation.
• Include fiber in your diet (fresh fruits and vegetables and/or fiber supplements such as Metamucil or Citrucel). Drink at least 6-8 glasses of water each day. Avoid foods that cause you to have gas for an upset stomach. Increase activity as tolerated – activity helps bowel function return to normal.
• Take stool softeners as necessary. You may consider using a stool softener (such as Colace) up to 3 times each day if you are taking narcotic pain medication and/or feel you are constipated. If you have not had a bowel movement within two to three days following your surgery, you may take over-the-counter Milk of Magnesia or Senokot over the counter as directed on the packaging.

I Have Burning When I Urinate, What Should I Do?

• Burning while urination, frequency, or urgency are signs of a possible urinary tract infection. Following a surgery where a foley was placed into your bladder, this type of infection is not uncommon. Call our office to schedule an appointment. A urine sample will be collected and you will be given antibiotics.
• If you feel burning at the end of urination, you are probably experiencing bladder spasms. While this may happen after any surgery, it is most common after a hysterectomy. This usually improves gradually during the first several weeks after surgery. As long as you don’t have frequency, urgency or burning, this is not a problem. However, if the discomfort is bothersome to you, you may try “AZO-standard” over the counter. If this does not offer enough relief, medications may be prescribed temporarily.

What Will We Be Discussing at My Follow Up Appointment?

• After surgery, we like to see you back in the office between 1-2 weeks depending on the type of surgery you underwent. At this time, we will review your recovery process and make sure you are on track. We will examine your incision and ensure there are no signs of infection. We will also let you know when you can resume normal activities.

What Signs or Symptoms Are Worrisome After My Surgery?

• Fever of 100.4°F or higher
• Severe abdominal pain not relieved by your pain medication (After laparoscopy, it is not unusual to have shoulder, chest, stomach or lower abdominal pain for 2-5 days. Your pain medication should relieve this.)
• Persistent nausea and/or vomiting and are unable to keep down fluids or food or experience diarrhea for more than 24-48 hours or you do not have a bowel movement within three or four days of your surgery.
• Bright red vaginal bleeding that soaks more than 2 pads in an hour and/or large/painful blood clots
• Increased redness, swelling, or pain around any incision(s)
• Pain with swelling, heat or redness around an IV site
• Pain or tenderness and swelling in the legs, especially back of the calf
• Difficulty urinating or have any signs of a urinary tract infection such as painful or frequent urination, urgency, foul odor or low back pain.
• Difficulty breathing, unusual shortness of breath or chest pain

If you have more questions, be sure to contact us right away at 713-654-8128 or 713-975-8353.