Patient Information
Discharge Information
Most laparoscopic operations allow you to be discharged the same or the following day. Following a laparotomy or major vulval surgery you will likely remain an inpatient for 4-5 days or possibly longer. Following discharge, should you feel your symptoms are deteriorating more than you expected, please contact the rooms on 02 4989 6896 for advice.
Follow Up Appointments
You will likely need to see Dr Jaaback again 2-4 weeks after your surgery. Please contact the rooms to make this appointment. If any problems are encountered prior to this check please contact the rooms to make an earlier appointment. Some patients will require multiple follow up visits. If you live a long distance from the practice, you may ask to arrange a video conference appointment using a software Avaya Scopia® and the receptionist will help you to download this to a smart phone, tablet or desktop. An additional but rebatable fee is associated with this consultation.
Sutures/Stitches/Skin-Clips and Wound Care
Your wounds may be sutured with a dissolvable suture material and therefore no stitches are required to be removed, or I may use skin clips which I will arrange to have removed on day 10-14. Occasionally the dissolvable suture material can become irritating and poke out of the skin. The sutures will eventually dissolve but can be removed if they are causing discomfort. If the wound becomes red or any pus discharges from the wound you will require antibiotics. Once the wound has sealed you may apply skin lotions as desired.
Vaginal Discharge
Following a hysterectomy or procedure to the cervix you may encounter some bleeding or discharge. This may be as heavy as a period in the first few days after the procedure but should lessen over time. This may continue for up to four weeks. Should you experience heavy bleeding with clots or flooding or the discharge becomes offensive - this is NOT normal - and you should seek medical attention.
Bladder and Bowel Function
Bowel and bladder functions are commonly affected after surgery. Your bladder is likely to feel irritated, and a urinary tract infection should be considered if this persists or becomes an issue over the next few weeks. Constipation is a very common problem post operatively and it is recommended for you to keep fluids up and take a stool softener like Movicol, Normacol, or Lactulose until your motions have returned to normal. If you experience ongoing problems please feel free to contact the rooms.
Medication
On discharge from the hospital you may be given medication for constipation prevention and pain relief. Continue to take this medication for as long as it is required. You can expect to reduce your need for pain medication over the following weeks to two weeks. All normal medications can be resumed once you are discharged unless directed otherwise.
Some patients will be required to self-administer a blood thinning injection (Clexane) for 1-4 weeks after discharge. If this is required, you will be given education whilst you are an inpatient on how to administer this. If you are unable to give it to yourself, a relative will be taught how to give the injection.
Sexual Intercourse
Intercourse is not recommended for 6-8 weeks following hysterectomy and 4 weeks following a procedure to the cervix. If there is ongoing vaginal discharge this restriction may be longer.
PAP Smears
If your hysterectomy was for a benign condition and all previous smears were normal, you are not required to have any further PAP Smears. For cancer surgery or if you had a pre-cancerous condition, Dr Jaaback will arrange any follow-up smears that are required.
Menopause Symptoms
If you had been menopausal prior to surgery, you will feel no different after recovery. If your ovaries have been removed at surgery and you were pre-menopausal, you are likely to start to feel some menopausal symptoms 10 days to 6 weeks post operatively. We generally avoid hormone replacement until you have returned to normal activity to reduce the chance of thrombosis. A variety of options for hormone replacement and symptom control may be available and Dr Jaaback will discuss these with you.
Driving and Travel
Your fitness to drive a car will depend on the type of operation you have had. Mostly after laparoscopic surgery, you will be able to drive after a couple of weeks, as long as you are able to react as quickly as you would have done prior to surgery. After more complex surgery you may drive once you are able to move around freely and do not require strong analgesic medication. Please check your insurance policy as well, in case there are extra restrictions placed by your insurer. If you undertake any long car journeys (greater than one hour) or plane travel in your recovery period, please wear your TED (compression) stockings. If any lymph nodes were removed or you developed a DVT (blood clot), you will need to wear these stockings for all significant car trips and plane travel in the future.
Resumption of Normal Activities
During your recovery will find that you will be able to increase your activities gradually. By 6 weeks most patients will be "back to normal". If you return to activities early, do so in small bites initially to ensure that you cope well the following day. It is important to do some physical activity during your recuperation, however this will need to be paced at a comfortable level for you.
Return to Work
Once you have seen Dr Jaaback for the check-up, you will be given a clearance date to return to work. If you require a medical certificate please inform Dr Jaaback and this will be arranged for you.