What to expect after surgery

Tagged surgery, follow-up; Posted 8 years ago by Andreas Obermair

The hospital stay: After a laparoscopic procedure (for example laparoscopic hysterectomy) patients will stay in hospital for one or two nights; after a laparotomy (open, abdominal) the hospital stay will be four to five nights but may need to be extended if necessary. Patients who have a laparotomy and extensive surgery for ovarian cancer can expect the longest stay.

Discharge process: I recommend patients plan ahead for your discharge in advance. Most patients require some level of assistance when they go home. That includes some help with grocery shopping, cleaning, or washing. If you live alone this should be discussed with your doctor before admission, and appropriate arrangements put in place in advance. Our patients will receive instructions and directions on what to expect post-surgery. All patients will be provided with discharge medication such as pain killers, or anti-coagulants and the hospital nurses need to sit down with you and explain when you need to take what medication. You may need to visit the hospital’s onsite pharmacy to collect medication.

Pain killers: After surgery it is important that patients take analgesics regularly (by the clock) for at least one week after discharge from hospital. It is much easier to maintain a pain-free state than to fight pain.

Follow-up consultations: All patients require a follow-up appointment post surgery. I will see all patients for postoperative appointment one or two weeks after a laparoscopic procedure and four to six weeks after a laparotomy. I will check the wound, make sure that the bowel and bladder work normally and discuss the histopathological findings. Arrangements for postoperative chemotherapy or radiotherapy will need to be made for some patients. To save patients unnecessary travel, I kindly ask the referring doctor of patients from rural/remote areas to see patients on my behalf for a routine postoperative check-up if everything is purely routine. I can additionally provide telehealth, video consultations if there are any concerns that require discussion.

Bladder infections after surgery are more likely the longer a urinary catheter was required. I appreciate if you could take an MSU for culture/ sensitivity and prescribe antibiotics if indicated.

Bowel function: Bowel function can be sluggish after surgery, which is often a consequence and side effect of pain killers. If the bowel function is impaired I recommend natural fibers (beans, lentils, or pear and prune juices) and yogurt first, and then laxatives if needed.

Vaginal discharge: After a hysterectomy, the top of the vagina has been sewn with stitches. As a sign of wound healing, a vaginal discharge is normal for up to 6 weeks and can even be blood-stained. Should the discharge become smelly you should contact my office or your GP, and antibiotics can be prescribed for a presumed local infection.

Hygiene: Clean water is good for a surgical wound and does not cause harm. Creams into the wound are not recommended as this could cause an infection. Exercise is great to prevent fatigue and depression. The sutures used for the operation will dissolve and usually hold all structures together but I recommend delaying any lifting, straining or heavy exercise. Normally, patients find out by themselves how much physical exercise they can manage. The amount of exercise tolerated will increase with time.

Skin Sutures: I use intradermal sutures which will dissolve and do not need to be removed and which give an excellent cosmetic result. However, these sutures could slightly stick out of the skin for a couple of weeks. With time these sutures will become loose and finally fall off by themselves. If the wound site becomes red and sore, please arrange for a wound swab and oral antibiotics or contact our rooms or the hospital’s Emergency Centre.

Prevention of blood clots: During your hospital stay you will receive blood thinners once or twice a day by nursing staff for the prevention of blood clots. Sometimes, blood thinners need to be continued for 4 weeks after surgery whilst recovering at home and the patient is recovering slowly. 

Menopause: No study on gynaecological cancer ever has demonstrated an adverse impact on prognosis if Hormone Replacement Therapy (HRT) is given. If patients present with menopausal symptoms after surgery I prescribe the lowest possible dose for one year. For research on the latest recommendations in HRT click here.

PAP smears are not necessary any longer if our patient had a hysterectomy for benign reasons. If she had a hysterectomy for a cancer or pre-cancer, I will advise on PAP smears/or the upcoming HPV test which replaces the pap smear as of mid 2017.

Sexual intercourse after hysterectomy: I recommend abstaining from sexual intercourse for 4 to 6 weeks after surgery. Otherwise, infections could develop.

Swimming: Abstain from swimming or full baths for 4 to 6 weeks after surgery to prevent infection.

Flying: Some patients travel a long way for surgery, and need to fly home. All air lines will require a certificate clearing postoperative patients for flying. Patients will need to contact my practice for a certificate.

Driving: While patients could feel fit for driving after the operation, in the case of an accident, the insurance could question a patient’s fitness to drive if she was in pain or still on pain killers. To be safe, patients should not drive whilst they are in pain or still on pain killers.

Should patients feel unwell after being discharged from hospital, please contact my rooms on (07) 3128 0800 or after hours (07) 3830 5824 regardless whether she had surgery at Greenslopes or outside Brisbane. Only when I know about a problem, I can help finding a solution.

Here is a short video explaining the above information.

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