Midurethral Sling Postoperative Instructions
After your surgery, it is common to feel sore in your groin and vaginal area. Some people describe this as feeling similar to the soreness felt after riding a horse or bicycle or like pelvic cramping. This will be much better after the first 2-3 days and mostly resolved by 7-10 days after surgery. Expect some intermittent pain as you continue to heal and become more active. If you have a sharp increase in pain after the first 2-3 days, you should call the office.
You may have bruising of the vulvar area and a small amount of vaginal bleeding. The bruising will resolve with time. The vaginal bleeding may last 3-4 days and might increase slightly as you increase your activity. The vaginal stitches will be absorbed after about two weeks. The groin incisions are closed with skin glue and will heal in about one week.
What If I Had a Catheter?
If you are not able to empty your bladder the morning after surgery, you will go home with a catheter and return to the office in 4-5 days to see if your bladder is ready to resume working normally. You can remove the catheter at home on the morning of your office visit, empty your bladder when it feels full, and come to you scheduled appointment with a modestly full bladder. We will have you empty your bladder at the office and then check to see how much urine is left in your bladder. If your bladder empties well at this visit then we will leave the catheter out.
Will My Bladder Work After Surgery?
Your bladder should work normally after surgery, but it is important to pay extra attention to the function of your bladder as you heal. Drink plenty of water to stay hydrated (8 glasses/day) but don’t overdue your water intake. Empty your bladder every 2-3 hours during the day, relaxing and giving your bladder plenty of time to empty. You will have to relearn to let your bladder empty by relaxation rather than pushing as pushing will now cause the urine flow to stop. Your stream may feel slow and weak initially but will become stronger as you heal.
Should I Be On A Special Diet?
It is common to have a decreased appetite after surgery for the first few days. However, it is important to maintain good nutrition while you heal from surgery. Eat regular meals or small, frequent healthy “snacks” making sure to include protein with each meal once your appetite is returning to normal and adding a multiple vitamin daily if you desire. Also be sure your bowel movements stay regular after surgery. You need to eat plenty of fresh fruits and vegetables, whole grains, and drink your 8 (6-8 oz.) glasses of water each day to keep your bowels moving. You can use Colace stool softeners (2-4 tabs/day) if needed to keep your bowel movements regular. You should use Milk of Magnesia or 2 tablets of Sennekot at bedtime to indue a bowel movement any day your bowels do not move during the first 7-10 days following surgery to avoid constipation. Constipation is not only painful but will interfere with your bladder working normally.
What Activities Can I Do?
You should be up and walking around the day of surgery and able to care for yourself by 1-2 days after surgery. You will then gradually increase your activity daily as tolerated. You may do light exercise like walking and stretching 10-14 days after surgery. Refrain from vigorous exercise, heavy lifting of more than 20 pounds, or sexual intercourse for 6 weeks after surgery. You will need to be out of work for 1-3 weeks depending on your job.
Starting one week after your surgery, you should use topical estrogen cream to the incision site on the urethra 2 times a week for 6 months if you still have your uterus or one year if your uterus has been removed. This will help the healing process and keep the tissues healthy. Simply squeeze a 1 inch strip on your fingertip, spread the labia, reach into the vagina to place the cream on the urethra.
When Should I Call The Office?
Please feel free to call the office (425-392-8611) if you have any questions or concerns or if you are uncertain whether your recovery is normal. Other things to call the office for are:
- Fever of greater than 100.0F
- Sharp increase in pain after the first 2-3 days
- Significant increase n bleeding after the first 2-3 days
- Leakage of Urine or the need to go to the bathroom frequently
- Constipation not responding to the above regimen