Recovery after major surgery

Urogynaecology Specialists — Post-Operative Information

This page provides recovery guidance following your major surgery at Urogynaecology Specialists. It is relevant for vaginal repair surgery, hysterectomy, and laparoscopic reconstructive procedures. Your surgeon will advise you of any specific instructions for your procedure. Please contact our rooms if you have any questions.

WHAT TO EXPECT AFTER SURGERY

When you wake after surgery you will have a catheter (a small tube draining urine from your bladder) and usually a vaginal pack (gauze placed inside the vagina to reduce bleeding). These usually remain in place for 24–48 hours.

You may have compression devices on your legs to reduce the risk of blood clots. You will receive blood thinning injections to reduce the risk as well. It is important to move your legs regularly and get out of bed as soon as you are able — this is one of the best ways to prevent clots from forming.

PREVENTION OF BLOOD CLOTS (DVT)

The risk of a blood clot in the legs or lungs (DVT/PE) is increased after major surgery. To reduce this risk:

  • Move your ankles in circles and bend and straighten your legs regularly while in bed

  • Get up and take short walks as soon as you are able — aim for 3–4 short walks per day in hospital

  • Wear compression stockings as instructed — for a minimum of two weeks after surgery

If you develop calf pain, swelling, redness, chest pain, or shortness of breath after going home, seek medical attention immediately.

ACTIVITY GUIDELINES

It is important to rest and allow your body to heal. The table below provides general guidance — your surgeon will advise if your restrictions differ for your specific procedure.

 Weeks 0–2

✓ You can/We recommend

  • Rest at home — pottering around is fine

  • Care for yourself (but not for others)

  • Gentle mobilisation to reduce DVT risk

  • Lie down for 1–2 hours in the middle of the day

✗ Avoid

  • Driving

  • Heavy lifting — shopping, children, washing baskets

  • Sexual intercourse

  • Baths or swimming

  • Tampons — use pads only

  • Work

  • Strenuous exercise

Weeks 2–4

✓ You can/We recommend

  • Light activity and gentle walks (5–10 mins twice daily)

  • Light housework — dusting, dishwasher

✗ AvoidDriving

  • Heavy lifting

  • Sexual intercourse

  • Baths or swimming

  • Tampons

  • Work

  • Strenuous exercise

Weeks 4–6

✓ You can/We recommend

  • Increase walking — 15–20 mins twice daily, building to 30–45 mins by 6 weeks

  • Light desk-based work from home if feeling well - we suggest reduced hours

  • Recommence vaginal oestrogens after your 4-week surgeon review

  • We recommend seeing a pelvic floor physiotherapist for rehabilitation and strengthening 4–6 weeks after surgery, particularly if you plan to return to high-impact exercise or sport.

  • Driving (AFTER you have been cleared by surgeon at post-op appointment)

✗ AvoidDriving

  • Sexual intercourse

  • Baths or swimming

  • Tampons

  • Heavy lifting (greater that 5Kg)

  • Strenuous exercise

Week 6+

✓ You can/We recommend

  • Return to work (office or workplace)

  • Resume sexual intercourse (when cleared by surgeon)

  • Baths and swimming

✗ Avoid

  • Heavy lifting (greater that 5Kg)

  • High-impact or strenuous exercise — weights, running, jumping, gym (until 12 weeks)

  • Overseas travel (until 12 weeks post surgery)

Months 3–6

  • Gradually return to full range of exercise slowly from 12 weeks - aim to be fully able at 6 months

  • Overseas travel and holidays from 12 weeks post surgery

PAIN RELIEF

Following major surgery, you can expect some pain or discomfort in the lower abdomen, groin, and vaginal area. If you have had a sacrospinous suspension procedure, you may also notice a deep aching or sharp pain in one or both buttocks — this is normal and will settle.

Take your pain relief regularly as directed (e.g. every 6 hours) rather than waiting until pain is severe. You will be discharged with sufficient pain medication to keep you comfortable. Note that medications containing codeine can cause constipation — see the bowel care section below.

Make sure you take time to rest each day. In the first 2 weeks, it is helpful to lie down for 1–2 hours in the middle of the day.

BLADDER

About 15% of women experience some difficulty emptying the bladder fully after major pelvic surgery. This is usually due to swelling and almost always resolves within a few days to 2 weeks.

You may notice that your urine flow feels slower or different from before surgery — this is normal and usually settles. If you are sent home with a catheter or have been taught to self-catheterise (intermittent self-catheterisation), your team will give you specific instructions.

If you are unable to pass urine or are unable to pass urine for more than 4–6 hours and are uncomfortable, please contact our rooms urgently or call the after-hours number.

BOWEL CARE

Constipation is common after major surgery. It is important to keep your bowels moving and avoid straining, as this puts pressure on the repair.

  • Drink 1.5–2 litres of fluid daily

  • Eat a bowel-friendly diet — kiwi fruit, pears, prunes, leafy vegetables, and wholegrains all help

  • Use Movicol or a similar product from the chemist if your bowels are not moving regularly

Foods that can cause constipation — try to limit these in the weeks after surgery:

  • Excess dairy — cheese, milk, ice cream

  • White bread, white rice, and white pasta

  • Processed and packaged foods

  • Fried and fatty foods

  • Unripe bananas

  • Chocolate

Some women notice burning or shooting pains in the rectum after surgery — this is common and usually settles within a few days.

VAGINAL BLEEDING AND DISCHARGE

Some vaginal bleeding is normal after surgery. Initially it may be bright red, then gradually change to a darker reddish-brown colour. The amount can vary from day to day and may be slightly heavier after activity — this is normal.

As bleeding decreases, you may notice a creamy white discharge. This is due to the vaginal sutures dissolving and can persist for several weeks.

Do not use tampons for at least 6 weeks after surgery — use pads only.

Heavy fresh red bleeding or clots requiring frequent pad changes is not normal. Please contact your team if this occurs.

STITCHES AND WOUND DRESSINGS

All vaginal stitches are dissolving — they do not need to be removed. They usually dissolve within 2–4 weeks.

Waterproof dressings are applied to any abdominal wounds. These can be removed 10–14 days after surgery. Underneath there is usually some skin glue and suture remnant — leave this in place as it will drop away on its own within a couple of days.

Showering is fine as soon as you feel ready. Avoid baths and swimming for at least 6 weeks while vaginal stitches are present.

SEXUAL INTERCOURSE

Avoid vaginal intercourse for at least 6 weeks after surgery. Your surgeon will assess you at your post-operative appointment and advise when it is safe to resume.

When you do resume intercourse, it may be a little uncomfortable at first — take things slowly and use a lubricant. If intercourse remains uncomfortable after 3–4 months, please seek advice from your surgeon.

POST-OPERATIVE APPOINTMENTS

Your surgeon will usually see you at 4 weeks and 6 months after your surgery. We also often arrange a 12-month review if needed. This schedule is a guide only and is frequently modified based on your individual clinical situation.

OUR SPECIALIST NURSE

Our specialist nurse Lucy will usually contact you in the 1–2 weeks after your surgery to check on your recovery. Lucy can also answer any post-operative care questions you may have.

Lucy works one day per week in most weeks. For non-urgent nursing questions you are welcome to email the rooms and she will try to get back to you when she is next working. Please don’t email urgent clinical concerns.

WHEN TO SEEK HELP

Please contact our rooms or present to your nearest emergency department if you experience any of the following:

  • Heavy or fresh red bleeding, or clots requiring frequent pad changes

  • Very offensive or heavy vaginal discharge

  • Burning or stinging when passing urine

  • Inability to pass urine for more than 4–6 hours

  • Increasing abdominal pain or new vomiting/severe nausea

  • Fever, vomiting, or signs of infection (redness, swelling, or discharge from a wound)

  • Calf pain, swelling or redness (possible blood clot)

  • Chest pain or shortness of breath

  • Any other urgent concerns

HOW TO CONTACT US

During business hours
UGS Rooms: (03) 9017 3159
Email: office@ugspecialists.com.au

After hours — urgent or emergency
To page your surgeon: (03) 9387 1000

After hours — ward contact
If you have recently been discharged and have a clinical concern, you can also call the ward you were discharged from:

  • Frances Perry House Surgical Ward: (03) 9344 5200

  • Epworth Freemasons Ward 1W: (03) 9918 8945

If you present to hospital in an emergency
If you have attended a hospital emergency department without first contacting your surgeon, please ask the treating doctor to contact your UGS specialist using the after-hours or clinic number as soon as possible. Please also ask that any discharge paperwork, results, and correspondence are sent to our rooms.