May 20, 2022 Author : Susana Coutinho Surgical correction of pelvic organ prolapse performed through the vagina may include several interventions that interfere with pelvic organs or ligaments, including a hysterectomy (removal of the uterus) . On average, recovery takes 4-6 weeks, depending on the interventions performed and individual particularities. Post-operative care Immediate care is most often the following: A urinary catheter is maintained in the first hours , to ensure and control the drainage of urine; A g auze compress is placed in the vagina to act as a tampon and prevent bleeding near the scar. Both the urinary catheter and the vaginal compress are usually removed within the first 24 hours. Getting up after the surgery for the first time is carried out according to the doctor indication and must always be carried out while accompanied . The start of fluid and solid intake depends mainly on the type of anesthesia. It is usual to start liquids after 3 hours and the common diet to be introduced 24 hours after the operation. Control blood tests may be requested, namely to more accurately assess blood loss during surgery or the risk of infection. The average length of stay at the hospital varies between 1-3 days . For example, it will in most cases be 1 day in the case of correction of isolated stress urinary incontinence, and 2-3 days if a hysterectomy is performed. Pain and discomfort after surgery Despite allowing a more direct access to structures, vaginal surgery can cause discomfort or pain in the lower abdomen, in the region of the pelvis or even in the thighs. This discomfort is more common in the first 24-48 hours after the intervention and gradually improves. During hospitalization, analgesic medication is given at regular intervals to control and prevent pain or discomfort that bothers or limits mobility. Also, in the first days after the surgery there may be some discomfort when urinating and/or having a bowel movement , which is transient. At the time of hospital discharge, your doctor will give you an indication of the medication to be taken. Infection control measures In vaginal surgery, antibiotic prophylaxis if performed before surgery , and can be repeated within the first 24 hours in the case of prolonged surgeries. In most cases of vaginal surgery, genital disinfection will not be necessary during hospitalization. To prevent urinary infections, the urinary catheter is removed as soon as possible, and fluid intake is recommended. Prevention of deep vein thrombosis After surgery, there is an overall increased risk of venous thrombosis, due to clot formation in the veins of the legs, abdomen, or lungs. To prevent it, elastic stockings are used , which will be placed before the surgery, and used during hospitalization. Anticoagulant drugs are also used , whose indication and administration protocol vary according to individual risk and interventions performed. After discharge, it may be advisable to keep wearing elastic stockings for up to two weeks after surgery. Recovery of urinary function After vaginal surgery it often takes longer than usual to empty your bladder . In about 5%-10% of cases, there may be incomplete emptying, that is, not being able to eliminate all the urine in the bladder. When the amount urinated is less than half the contents of the bladder, it may be necessary to place a catheter until it is possible to urinate effectively. This type of reaction resolves spontaneously within the first two weeks after the operation. Recovery of bowel function Constipation is a common problem after surgery and is related to the operation, anesthesia, pain medication and immobilization in bed. The intake of fruit and other foods rich in fiber , a good intake of water and other liquids is essential to help restore intestinal transit and have soft stools. Early ambulation is also important to promote normal bowel function. Laxatives are sometimes recommended to avoid straining at stool. These efforts are not advisable in people undergoing interventions for genital prolapse. Vaginal discharge Shortly after the surgery there may be a vaginal discharge , sometimes bloody or brownish, which can be present up to 4-6 weeks after the surgery and be intermittent. It is due to the stitches in the vagina, which will be reabsorbed in that period of time. When there is an increase in discharge, an unpleasant odor or more liquid and abnormal leakage is noticed, the attending physician should be contacted. Eating during recovery After discharge, a varied and balanced diet should be maintained , including foods and liquids that promote good urinary and intestinal functioning. Fiber-rich foods like cereals and fruits like plums and kiwi are good examples, as well as drinking at least 1.5 liters of fluid a day. What to avoid and what to do after surgery For 6 weeks after surgery : Avoid demanding work or personal commitments. Avoid physical efforts such as carrying weights greater than 5 kg, not picking up children or carrying groceries. Avoid sports, swimming, or high-impact physical exercise such as running or weight training. Avoid sexual intercourse, as these jeopardize the good evolution of healing. Tobacco is not recommended, as it delays healing and increases the risk of infection. Avoid immersion baths and swimming pools, as they can lead to infection of the sutures. Prevent constipation by ensuring adequate food and fluid intake. Empty your bladder regularly, 6-8 times a day, so as not to promote urinary retention. It is normal to feel tired after surgery. Therefore, you should save time to rest throughout the day. However, moving around after surgery is very important , namely to prevent the formation of clots in the veins and the consequent thrombosis. So: Avoid sitting for a long time without moving, but do not stand for more than two hours at a time without sitting. Housework and short walks close to home are good physical activities during this time. According to medical advice, physical therapy exercises for the pelvic floor without manipulation can be started about 2 weeks after discharge. Resume usual activities, including work and exercise Each person has their own recovery pace, but this depends mainly on: Previous physical condition; Type of intervention performed; Occurrence of complications. In the first 4-6 weeks recovery is gradual. After this period, you should feel able to resume your usual activities. During this period, one or more appointments are scheduled, depending on the need. One month after the surgery, the end of convalescence is determined and the return to professional activity and other occupations is determined , always considering the type of professional activity in terms of physical effort, working hours and daily commute. Resume sexual activity Overall, s exual intercourse should be avoided for 6 weeks after surgery. At the appointment scheduled close to this date, you should confirm with the doctor the possibility of restarting it. The first attempts of intercourse after surgery can be uncomfortable. Therefore, a long restart and the use of a gel lubricant are recommended . If the discomfort persists after the second month, you should inform your doctor. Seek medical care In of the following warning signs you should contact your doctor or go to a hospital emergency department: Increased discharge with possible strong odor or other liquid leakage from the vagina in a amount greater than usual; Urinary complaints such as burning or pain when urinating, increased urinary frequency or abnormal appearance of the urine; Pain in the abdomen that becomes progressively more intense; Fever, vomiting, feeling faint or generally unwell; Pain or swelling in the legs, feeling short of breath or chest pain. Meet the obsterics-gynecology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
