Charles E. Miller, M.D. & AssociatesCharles E. Miller, M.D. & Associates
Specialists in Minimally Invasive Gynecologic Surgery


Postoperative Instructions

GENERAL LAPAROSCOPY

 
DIET:  Drink lots of fluids. You will be dehydrated from fasting and the bowel prep. You should drink 128 oz (one gallon) of fluids daily.
 
Start with a liquid diet, once you are passing gas rectally, you may advance to a soft diet; applesauce, toast, noodles, etc. If you can tolerate this, then return to your regular diet.
 
GAS PAIN:  Upper back, shoulder and chest pain is normal following laparoscopy from the CO2 gas used during the procedure. It should subside within 48-72 hours.
 
INCISIONS: You may have 3 or 4 incisions. These will be closed with absorbable suture. You will have both steristrips and tegaderm dressings. These should stay on for one week unless they become wet or bloody underneath. If this happens, remove the tegaderm dressing trying not to disturb the steristrips. If the steristrips are wet or come off, do not worry.  Just keep all incisions dry. Use a blow dryer (on cool setting) to dry the belly button after showering.
 
Pain, burning and pulling at the incision sites is normal. This may last 2-3 weeks. You may apply ice to your incisions for 20 minutes at a time. Allow 20 minutes between ice application (20 minutes on then 20 minutes off).
 
SORE THROAT: You may have a sore throat for up to a week. This is from the tube they used to help you breathe. You may use lozenges.
 
TEMPERATURE: Monitor your temperature. If you have two temperatures above 100.4 four hours apart, please contact the office.
 
BLEEDING: It is normal to spot or bleed like a period for up to 2 weeks. If you are saturating greater than a pad every hour contact the office.
 
CONSTIPATION: Constipation is normal following surgery. It may take 3-7 days to get back to normal. If you are passing gas rectally you may use a gentle laxative such as Miralax or Milk of Magnesia. Reduce your use of pain medication if possible. If you continue to have problems, please contact the office.
 
INTERCOURSE: May be resumed after two weeks unless you continue to have vaginal bleeding. You should wait until the bleeding subsides.  Remember to use protection (do not attempt pregnancy) if you have had a myomectomy, septum resection, or uterine adhesions resected until you have been cleared by the doctor to do so.  Supracervical Hysterectomy patients must wait for 3 weeks and Total Hysterectomy (cervix removed) patients must be examined by the doctor prior to having intercourse.  If you have a bladder sling/TOT/TVT you may not have intercourse for 6 weeks.
 
EMERGENCY: If after Hours you feel you have an emergency please contact the answering service at 847-813-7468. In an extreme emergency, return to the emergency room at the hospital where you had your surgery, if possible.
 

MYOMECTOMY

 
You may have some cramping and bleeding like a period for up to 2 weeks.
 
Your first1- 2 periods after surgery may be more heavy and painful than usual. This is because your uterus is still in the healing process. You may use ibuprofen as needed.
 
You must wait at least 2 months to try and achieve pregnancy. If you have any questions at all please contact the office before attempting pregnancy.
 

EXCISION ENDOMETRIOSIS/OVARIAN CYSTECTOMY/ADHESIONS

 
We usually use large quantities of irrigation fluid in your pelvis with these procedures. You may notice watery/bloody fluid leaking from one or more of your incisions. This is normal. Remove your tegaderm dressing and replace with a gauze dressing. If you can, tape the dressing tightly to the skin so as to apply pressure over the incision. Change the dressing as needed. This will usually subside within a day or two.
 
If your endometriosis involved the bowel, you should start with a clear liquid diet and only advance when you are passing gas rectally (this tells us your bowel is awake and functioning).
 

UTERINE SEPTUM RESECTION/INTRAUTERINE ADHESIONS

 
A uterine stent (balloon) will be placed inside your uterus. This will stay in place for 5 days. You will need to schedule an appointment with a nurse in the office to have it removed. It will not drain. It does not have any effect on urination. The end that comes out of the vagina may be tucked up into the vagina or may be left hanging out.
 
You may also be placed on Estrogen for 30-60 days after the procedure. This helps prevent the formation of scar tissue inside the uterus by building up the lining quickly. You may experience some bleeding during the time you are on this medication. If your bleeding becomes heavy like a period, contact the office. You will also be given prometrium to be taken at the end of your estrogen treatment. This will cause you to get a period. This period may be heavier than usual.
 

HYSTERECTOMY

 
If your cervix was removed (total laparoscopic hysterectomy), you may not have intercourse until you are seen by a doctor. You will need to be seen 4-6 weeks after surgery.  If your cervix was left in place (supracervical) you may have intercourse 3 weeks after surgery.
 

TRANSOBTURATOR TAPE (BLADDER SLING)

 
You may have some pulling / burning sensations in the groin area.
 
It is important that you do not lift >15lbs, no running, jumping, or strenuous exercise or intercourse for 6 weeks
 

PRESACRAL NEURECTOMY

 
You may have an achy lower back pain for about one week after surgery.
 
The sensation to urinate may be different following surgery, you may need to pay more attention to your body and empty your bladder frequently until you become accustomed to this (usually about a day).
 

ENDOMETRIAL ABLATION

 
You may have some bleeding/spotting after the procedure. This may last a few days to 2 weeks. You may have another episode of bleeding about 4-6 weeks after surgery. It may be as heavy as a period or only light spotting. Some patients experience only a clear watery discharge.
 

D&C or ECTOPIC (TUBAL) PREGNANCY

 
If your D&C was done for a miscarriage, you will need to repeat your HCG level in our office one week after your surgery.
 
 
 
 
Advancing gynecologic care safely and successfully through minimally invasive means.