Gynaecological surgery: aftercare advice
Information for patients from Women's Health
This leaflet gives advice for patients recovering after gynaecological surgery.
It is for general circulation to all patients having major gynaecological surgery. If you have specific instructions from your doctor or nursing staff, some of the advice may not apply to you.
Exercises from the first day after your surgery
The exercises listed below are a guide; perform them as your body allows.
Deep breathing
Sit up well in bed.
Breathe in slowly, trying to direct one breath to the lower part of your chest.
When your chest feels comfortably full, breathe out through your mouth.
Repeat 3 times.
Coughing
Most people feel the need to cough after an anaesthetic.
It will hurt less if you sit well in bed with your knees bent and apply firm pressure over your stitches.
If you have a cut in your abdomen (tummy), support your wound or cuddle your tummy with your hands, forearms, or a pillow.
In both cases, give a good strong cough and spit out any phlegm.
Repeat several times during the day. Continue for 3 to 4 days.
Foot and leg exercises
Foot and leg exercises help increase the circulation in your legs. Increasing circulation reduces your risk of developing blood clots in your veins after surgery.
Flex your feet up and down quickly at your ankles, then round in a circle.
Bend up one knee, then straighten. Repeat with your other knee.
Repeat 5 times with each leg.
Do these exercises as often as you can. Continue them at least until you go home.
When can I get out of bed and move around?
We encourage most patients to get out of bed the day after their operation. If needed, a nurse will help you get out of bed the first time. When getting out of bed follow these instructions.
Bend your knees up, and roll onto your side keeping your knees together.
Push yourself up to a sitting position with your hands.
Allow your feet to lower down to the floor.
Once standing, stand tall with your bottom tucked in.
Pelvic floor muscles
Where are my pelvic floor muscles?
Pelvic floor muscles stretch like a hammock from the pubic bone in front, to the bottom of the back bone. They encircle the openings of the bladder, vagina, and back passage.
What do they do?
Pelvic floor muscles work steadily all day. They help with bladder control, keeping urine in the bladder until we reach a toilet. They also stop urine from leaking when we cough, laugh, sneeze, lift something, or exercise.
Why should I exercise my pelvic floor muscles?
Exercises after your operation will help keep / regain control of your pelvic floor muscles. There are many reasons why pelvic floor muscles weaken, including:
pregnancy
labour
persistent coughing
constipation
being overweight
menopausal changes
persistent heavy lifting, and
pelvic surgery.
To strengthen your pelvic floor and prevent urine leakage, you must exercise your pelvic floor muscles.
How do I exercise my pelvic floor muscles?
Tighten the ring of muscle around your back passage, as if you are trying to stop passing wind. Also try and tighten and pull up the ring of muscle around your vagina as if trying to stop passing urine, then relax. This is a fast contraction.
Complete 10 fast contractions each day. Do not do all the contractions at once.
Tighten the same muscles and hold the tightness for approximately 10 seconds. This is a slow contraction.
Complete 10 slow contractions each day. Do not do all the contractions at once.
These two exercises may also help with backache and trapped wind.
When should I exercise my pelvic floor muscles?
If you have a catheter, wait until it is removed. After the catheter is removed you cannot exercise too often. Aim for at least 5 times a day.
You can exercise lying, sitting, or standing. You can exercise while you eat, washing your hands, or using the telephone. This is an exercise for life.
How do I know that I am doing the exercises properly?
Try to stop your urine flow, but only once a week - this is just a test. Repeatedly stopping your urine flow can cause problems.
When exercising your pelvic floor muscles, do not:
hold your breath;
squeeze your legs together; or
tighten your tummy and buttocks.
These are not the right muscles.
Lower abdominal exercises
The following exercises tone up your abdominal (tummy) muscles. These muscles may have weakened following your surgery. These exercises also support your lower back.
Start the following exercises 2 to 3 days after your operation, or when you feel ready.
Lie on your back with your knees bent.
Take a deep breath in and out.
Gently flatten your lower stomach muscles by drawing in your belly button towards your spine.
Start the contraction by pulling up your pelvic floor muscles. Your pelvis should not move during this contraction.
Do not allow your upper stomach muscles to take over.
Do not hold your breath, but continue to breath gently in and out.
Hold the contraction for 10 seconds, and aim to repeat 10 times.
You can move on to doing this exercise sitting and standing.
Exercise rules
Listen to your body.
Stop if it hurts.
Stop if you become tired.
Never do a sit-up with your legs straight.
Never do a double leg lift from lying.
Other points to remember
Once you go home
Continue with a good balance of rest and exercise for the first few weeks at home.
Continue the programme of exercises and try to do two short walks each day. These walks should be for about 10 minutes, increasing as you feel your energy levels returning.
By the fourth week, most patients can manage a 40 minute walk.
Swimming is excellent, but not until after your 6 week check-up.
Do not start competitive sport or energetic activity for 3 months.
Going up and down stairs is quite safe. If you are unsure, try to limit how many times you have to use the stairs.
For the first 1 to 3 weeks, you may need help with easy household jobs. These jobs include light dusting, preparing light meals, and peeling vegetables. Gradually do more as you feel able. Six to 8 weeks after surgery most patients are able to do everything except heavy lifting.
If you pick up anything on the floor, always remember to bend your knees not your back, to avoid back strain. Pull in your tummy muscles and tighten your pelvic floor.
For the first 2 to 3 weeks do not:
lift any heavy shopping bags (maximum one 2kg bag);
dig the garden;
move any furniture;
use the vacuum cleaner; or
lift baskets of wet washing.
Do not forget your posture is important at all times. Remember to sit and walk tall, with your tummy and bottom pulled in.
Avoid sex for 4 to 6 weeks.
You may drive again 2 to 4 weeks after leaving hospital, depending on what surgery you had. Please check with your insurance company before driving.
Avoid constipation by eating a balanced diet, including fibre and drinking plenty of fluids.
If you have bladder symptoms, discuss this at your 6 week check-up.
It is important that:
you wear your surgical stockings; and
complete the course of any blood thinning injections we give you.
What if I feel unwell at home?
Please contact the ward to discuss any concerns you may have once you have left the hospital.
Gynaecology Assessment Unit, Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
Telephone: 01843 235009 (open 24 hours a day)Women’s Health Suite, William Harvey Hospital, Ashford
Telephone: 01233 651987 (open 24 hours a day)
Please note
This leaflet is for general circulation to all patients having major gynaecological surgery. If you have specific instructions from your doctor or nursing staff, some of the advice may not apply to you.
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