Our GYN clinic is committed to ensuring that your post-operative experience is as comfortable as possible. The following information will help answer frequently asked questions and will help you understand some of the common experiences that may occur after your surgery.
You will have your first post-op visit 5-10 days after surgery for evaluation and possible suture removal (rare cases). If you have any questions or concerns prior to or after that time, please call Dr. Ivanov at his office, (215) 631-3873.
If an ER visit is necessary post-operatively, always go to your nearest hospital emergency room.
Call your doctor right away if you experience:
- Fever higher than 100.4 degrees
- Shortness of breath
- Heavy vaginal bleeding
- Severe pain not relieved with your pain medication
- Persistent nausea or vomiting
- Increased pain, redness, or swelling at the incision
The ultimate success of your surgery is partially dependant on your self-care in the weeks after
your procedure. It is very important that you follow the instructions as given. Instructions are as follows:
After each urination and bowel movement rinse yourself well with your “peri-bottle” and gently dab (DO NOT RUB) the area with a “Tucks” pad, then apply a clean “Telfa” (non-adherent dressing, helpful in the first few days after surgery while the incisions may be draining) and sanitary pad.
*Do not use toilet paper for the first 7 days as it can stick to your incisions.
*Keeping the “Tucks” in the refrigerator provides an added cooling effect.
Starting the evening of surgery, thoroughly rinse the area in the shower ONCE daily for the first 7 days.
You may use a hand-held nozzle or “cup” your hand between your legs, let it fill with water and hold it there for 1-2 minutes. *Do not rub or scrub the area.
Pat the area dry with a soft cloth/towel or dry with a hair dryer (high blow, low heat), then apply your Cu-3 cream and a clean “Telfa” and sanitary pad.
Place your ice pack in a plastic “zip-lock” bag and cover with a paper towel, place against the labia for 15-20 minutes, 4-5 times per day for the first 4-5 days after surgery to help with swelling and discomfort. (You may also do this by filling a plastic “zip-lock” bag with crushed ice or frozen veggies, i.e.: peas, corn, etc.)
*After this time, you may use a heating pad if needed for swelling and discomfort.
Dr. Ivanov strongly encourages the use of your pain medication beginning when you get home (or leave the office) and every 4 hours for a minimum of 18 hours after surgery and then using it on an “as-needed” basis. Always take your pain meds with food. Please do not drive while taking pain meds. *Pain medications can cause constipation. See below for prevention instructions.
Start your Arnica (homeopathic, gentle anti-inflammatory) as soon as possible. Take it as directed on the packaging starting the day of surgery until the swelling and “oozing” is gone. *Take Arnica on an empty stomach, then eat, then take your pain medication.
Using clean hands, gently apply your Cu-3 intensive hydrating gel (tissue repair cream with a soothing base, used to enhance healing immediately post-procedure. It helps prevent the formation of “crusts” and scabbing while maintaining skin hydration) to your incisions 2 times a day ONLY (1 time/day in addition to once after your shower) for the first week. Use your Dermaplast (pain and itch relieving) spray as needed only for surface stinging or itching on the external/visible incisions/suture lines.
A small to moderate amount of bloody spotting, swelling and bruising/discoloration in the area for the first 7 days. This will lessen over time. It is also not unusual to have a small area (not > ¼”) where the superficial skin may separate. The surface layer of sutures will dissolve in the first 7-14 days, while the underlying sutures will take 4-6 weeks.
For significant swelling not well relieved by ice, please take Ibuprofen (“Advil”) 600mg (3 OTC tabs) every 6-8 hours around the clock until swelling subsides. *Please take with food and do not take longer than 5 days maximum.
For the first 5-7 days you should relax and take it easy. Limit your activities to light/desk work; slow walking, minimal stair climbing. This is a great time to catch up on your reading, television shows or other leisurely activities you rarely have time for.
For TWO FULL WEEKS after surgery it is extremely important NOT to do any heavy lifting (over ~10-15 lbs.), vigorous activities or exercising, including but not limited to: fast walking, stair climbing, dancing, swimming, etc. Sexual intercourse, biking, running and horseback riding should be withheld for a total of ONE MONTH. *Do not have intercourse or insert anything into the vagina until cleared by Dr. Ivanov. (*Please use pads only with your first period after surgery.)
Anytime you can, lie down and elevate your pelvis and legs. Avoid “ups & downs”, walking/“rub, rub, rub”.
You should NOT shave or wax in the vaginal area until cleared by Dr.Ivanov at your one month post-op appointment.
After surgery, your vulva will become VERY discolored and swollen from approximately day 1-7. Please evaluate yourself for signs of excessive bleeding, wound separation, or blood clot (“goose-egg”) formation in the first 36 hours after surgery ONLY. Following that, it is important and best not to visualize the area frequently, nor handle it excessively. The appearance will change day-by-day, and the changes and irregularities noted initially can “drive you crazy”.
**Please avoid excessive “handling”**
Take your pain medication only if you need it (after the first day), stay hydrated, eat dried prunes (8-10 per day) or drink ice cold prune juice. AFTER SURGERY ONLY– a stool softener such as Duloclax or Colace (taken twice/day) may be helpful. If you have not had a bowel movement after 3 days, drink “smooth move” tea, and/or take Senakot, Miralax or other laxative if needed.
Evidence of infection (redness, swelling and perhaps a yellowish discharge, and/or fever), increasing day-by-day pain, and bleeding that is more than light spotting. If you notice one area/side is significantly more swollen than others, please apply 5 minutes of firm pressure to the area with a pad or wash cloth, using the heel of your hand. Look at the area, if it seems unchanged, apply 5 more minutes of pressure and call Dr. Ivanov.