For this procedure 2-3 ports (plastic tubes) are inserted through the abdominal wall, so there is a chance you may have some bruising at these sites. Since you can't rest the abdominal wall muscles all the time (where bruising may occur), most patients are tender for the first 3-5 days. The procedure is usually considered Day Surgery meaning you can go home the same day although at this point you are unable return to normal activity (adult or otherwise).
1 in 40 patients may need to stay because of nausea. Very occasionally a patient is unable to pass urine as a reflex response to pain. In this instance a catheter will be passed as a temporary measure.
Sutures are in the wounds which will dissolve eventually, however in most instances I will remove these at your post-operative appointment. This visit also provides us with a good opportunity to discuss the outcome of surgery.
Wound Care: Bruising is common and as it rises to the surface can cause a round, reddened area extending downward from the belly button. This is not an infection but can mimic one, some please contact my rooms to arrange to be reviewed if you are concerned. Leaking a watery, yellow fluid (serum) is also normal. Dressings on the wounds should be removed after 48 hours and the cuts left open to the air. You can shower normally at this time.
Risks: There is always a risk of a nick, puncture or injury to another structure in the abdomen during any operation. Large blood vessels, bowel, bladder, ureter (connects your kidney to the bladder) are all at risk of injury. The risks and benefits will be discussed with you prior to your procedure.
Follow-up - 'Diagnostic' means we just looked, so recover should be quick and you are usually reviewed within a week to discuss the next management phase of your treatment, if any.
This, mostly diagnostic, operation involves passing a thin telescope through the cervix and into the cavity of the uterus. The cervix is grasped during this to stabilise the uterus and this grasp point on the cervix can be a source of spot bleeding for a few days after surgery. Among the potential, well recognised but infrequent complications is perforation of the uterus. The management of this can be to simply halt the procedure and observe for 24 hours. It is common to perform a Laparoscopy to confirm there is no ongoing bleeding inside the abdomen. This complication is more common when the uterus is very soft (pregnancy – miscarriage) or the cervix tightly closed and difficult to dilate for passage of the telescope. Some cramp (period type pain) is common after the operation but most women are able to leave hospital quickly and are well the next day. Bleeding can be variable. Some women have nothing or only spotting, which may be intermittent, and others may have a period for 7 – 10 days. Review is usually within 7-10 days.
This is an operation to obliterate as much of the uterine lining as possible. Its aim is to reduce menstrual flow and cause very light periods. Some woman will cease having periods. The 2 techniques I employ are:
- Thermachoice Balloon Ablation
- Novasure Ablation (www.novasure.com)
These are both day case operations and women experience low abdominal ‘period-like' pain for the first 24 hours. A watery bloody discharge persists for the first month.
Recovery is usually the same as for those having a Hysteroscopy/D&C
These methods are only for those women who do not desire future pregnancies and it is unsafe to conceive after these procedures.
A Tubal Ligation may be recommended / performed at the same time