Your Surgery with Eve Health

There are currently no government restrictions for elective surgery. Please continue to prepare for your elective surgery to proceed as planned.

Obstetric procedures including elective caesarean sections are not affected and will continue as planned.

Fertility procedures such as egg collection and embryo transfer that are currently booked and arranged with your doctor are also not affected and will continue as planned.

Stay safe, wash your hands and together we will get through this.

Our doctors at Eve Health offer surgery at a variety of locations, some of which include Mater Private Hospital Brisbane, Mater Mothers’ Private Hospital Brisbane, Spring Hill Specialist Day Hospital, Brisbane Day Surgery, St Andrew’s War Memorial Hospital, The Wesley Hospital, and for intermediate surgery, Mater Hospital Brisbane. For more information please contact Reception on 07 3332 1999 or [email protected]

Eve Health reception will provide you with a hospital booklet or a link to online admission forms to assist with preparing for your admission. Should you have any specific hospital related questions, pre-admission clinic nurses at your chosen hospital are available to discuss concerns and answer questions about your hospital stay.  Alternatively, the nursing team at Eve Health can assist or direct you to the appropriate person.

You will be advised by Eve Health reception the specified time you will be required to stop eating and drinking prior to your surgery. It is usually at least 6 hours before your scheduled surgery time. You will be notified of any changes if your theatre time changes.

This may be necessary if the bowel is likely to be operated on during your surgery. Bowel prep is a treatment to empty the bowels. Your doctor may ask you to have a bowel prep the day before surgery and you can follow the instructions given to you by your Eve Health gynaecologist. If you have any questions, please do not hesitate to contact the Eve Health nurses.

No special wash or scrub is needed. Please wash with soap or body wash and water prior to surgery unless otherwise advised. Prior to laparoscopic procedures please clean the umbilical area (belly-button) with soap and water before laparoscopic surgery. If any dirt or fluff is difficult to remove, use a cotton bud.

Please see our page Accommodation Options for Long Distance Patients for suggestions of lodging close to the hospitals where our specialists offer surgery or treatment. Please note hospitals will only accommodate you for the time clinically required for your admission – i.e. from the day of your admission for approximately 1 or 2 nights, unless indicated otherwise. You will require separate accommodation for the remainder of your stay in Brisbane, including any days in Brisbane prior to your surgery.

During your hospital stay gentle movement, lower limb circulation exercises and deep breathing exercises will reduce your risk of blood clots, lung infections and bloating or gas pain. Gentle mobilisation around the ward is encouraged.

Generally, increasing your exercise over 4-6 weeks before adding in more vigorous exercise (running, gym programs) is advisable.  Avoid lifting more than 6kgs from the floor for 6 weeks after major abdominal or vaginal surgery and 2 weeks after laparoscopy. A good rule of thumb is if you can’t lift it with one hand, avoid until 6 weeks.   Good pelvic health and recovery also involves correct activation and use of your pelvic floor muscles. This can be difficult and in some instances limited initially after surgery but should be encouraged after 4-6 weeks. If you have concerns, please discuss a detailed return to exercise or pelvic floor program with your physiotherapist.

Constipation is a common problem post-operatively. It is important for your recovery and pain management to actively manage any constipation in the short and medium term. A guide for optimising bowel function would be to have bowel motions that are formed but easy to pass and occur every 1-3 days. Some options for management:

• Ensure a good toileting position, not straining
• Keep well hydrated
• Have a high fibre diet (fruit and vegetables)
• Use stool softeners such as Movicol
• Drinking prune or pear juice may help

Medications may include analgesia, anti-nausea, laxatives and in the case of long procedures or prolonged bed rest a blood thinner (Clexane or heparin) to avoid the formation of clots. It is important to take pain relief as instructed by your doctor as some allergies or interactions with other medications may affect what you are prescribed or recommended to take. After most moderate to major surgery, strong pain relief will be given in hospital and by the time you go home you should be taking regular paracetamol (2 tablets, 4 x / day) and a regular anti-inflammatory such as ibuprofen or diclofenac. Strong pain relief such as tramadol or oxycodone is often only required for severe or breakthrough pain. Gas pain, cramping or bloating is common after a procedure. Shoulder tip pain is due to the gas used to expand the abdomen during surgery and can last for one week. Heat packs may help. As the pain lessens, the strong pain relief should be stopped first, followed by the anti-inflammatory, and finally the paracetamol. If pain is worsening, rather than improving, or you develop abdominal distension, not passing wind, have no bowel motions or a raised temperature, these may be signs of a complication and you should seek advice from your Eve nurse or surgeon.

Leave dressing intact for 24 – 48 hours unless they are soiled or wet. Do not apply antiseptic creams, Dettol or methylated spirits to wound sites. The best way to achieve minimal scar formation is to leave the wounds alone until healed. Some redness is usual, especially around the site of the wounds. If the redness is spreading or the wound is discharging fluid or pus or opening of incision, please contact the Eve Health nurses.

• Wound sites may feel numb or sensitive for some time. Scars may not reach their final appearance for up to a year. Bio oil may be applied once healed.
• Dissolvable sutures are primarily used and therefore do not require removal.
• Skin glue may also be used to add strength and protection to an incision and will start peeling off after a week.
• Steri-Strips may also be applied over the wound site and may be removed one-week after your surgery
• Non-dissolvable skin sutures (stitches) will be removed approximately 7 days after your surgery. Your doctor will inform you when these are to be removed.
• Vaginal surgery sutures will be dissolvable and may take up to 6 weeks to dissolve. Light vaginal bleeding or pink brown discharge is normal as sutures dissolve.

Light spotting or bleeding is expected several weeks after surgery especially the first week. Should you experience any heavy bleeding, such as soaking a pad in less than one hour or passing clots, notify your Eve Health Gynaecologist or Nurses immediately. Tampons should not be used until at least 2 weeks’ post-surgery.

Vaginal Surgery: 6 weeks

Hysterectomy: 6 – 10 weeks

Laparoscopy: When you feel like it unless directed otherwise

Cervical Surgery: 4-6 weeks

Hysteroscopy: 1-2 weeks

Showers are possible straight after surgery. You can wet the wound site after dressings removed while showering and pat dry afterwards.  Baths and swimming should be avoided for 2 weeks after your surgery.

For 4-6 weeks after any treatment to remove abnormal cervical tissue:

• Avoid having sex to reduce risk of infection
• Use sanitary pads rather than tampons

In general, patients can drive 1-2 weeks after a laparoscopy and 4-6 weeks after open surgery or a caesarean section. It is important that you have recovered sufficiently to comfortably wear a seatbelt, perform an emergency stop, and reverse safely. After minor surgery, you should not drive for 24 hours after an anaesthetic. Do not drive while taking narcotic or sedative medications or if you are unable to operate the vehicle in full capacity. Check with your own insurance company first before driving after surgery as they may have specific exclusions.

Hysteroscopy: Day procedure

• You can usually go back to work within 24 to 48 hours.

LLETZ/ Cervical Biopsy: Day procedure

• You can usually go back to work within 24 to 48 hours.

Laparoscopic procedures minor and medium such as treatment of mild endometriosis, removal of ovarian cysts or treatment of ectopic pregnancy. Day procedure or overnight stay.

• Back to work in 5 – 7 days

Longer laparoscopic procedures such as laparoscopic hysterectomy or treatment of severe endometriosis. One or two days in hospital

• Back to work in 2 to 4 weeks

Stress Incontinence surgery such as TVT or TVT-O: Day procedure or overnight stay

• Back to work in 2 weeks.  No heavy lifting for 4 to 6 weeks

Pelvic floor reconstructive surgery for prolapse: Two to three days in hospital

• Back to work in 3 to 4 weeks depending on kind of work.  No heavy lifting for 6 weeks

Please seek medical advice at once if you notice any of the following:

• Abdominal pain or bloating that is severe, lasts for 3 hours and is not relieved by pain medication
• Persistent bleeding from the vagina that is smelly or becomes heavy or bright red.
• Nausea and vomiting that is worsening
• Fever > 38 degrees Celsius
• Skin incision redness, drainage of fluid, pus or opening of incision
• Swelling in an extremity (arm or leg that is much greater in size on one side than the other)
• Shortness of breath
• Foul smelling, green or dark yellow vaginal discharge
• Pain or burning on passing urine or the need to pass it frequently.
• Unable to move bowels, diarrhoea.