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Surgical treatments of endometriosis: after laparotomy

        SURGICAL TREATMENTS OF ENDOMETRIOSIS: AFTER LAPAROTOMY

After your operation you will have an intravenous drip in your arm to provide you with fluids so that you do not become dehydrated as you will not be allowed to drink. You will usually have a catheter draining your bladder for the first day or two if you have had a hysterectomy. You may also have a tube coming out of the surgical wound to drain any excess fluid and debris from the area of the operation.
For the first twenty four hours after your operation the nurses will observe you closely. They will chart your pulse, breathing rate, blood pressure and temperature frequently, and check your wound and record any vaginal bleeding. During this time your gynecologist will come and discuss the operation with you.
The physiotherapist may visit you again to help you with your breathing and foot and leg exercises.
You may experience some nausea and/or vomiting immediately after the operation. To help relieve this you may require an injection.
You will usually feel drowsy and experience pain for the first few days following your surgery, particularly from your wound. The tube that was placed in your throat may give you a sore throat for the first day or so. Two to four days after your operation you will probably experience wind pain which can be very unpleasant and uncomfortable.
For the first day or two you will either be given painkilling drugs continuously through your intravenous drip or you will be given painkilling injections every four to six hours. You will then progress to painkilling tablets.
When you first start to drink again you will be allowed only to suck ice and sip small quantities of fluid. Once you are able to cope with fluids and any nausea and vomiting has ceased your intravenous drip will be removed. When you have passed wind you will be able to progress onto a light diet of semi-solids and then onto a normal diet if you have no problems. You will probably not open your bowels for the first two to four days after your operation but if constipation becomes a problem you may be offered suppositories.
You will sit out of bed for a short time on the day after your operation and you will be encouraged to move around a little more each day as your condition improves.
When you return home you will then require another three to five weeks of recuperation if you have had a conservative laparotomy, or another three to seven weeks if you have had a hysterectomy. It is important that you do not just rest in bed but that you move and walk around each day and gradually increase your activity level as you recover and feel better.
You may tire quickly for the first week or two, so you will need some help with household tasks for the first one to three weeks, especially if you have children. When you start to do the household jobs again you should do a little at a time and still have plenty of rest. Do not try to be a superwoman as it will only slow down your recovery in the long-term.
For the first week or two after you return home you may still have some discomfort or pain so a mild painkiller such as Panadeine or Panadol may be necessary. The vaginal discharge, if you have had it, usually persists for about two weeks after surgery but it may last for up to six or eight weeks following a hysterectomy.
Most of the healing of the wound occurs in the first two weeks after surgery. After that you can lift light loads but it is probably best to avoid lifting heavy loads if possible for the first month or so. You can drive the car again when you are fit enough to do light gardening and walk up stairs quickly, generally about three to six weeks after surgery. You can have sexual intercourse again when your doctor has examined you about six weeks after your operation.
You should notify your gynecologist immediately if you develop any of the following symptoms:
• a fever
• your wound becomes tender, swollen and red
• a discharge appears from your wound
• severe abdominal pain or cramps
• urinary frequency and scalding when passing urine
• pain or bleeding when using your bowels
• your vaginal discharge develops an unpleasant odour
• your vaginal discharge persists beyond six to eight weeks
• tenderness and/or swelling in your calf muscles
• increasing soreness of the calf muscles when walking
• shortness of breath, chest pain or pain when breathing.

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