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Urethral Sling Surgery: What to Expect at Home

Your Recovery

Urethral sling surgery is done to treat stress urinary incontinence if you have a vagina. The sling supports the urethra, which is the tube that carries urine from the bladder to outside the body. After surgery, you may feel weak and tired for several days. Your pubic bone may feel bruised, and you may have some pain or cramping in your lower belly. These symptoms should get better in 1 to 2 weeks. You also may have some vaginal spotting for up to 1 month. This is normal.

You should have less or no urine leakage when you sneeze, cough, laugh, or exercise. In fact, at first you may find that it is harder than usual to empty your bladder. This usually gets better after 1 or 2 weeks.

You will probably be able to go back to work in 1 to 2 weeks. But you will need at least 6 weeks to fully recover before returning to all normal activities. You must avoid heavy lifting and strenuous activities during this time. These might put extra pressure on your bladder while you recover.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

Rest when you feel tired. Getting enough sleep will help you recover.
Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
Avoid strenuous activities, such as jogging or weight lifting, and straddling activities, such as bicycle or horseback riding, for 6 weeks. Or wait until your doctor says it is okay.
For 6 weeks or until your doctor says it is okay, avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
Ask your doctor when you can drive again.
You will probably need to take 1 to 2 weeks off from work. It depends on the type of work you do and how you feel.
You may shower as usual after 24 hours. Pat the cuts (incisions) dry. Do not take a bath or swim for the first 2 weeks, or until your doctor tells you it is okay.
Avoid putting anything in your vagina for 6 weeks or until your doctor says it's okay. This can include having sex or using tampons.

Diet

You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
Drink plenty of fluids (unless your doctor tells you not to).
You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

If you have strips of tape on the incisions, leave the tape on until it falls off.
Do not wash the area directly, but allow warm, soapy water to run over the incision daily. Then pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
Keep the area clean and dry.

Exercise

Ask your doctor when you can do pelvic floor (Kegel) exercises, which tighten and strengthen pelvic muscles. Your doctor may want you to wait several weeks after surgery before you do them.
To do Kegel exercises:
- Squeeze your muscles as if you were trying not to pass gas. Or squeeze your muscles as if you were stopping the flow of urine. Your belly, legs, and buttocks shouldn't move.
- Hold the squeeze for 3 seconds, then relax for 5 to 10 seconds.
- Start with 3 seconds, then add 1 second each week until you are able to squeeze for 10 seconds.
- Repeat the exercise 10 times a session. Do 3 to 8 sessions a day.
If you are having trouble finding out what muscles to squeeze, you can try stopping the flow of urine a few times. But don't make it a practice to do Kegels while urinating.
If doing these exercises causes pain, stop doing them and talk with your doctor. Sometimes people have pelvic floor muscles that are too tight. In these cases, doing Kegel exercises may cause more problems.
If you aren't sure how to do these exercises, talk to your doctor about getting a referral to a pelvic floor physiotherapist.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have chest pain, are short of breath, or cough up blood.

Call your doctor or nurse advice line now or seek immediate medical care if:

You have bright red vaginal bleeding that soaks one or more pads in an hour, or you have large clots.
You are sick to your stomach or cannot drink fluids.
You have pain that does not get better after you take pain medicine.
You have loose stitches, or your incisions come open.
Bright red blood has soaked through the bandages over your incisions.
You have vaginal discharge that has increased in amount or smells bad.
You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
You cannot pass stool or gas.
You have signs of a blood clot in your leg (called deep vein thrombosis), such as:
- Pain in your calf, back of knee, thigh, or groin.
- Redness and swelling in your leg or groin.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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