Laparoscopic Retropubic Suspension: What to Expect at Home

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Your Recovery

Retropubic suspension is surgery to treat stress urinary incontinence in women. The surgery lifts the sagging bladder and urethra and supports them in their normal positions. The urethra is the tube that carries urine from the bladder to outside the body. After surgery for urinary incontinence, you may feel weak and tired for several days. You will probably feel some pain or cramping in your lower belly and need pain medicine for a week or two. You may feel like you need to urinate more often, and your urine may be pink. This usually gets better 1 to 2 weeks after surgery.

You will have a tube (catheter) in place to drain urine from your bladder. Your doctor will remove the catheter when it is no longer needed.

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 1 to 2 weeks after the catheter is removed.

You will probably be able to go back to work and most of your usual activities in 1 to 2 weeks. But you may need 4 to 6 weeks to fully recover. Try to avoid heavy lifting and strenuous activities that 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 bicycle riding, jogging, weight lifting, or aerobic exercise, for 4 to 6 weeks or until your doctor says it is okay.
  • For 4 to 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 child, or a vacuum cleaner.
  • Ask your doctor when you can drive again.
  • You will probably need to take 2 to 4 weeks off from work. It depends on the type of work you do and how you feel.
  • You may shower as usual. Pat the cuts (incisions) dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
  • Ask your doctor when it is okay for you to have sex.

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. He or she will also give you instructions about taking any new medicines.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
  • 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 for a week or until it falls off.
  • Wash the area daily with warm, soapy water, and 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 the same muscles you would use to stop your urine. Your belly and thighs should not move.
    • Hold the squeeze for 3 seconds, then relax for 3 seconds.
    • Start with 3 seconds. Then add 1 second each week until you are able to squeeze for 10 seconds.
    • Repeat the exercise 10 to 15 times for each session. Do three or more sessions each day.

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 call line 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 severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood.
  • You have severe pain in your belly.

Call your doctor or nurse call 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 keep fluids down.
  • You have pain that does not get better after you take pain medicine.
  • You have loose stitches, or your incisions come open.
  • Your incisions are bleeding.
  • 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.
    • Swollen lymph nodes in your neck, armpits, or groin.
    • A fever.
  • You have clots of blood in your urine.
  • You have trouble passing urine or stool, especially if you have pain or swelling in your lower belly.
  • You have new or worse pain when you urinate.
  • You have pain in your back just below your rib cage. This is called flank pain.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You do not have a bowel movement after taking a laxative.

Where can you learn more?

Go to http://www.healthwise.net/ed

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