Preparation for surgery

• Make an appointment, usually with your primary care doctor, for a history and physical (H&P) examination. Regulations require that this exam take place within 30 days of your surgery, or your surgery will be delayed or canceled.
• If you take medication daily, please check with your prescribing physician for instructions on whether to stop or continue to take them the day of surgery. Medication on the day of surgery can be taken with a sip of water that morning.
• Do not take any aspirin or over-the-counter products that contain aspirin 1 week prior to surgery. You may take Tylenol only.
• If your procedure requires a bowel prep, you may have solid food up until you start the prep. Once started, you may only have clear liquids up until 6 hours before your surgery. If you do not require a bowel prep, have nothing to eat after midnight; you may have clear liquids up until 6 hours before your procedure.

Preoperative bowel preparation

Your surgery requires a bowel prep to cleanse your bowel of all solid material. Follow the instructions below. Proper bowel preparation will reduce the risk of injury to the bowel during surgery.

A few days prior to surgery

• You will need to purchase 2 bottles of Magnesium Citrate (10 oz. each) and 2 Bisacodyl tablets (5 mg each tablet) from your local grocery store or pharmacy.

One day prior to surgery

• Your bowel prep begins the day before your surgery. You can have solid foods the day before, but once you’ve started the bowel prep you can only have clear liquids.
• We also recommend that if you do eat solid foods before your prep that you eat lightly. Examples: Toast, yogurt, soup.
• OPTION 1 (noon & 4 p.m.) — If you will be home the day before your surgery, start bowel prep:
  • At noon — Drink one bottle of Magnesium Citrate. This can be swallowed alone or mixed with a clear liquid of your choice. Continue to drink at least 8 oz. of clear liquid each hour.
  • At 4 p.m. — Drink the second bottle of Magnesium Citrate (10 oz.) AND take 2 Bisacodyl tablets. Continue to drink at least 8 oz. of clear liquid each hour until retiring for sleep.
• OPTION 2 (4 p.m. & 8 p.m.) — If you are unable to be home the day before your surgery, start bowel prep:
  • At 4 p.m. — Drink one bottle of Magnesium Citrate. This can be swallowed alone or mixed with a clear liquid of your choice. Continue to drink at least 8 oz. of clear liquid each hour.
  • At 8 p.m. — Drink the second bottle of Magnesium Citrate (10 oz.) AND take 2 Bisacodyl tablets. Continue to drink at least 8 oz. of clear liquids each hour until retiring for sleep.
  • We would like you to have at least 10 8-oz. glasses of clear liquid from the time you start the bowel prep until you go to sleep.
  • You may drink clear liquids up until 6 hours prior to your scheduled surgery time.
  • You will notice an increase in watery bowel movements throughout the day. If this does not occur by the completion of the second dose of Magnesium Citrate, you may take a Fleet Enema or Milk of Magnesia to completely clear your bowels.
  • Because you are drinking an increase in clear liquids during the bowel prep experience, you may notice that your urine is a light clear yellow color.
  • Note: The later you start your bowel prep, the later you’ll be awake with bowel movements.

Clear liquid diet

These items are allowed during your bowel prep up until 6 hours before surgery:

• Water
• Clear broths (chicken or beef)
• Juices (apple or cider)
• White grape juice
• Clear soda
• Tea (no milk, creamer, or honey)
• Coffee (no milk or creamer)
• Jell-O (without fruit/no red Jell-O)
• Popsicles (without fruit/cream)
• Italian ice (no red)
• Clear Gatorade
• Spices and seasonings such as salt, pepper, sugar, and sugar substitutes may be used.

These Items Are Not Allowed

• Milk
• Cream
• Milkshakes
• Orange juice
• Tomato juice
• Creamy soup or any soup other than clear broth
• Solid foods

Day of the procedure

• Do not shave or mark your skin anywhere near your surgical site.
• Do not wear makeup.
• All jewelry, including body piercings, must be removed prior to surgery. Leave all jewelry at home.
• Wear loose and comfortable clothing.
• Please arrive on time. Every effort is made to ensure your surgery begins at the scheduled time; however, your surgery may be delayed as a result of a hospital emergency or because of commonly encountered variations in the length of certain procedures due to unanticipated findings.
• All patients are required to have an escort home after surgery.

If you are going home the same day

• If your surgery involves anesthesia or sedation, you must be accompanied by a responsible person when you leave the hospital. You cannot drive yourself home.
• You should have an adult stay with you for 12-24 hours following your surgery.

Questions

• If you have questions about your surgery, contact our office during office hours, 718-576-0730

Postoperative instructions for most gynecologic surgeries

The recommendations that follow are intended as a general guide to your first weeks at home. However, the most important thing is to use good common sense in planning your activities. If it hurts, don’t do it; and don’t do anything to the point of exhaustion.

• After minimally invasive procedures, laparoscopy, hysteroscopy, vaginal surgeries, and robotic procedures, you should be up and moving about freely soon after the surgery. Gradually increase your activities.
• You are allowed to climb stairs, but try not to become too tired.
• Avoid heavy lifting. Avoid strenuous exercise or sports for 2 weeks.
• Do not drive until you can do so without discomfort and without using pain medicine. This can take from 3 to 7 days.
• You may shower and wash your hair. Soapy water can run over the incisions. Do not soak the incisions in a tub immediately following surgery.
• No intercourse, douching, or tampons for at least 2 weeks. Longer restrictions may apply to vaginal surgeries.
• It can be normal to have a slight vaginal discharge, which may be bloody. Use sanitary pads not tampons.
• If you experience bleeding heavier than a period, call the office.
• You may eat and drink as tolerated. Go easy at first, with clear liquids, soup or broth, and crackers, before progressing to solids.
• Increase fiber and fluids if you get constipated. If needed, a stool softener (Surfak, Colace, or a generic equivalent) may be purchased and taken by mouth as directed. It is common for narcotic pain medicines to cause constipation. If no bowel movement has occurred for 2-3 days, you may use Miralax, Milk of Magnesia, or Senokot. Do not use Correctol or Ex-Lax.

Precautions

• Contact the office if you experience fever of 100.4 or higher, chills, vomiting, pain unrelieved by using pain pills, vaginal bleeding heavier than a period, or foul-smelling discharge.
• Contact the office if you experience any urinary frequency, urgency, or burning that doesn’t respond to increasing fluids, cranberry juice, and nonprescription bladder medicine such as AZO.
• Contact the office if you have any chest pain, shortness of breath, pain in the calves or legs, or redness, drainage, or separation of the incisions.

Follow-up

• If an appointment has not been scheduled for you, call the office and tell them the date of your surgery and which procedure you had, and they will schedule the follow-up visit. A pelvic examination is often done at that visit.