Hysteroscopic Procedure

Transcription

1 gynaecology program Pre- and Post-operative Instructions: Hysteroscopic Procedure

2 Informed Consent As part of informed consent, your doctor will talk to you about: What will be done during the surgery Why you need it Risks of surgery Risk of not having any treatment What other choices you may have You may also be asked to consent to Blood Transfusion and/ or Blood Products, consent for Tissue Samples for Research Purposes, and/or consent for Photography. Make sure you understand this information. Don t be afraid to ask questions. Have your doctor go over something if it is not clear to you. What is a Hysteroscopic Procedure? During a hysteroscopy, a thin, telescope with a light is inserted into the uterus to look at the lining and inside cavity. The most common uses for hysteroscopy are to diagnose or to treat some problems like abnormal bleeding from polyps or fibroids. When polyps or fibroids are found by the doctor, a special instrument passed through the hysteroscope can be used to remove them. If none are found, a tissue sample can be removed from the lining. This is called a biopsy. A less common reason for doing a hysteroscopy is if the uterus contains a septum (tissue dividing the cavity). 1

3 What are the risks? Overall, hysteroscopy is a very safe procedure. There are risks, but they are very small. These risks may include: A puncture of the uterus by the hysteroscope, which may require further surgery Abnormal blood loss requiring a transfusion Infection which can be can be treated with antibiotics The fluid used to distend the uterus is absorbed into your bloodstream; medications may be needed to help you to void out the excess fluid* Tears to the cervix which might require stitching to reapproximate Please be assured that if any problem occurs during your procedure, it will be treated. Speak with your doctor if you any questions about hysteroscopy or to discuss the risks. *To see the inside of the uterus, the cavity is filled with fluid. When will I be going home? You will be going home on the same day as you have your surgery. You must have someone accompany you home and it is preferred that someone stay with you overnight. If no one lives with you, please make arrangements before your surgery to have accompaniment home and someone to stay with you overnight. Please be assured that it is safe for you to go home and most people actually prefer to recover at home. Day of surgery When you arrive at the hospital you should report to the Admitting Department on the main floor. Bring your Mount Sinai Hospital card and health card with you. Please arrive two hours before your planned surgery time. 2

4 How will I feel after the surgery and when I am at home? Many people feel tired, lethargic and unwell following an anesthetic. However, they recover quickly by following the instructions listed below. If you have any questions or concerns, speak with your doctor or the nurses looking after you. 1. You may vomit or feel nauseated (especially after the car ride home). This often passes quickly. If the nausea and vomiting do not pass after one hour you may take some Gravol by mouth (50 mg every four hours as needed). Gravol is an over-the-counter medication available at your local drugstore. Remember it is very important to take frequent sips of fluid to keep you hydrated. 2. Do not use tampons. Use sanitary pads as long as you are experiencing any vaginal bleeding. Some women experience very little bleeding or none at all. Others may experience bleeding similar to menstruation. Spotting may continue for a few days or up to a couple of weeks. Some women may have a watery vaginal discharge as well. 3. You may shower the next day after surgery, but should avoid tub baths, swimming and douching for two weeks or until the vaginal bleeding has stopped. 4. It is important to do deep breathing and coughing exercises. Take some time every hour or two for the first day or so after surgery to take eight to ten nice deep breaths and cough. You want to make sure you do not have any lung congestion after having anesthetic. 3

5 How much pain will I feel? Pain and/or discomfort are usually minimal, similar to menstrual cramps. It should be controlled with the prescription given to you by your doctor when you are discharged home. Tylenol or Tylenol Extra Strength is usually enough for mild pain. Ibuprofen products can be used instead of or with the Tylenol to help with your pain. What about activity? You may go back to work when you feel up to it often within 48 to 72 hours. If it is the next day, make sure you are not standing for long periods, lifting heavy objects, driving or operating machinery. If you are unsure as to when you should return to work, talk with your doctor or nurse. No sexual intercourse until your doctor says it is okay to resume. What about eating? You may resume a normal diet upon discharge from Hospital. Will my bowels function normally? 1. Some people experience constipation following a surgical procedure. It is important not to be straining hard to have a bowel movement. It is a good idea to eat foods with high dietary fibre such as whole grains, raw fruit and vegetables to help prevent constipation and make it easier to have a bowel movement. Please ensure you are drinking lots of fluids (especially water), one to two litres per day is healthy. 2. If your bowels have not moved in 48 hours after surgery, you may use a mild laxative like Milk of Magnesia or Agarol. If you are still unsuccessful after taking a laxative, repeat after 12 hours if there are no abdominal cramps. 4

6 What should I be concerned about and report? Persistent fever, chills, sweating Any difficulty breathing or shortness of breath Persistent and increasing abdominal pain Persistent vomiting and inability to drink liquids for greater than four hours Not being able to urinate within the first 12 hours after surgery Vaginal bleeding that is more than a normal menstrual period In case of Emergency Go to Mount Sinai Hospital Emergency Department or if you live outside of Toronto, go to your nearest Emergency Department. For non-urgent questions, please contact your surgeon s office. Why are students taking part in my care? Mount Sinai Hospital is a teaching hospital affiliated with the University of Toronto and the team includes medical students and residents. This should enhance your hospital experience by providing you with additional care from these doctors-in-training. Your willingness to allow students to take part in your care enhances the experience of those who are eager to learn, helping to ensure well-trained doctors in the future. They are fully supervised, and are only given responsibilities that are appropriate to the level of education they have. Final responsibilities always rest with the staff physician. The people taking care of you should always introduce themselves and ask your permission before commencing any care. 5

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