1. Nursing Instruction
  2. Overview
  3. Women's Health
Purposes:
Women with loose and weak pelvic muscles may lead to clinical symptoms, including difficulty in urination, frequent urination, uterine prolapse, cystocele(Bulge of bladder), proctocele(Bulge of rectum), discomfort in sexual life, the sensation of abdomen dropping, and involuntary leakage of urine while coughing, laughing, or sneezing. Therefore, it is necessary to enhance muscle strength of the pelvic floor muscles through pelvic reconstruction surgery to improve the uncomfortable symptoms caused by the genitourinary system organs misplaced.
 
 Pre-operative preparations:
  1. The patient shall complete examinations ordered by the doctor, inculding blood draw, chest X-ray, and electrocardiogram.
  2. Before the surgery, the doctor will explain the conditions and operation-related matters to the patient and the family members. Consent forms for operation, anesthesia, blood transfusion, and the various self-pay items would be filled out.
  3. Before the surgery, it is necessary to shave the hair around operation area. The patient would take laxatives, receive an enema, remove nail polish (including phototherapy nails), and receive nursing instructions regarding operations.
  4. It is forbidden for the patient to intake food and water after midnight the day before the surgery. However, the patient should ask the doctor whether to stop special medicines, such as antihypertensive drugs.
 
 On the surgery day:
  1. The patient would be pit on surgical gown. All movable dentures, watches, jewelry, glasses, and other metallic objects shall be removed from the patient.
  2. The patient shall urinate before surgery.
 
Post-operative care:
  1. After returning to the ward, the patient can start drinking and eating according to the doctor's order. The patient could intake some warm water first. If no vomiting occurs, the patient can eat a liquid or soft diet.
  2. The purpose of putting gauze in the vagina is to stop bleeding. The gauze will be removed by the nursing staff the next day after operation, following the doctor's advice.
  3. After the operation, the urinary catheter will be placed around 2 to 3 days. After the urinary catheter is removed and urination is smooth and no discomfort, the amount of residural urine in the bladder will be measured through a single catheterization. Subsequently, the patient will be discharged from the hospital according to the doctor's instructions.
  4. After the operation, there will be some soreness feeling around the inner thigh due to the surgical wound. The doctor will prescribe painkillers as needed. This soreness will be relieved about 1 to 2 weeks later.
 
 Home care after discharge:
  1. After the operation, the patient should take medicine as instructed by the doctor.
  2. Frequent urination will occur for about 2 to 3 weeks after the operation. Generally, it will improve after the patient takes medicine. If the patient finds it is challenging to urinate smoothly, with frequent urination, lower abdominal pain, and burning sensation, she should return to the obstetrics and gynecology outpatient clinic to see the doctor.
  3. There will be a small amount of vaginal bleeding within 2 weeks after the operation, which will gradually decrease. The patient should continue to observe the bleeding and return to see the doctor for any abnormal condition, such as heavy vaginal bleeding.
  4. The patient can start taking a shower immediately after returning home, and she shall follow the doctor's instructions to perform a sitz bath 4 times a day. (Extended reading: sitz bath)
  5. The patient can resume normal activities and do housework 7 days after the operation. The patient should avoid lifting heavy objects within 3 months after the operation, with no more than 3 kg by one hand and no more than 5 kg by both hands.
  6. When returning to the hospital for follow-up visits, the patient should discuss the time for recovery of sexual life with her doctor.
  7. The patient should try to avoid excessive force in bowel movement after the operation. If the patient has constipation, she should take the initiative to inform the doctor and take stool softeners if necessary.
  8. The patient should follow the doctor's instructions to return to the obstetrics and gynecology clinic regularly for follow-up visits.
 
References
  1. Farthman, J., Watermann, D., Zamperoni, H., Wolf, C., Fink, T., & Gaberiel, B. (2017). Pelvic organ prolapse surgery in elderly patients. Archives of Gynecology ＆ Obstetrics, 295(6), 1421-1425. https://doi.org/10.1007/s00404-017-4367-z
  2. Ko, I. C., Lo, T. S., Lu, Y. Y., Tsao, L. I. (2017). The Life Impacts and Symptom Distress in Women with Pelvic Organ Prolapse Syndrome Before Pelvic Reconstruction Surgery. The Journal of Nursing, 64(1), 41-50. https://doi.org/10.6224/JN.000007
  3. Lyu, J. Y., Chang, L. I., Tsai, C. H. (2017). Pelvic Health: Healthcare Needs from Medical and Women Perspectives. The Journal of Nursing, 64(2), 12-18. https://doi.org/10.6224/JN.000020
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    Taipei Veterans General Hospital 
    No.201, Sec. 2, Shipai Rd., Beitou District,  3e72dadb9904d06fa0fb3744e4ed2612.png
    Taipei, Taiwan 11217, R.O.C.
    Tel: +886-2-2871-2121 #04
    • Smoking and chewing betel nut significantly induce oral cancer. Obesity will potentially increase the risk of breast cancer and colorectal cancer. Please control body weight and keep away from tobacco and betel nut.
    • Information provided above can’t overcome physician's treatment and replace physician patient relationship.
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