Admission guide

The Australian Centre for Female Pelvic and Vaginal Rejuvenation

Dr Onuma will indicate which of the following apply to you for the particular procedure that you are being admitted for.

  • Please remove all of the top 2cm of pubic hair 2-3 days before your operation.
  • Please remove (trim, shave or wax) all pubic hair around the vagina and labia 2-3 days before your operation.
  • You are required to have some blood taken from the lab (Healthscope Clinpath SA Pathology) in preparation for your surgery. This needs to be done 1-3 days before your operation during normal office hours. You will not need an appointment or need to fast. The results will be sent directly to Dr Onuma, your GP and the hospital so you will not need to wait for any results.
  • If you are on blood thinning medications (aspirin, warfarin, fish oil etc) these will need to be stopped 10 days prior to surgery. Please note that some herbal/natural remedies do cause blood thinning, so if in doubt STOP using them. It is very important that you discuss this matter with Dr Onumain good time. [**Stopping blood thinners may increase your risk of having a stroke. Continuing blood thinners may increase your risk of bleeding during and after surgery].
  • You will need to use a bowel preparation. Please read the separate document provided.
  • Please arrive at the hospital at the time indicated on your admission forms.
  • Please note the fasting times on your admission forms. Milk is considered to be a food.
  • You will usually see your anaesthetist on the ward before being transferred to the operating theatre.
  • You will usually (but not always) see Dr Onuma either in the waiting area or in the operating theatre prior to surgery. If you go home on the day of surgery or the following morning you are unlikely to see Dr Onuma before you are discharged from hospital unless there is an issue that needs to be addressed.
  • Anticipate going home from hospital on the day of surgery or being in hospital overnight (*If you go home the same day you need a responsible adult to be with you overnight) or after 2-5 nights.
  • TED (elasticated) stockings will be fitted for you by the nursing staff before you come into the operating theatre. By improving the flow of blood from the legs back to the heart they reduce the risk of DVT (deep vein thrombosis) and PE (pulmonary embolus). You will need to wear the TEDs until you get home. Once you are at home you will no longer need to wear them as long as you are mobile. If you fly or take a long car journey within 6 weeks of surgery you are advised to wear them for the trip.
  • Clexane thins the blood, reducing the risk of DVT and PE. Thinning the blood increases the risk of bleeding and being returned to theatre to control bleeding. Nevertheless, prevention of DVT/PE is, comparatively, very much more important. The first injection will usually be given towards the end of the surgery or occasionally delayed until you reach the recovery area or ward. The nursing staff will give you an injection everyday until you go home.
  • You will receive antibiotics into the vein whilst under anaesthetic.
  • You will be required to take a course of oral antibiotics for 5 7 days after completion of the IV antibiotics.
  • You may be asked to commence the oral antibiotic course 1 2 days prior to surgery.
  • You are likely to continue to receive intravenous antibiotics for a period of up to 24 hours after surgery.
  • Trans-vaginal mesh may be used as discussed. If you have any concerns about this then discuss with Dr Onuma again prior to surgery.
  • During your operation you will receive painkillers either as an injection into the vein or as suppositories in the rectum. You will receive painkillers and anti-nausea/vomiting drugs as required whilst on the ward. **Do not hesitateto request these from the staff as required.
  • You will have a drip in your hand through which you will receive fluids into the vein. This will be ceased when you are drinking enough by yourself.
  • You are likely to have a catheter sited. This will come out after surgery.
  • You are likely to have a vaginal pack sited. This will come out after surgery.
  • You may have a drain left in the abdomen to remove excess gas or fluid. The drain will be removed before you leave the hospital.
  • Dr Onuma will be happy to phone one relative of your choice when the surgery is finished. If there is no answer on the number provided, Dr Onuma will leave a short message if there is facility to do so.
  • The nursing staff will check the amount of urine you pass and the amount left in the bladder (with a portable scanner) once the catheter is removed. I have a specific protocol (copy provided for your information) and the staff will phone me if they have any concerns.
  • You will be on a soft diet after your operation until you are passing flatus.
  • A calf compression device may be fitted during surgery.
  • Admission to hospital involves a change in diet, fluid intake and environment. Many women will find that they have a temporary change in bowel habit, most often tending towards constipation. Dr Onuma generally prescribes Coloxyl with Senna, 2 tablets each evening from the day after surgery. If there is a particular product that works best for you then bring it into hospital with you and Dr Onuma will assess whether you can continue with it during your admission instead of using Coloxyl with Senna. It is not uncommon for patients to worry about their bowel function after surgery, however, it is not a requirement to have opened your bowels prior to being discharged from hospital.
  • Pelvic reconstructive & investigative surgery is commonly associated with some blood loss. Excessive bleeding requiring transfusion is an uncommon but known risk of surgery. Dr Onuma would only transfuse you with blood if he thought it to be absolutely necessary. *If you are a Jehovah’s Witness please provide the appropriate signed documents relevant to acceptance/non-acceptance of blood products before your admission to hospital.
  • The loss of small amounts of vaginal blood following surgery is normal. Some women will get an extra ‘gush’ of blood between 7-21 days after surgery. This is also not unusual. If you feel that the loss is excessive &/or offensive then contact Dr Onuma‘s staff for an earlier review. You may require some antibiotics.
  • Pudendal nerve block; an injection given into the vagina to decrease pain related to surgery. The injection may delay the ability to empty the bladder between 4-12 hours and can cause temporary reduction of sensation/movement of the legs. If this occurs, an indwelling catheter may be required overnight.
  • It is not uncommon to suffer from bloating/cramping of the abdomen with associated discomfort after keyhole or open surgery. This tends to happen more often in women who suffer from irritable bowel syndrome. This may take several weeks to settle completely. Occasionally tablets to help settle the bloating/cramping may be required.
  • It is not uncommon to suffer from shoulder tip pain/discomfort after keyhole surgery.
  • Dissolvable sutures are used in vaginal repairs, labial surgery and closure of abdominal wounds. When they do not dissolve spontaneously they can become brittle, may irritate the local skin and may require removal.
  • Please remove your abdominal wound dressings 5 days after surgery. Do not wait for the dressings to fall off.
  • Recommence using Vagifem Ovestin   weeks after surgery.
  • Recommence using your Steroid Cream   weeks after surgery.
  • Commence using Bio Oil to Labia  Perineal Body 7 days after surgery.
  • Recommence Ditropan Oxytrol Betmiga Vesicare Tofranil Macrodantin Cephalexin when you get home from hospital.
  • Whilst you may be a passenger in a car, your insurance will not cover you to drive for 24hrs following most day case surgery or 1-2 weeks after most inpatient procedures (4-6 weeks if you have had open surgery). Please discuss with your car insurer if necessary.
  • Post surgery follow-up will be arranged for you at the time of your consents for surgery. If you think that you need to be seen prior to your scheduled appointment then speak to Dr Onuma’s staff to arrange this.

Dr Onuma is happy to provide a ‘Sick Certificate.’ He can only provide you with this from the time of admission, not beforehand. If you require a certificate then make the request to Dr Onuma’s staff and provide them with the required dates. Where necessary, ‘Carer’s leave’ certificates can also be provided.

This is a medical website and contains graphic material. The material provided is for education and information only. Always consult your own health care provider.
Laser Vaginal Rejuvenation Institute of Adelaide