Recovery guide for vaginal hysterectomy and pelvic floor repair
Vaginal surgery heals from the inside, and the two most important things you can do to protect your repair are: avoid constipation and straining, and follow your lifting restrictions. These directly affect the success of your surgery.
| Medication | Dose | Schedule |
|---|---|---|
| Paracetamol | 1 g (2 tablets) | Every 6 hours (max 4 g/day) |
| Ibuprofen | 400 mg | Every 8 hours with food |
| Opioid (if prescribed) | As directed | Breakthrough only — max 3–7 days |
Take paracetamol and ibuprofen regularly for the first 5–7 days. Opioids cause constipation — this is especially dangerous after pelvic floor repair. Use only if non-opioids are insufficient, and take stool softeners alongside.
Nothing in the vagina — no intercourse, tampons, or douching.
The vaginal vault and repair suture lines must heal completely. Premature intercourse risks vault dehiscence (wound separation) — a surgical emergency — or repair failure with prolapse recurrence.
Lifting increases intra-abdominal pressure directly on suture lines. Premature heavy lifting contributes to prolapse recurrence (overall risk 25–30%). After 6 weeks, use proper technique: feet apart, bend knees, brace pelvic floor, hold object close.
Straining increases pressure on suture lines, weakens pelvic floor muscles, and is a significant risk factor for prolapse recurrence.
| When | What to Expect |
|---|---|
| Weeks 1–2 | Light bleeding — bright red initially, then darker reddish-brown |
| ~Day 10 | Possible sudden gush of old blood — usually stops quickly |
| Weeks 2–6 | Brownish discharge gradually decreasing |
| Up to 8 weeks | Creamy white discharge from dissolving stitches — entirely normal |
Pieces of suture material passing is expected. Not normal: heavy red bleeding soaking >1 pad/hour, large clots, or foul-smelling discharge.
Monitor bladder function closely. A voiding trial is done before catheter removal. A temporarily slower urinary stream is common. If unable to void, you may need intermittent self-catheterisation for 1–2 weeks.
Bowel care is paramount. No rectal medications or enemas for 2 months. Avoid straining at all costs. Follow the bowel protocol on page 1 diligently.
Longer recovery (6–8 weeks minimum). More restrictive pelvic rest (8–12 weeks for intercourse). Greater fatigue. More vigilance for vault dehiscence if hysterectomy was included.
| Timeframe | What to Expect |
|---|---|
| Days 1–2 | Hospital. Mobilise. Eat and drink normally. Catheter and vaginal pack removed. |
| Days 3–7 | Discharge home. Mild pain, fatigue. Daily walks. Begin gentle pelvic floor exercises. |
| Weeks 2–3 | Approaching pain-free. Walking 30–60 min. Possible return to reduced-hours desk work. |
| Weeks 4–6 | Most activities with correct lifting. Continue pelvic floor exercises. |
| 6 weeks | Follow-up appointment with surgeon. Activity clearance. |
| Activity | When Safe |
|---|---|
| Desk work | 2–3 weeks |
| Moderate physical work | 4–6 weeks |
| Heavy manual work | 6–8+ weeks |
| Driving | 1–2 weeks |
| Swimming | 2–4 weeks (if bleeding stopped) |
| Exercise / gym | 6+ weeks |
1. Don't strain on the toilet — ever.
2. Don't lift heavy — follow the weight limits.
3. Nothing in the vagina until your surgeon clears you.
Following these rules gives your surgical repair the best possible chance of long-term success.