Possible complications of robot-assisted prolapse surgery

There are general risks involved with having any surgery. These include adverse reactions to the anaesthetic, excessive bleeding, infection and the potential for blood clots. Antibiotic are given during surgery and continued after your operation to reduce the risk of infection. Medication (e.g. Fragmin or Clexane) to thin your blood is given during surgery and while you are in hospital to reduce your risk of developing blood clots. It is very uncommon to experience serious bleeding or need a blood transfusion.

Generally, there is improved sexual function after prolapse surgery, however about 2% of women experience painful intercourse after surgery and this may require minor corrective surgery or the use of vaginal dilators.

Occasionally bladder problems can occur after surgery (e.g. difficulty with bladder emptying, cystitis or urinary leakage) but these problems usually settle soon after surgery. However, if incontinence remains a problem then further surgery or medication may be required.

Pain may occur immediately after surgery, but this generally settles after a few days or weeks. It is rare for women to experience long-term pain following prolapse surgery.

Rare complications from prolapse surgery may include injury to a nearby structure (e.g. bowel, bladder, ureter, nerve). Dr Carey may inspect the bladder with a fine telescope (cystoscopy) at the completion of surgery to exclude any bladder or ureter injury. Rare long-term complications after robot-assisted prolapse surgery include bowel obstruction from adhesions and abdominal hernia. Further surgery may be necessary if a complication occurs.

Whenever synthetic graft is used during robot-assisted surgery, there is a small risk (in Dr Carey’s practice this occurs in 1 in 200 women) of a small portion of the synthetic graft becoming exposed in the vagina. This is usually treated either by vaginal oestrogen pessaries or a small vaginal operation to remove the exposed synthetic graft (usually the entire graft will not need to be removed).

Recovery time and instructions following robot assisted prolapse surgery

Most women stay in hospital for one, two or three nights.

It is MOST important to rest after the operation and allow the area to heal.

You will be seen by Dr Carey 5 weeks following surgery to check for any problems and remove the S-POP device. You will also have a final review with Dr Carey 12 months following surgery.

Generally it is recommended to…..

• Completely restrict your level of physical activity for two weeks.
• From two to four weeks do light activity only.
• Avoid heavy lifting (nothing heavier than 5 kg) for four weeks, including small children.
• Abstain from sexual intercourse for six weeks.
• Avoid playing sport and impact exercises such as jogging or jumping for four weeks.

Pain relief

• If you experience pain after discharge we suggest that you take pain control medication (e.g. Panadol) every four hours as required until pain resolves.
• Make sure you take some time each day to rest.

Maintain good bowel habits

• Try do drink approximately 1.5 litres of fluids each day.
• Maintain a healthy diet.
• Use Movicol or similar preparations (available at the chemist or supermarket) if required to maintain regular bowel function and to keep your bowel motions soft.

Any stitches that you still have in when you go home will dissolve in about 10 days (but possibly up to three weeks).  These do not need to be removed.

Dr Carey will be happy to answer any questions you may have and can give more specific advice. Before deciding to have surgery, you should read carefully all the information about your operation and consider obtaining a second opinion.

If you experience complications after you leave hospital, contact Dr Carey or the nursing staff on 1 West at the Epworth Freemasons Hospital for advice. In an emergency you may attend the Royal Women’s Hospital, Parkville or Epworth Hospital, Richmond emergency department or attend your closest hospital emergency department.