Surgical Solutions

Hysterectomy Options

If you and your doctor have decided the best treatment option for you is a hysterectomy, you have several options. Abdominal hysterectomy, vaginal hysterectomy and laparoscopic hysterectomy are all different surgical approaches, and each has its own advantages and disadvantages.

Abdominal hysterectomy has traditionally been the most common type of hysterectomy. Your hospital stay is usually two to three days, recovery may take longer than other methods and there tends to be more post-op pain.

Vaginal hysterectomy has the advantage of a shorter hospital stay, typically less post-op pain and no incision on your abdomen. Unfortunately, women with a large uterus or multiple Cesarean sections may not be good candidates for this approach.

The use of laparoscopic hysterectomy has increased recently due to significant technological advances that allow the surgeon to remove the uterus through three tiny incisions. We are able to perform this surgery on women that have routine indications for surgery such as heavy bleeding. We are also able to use this technique on patients that have had multiple Cesarean sections and women with an enlarged uterus due to fibroids. We have been very happy with the results of this procedure. The hospital stay is only overnight, there is typically very little post-op pain and patients are able to return to normal activity much faster than with the traditional abdominal approach.

Incontinence Surgery

Urinary incontinence, or unexpected leakage of urine, is a very common complaint in our office. There are primarily three types of incontinence that we see — urge, stress, and mixed.

Urge incontinence is unexpected leakage of urine preceded by a strong urge to urinate, which the patient is unable to control. This is very common and can be worsened by different medications, particularly some blood pressure medications. Certain bladder irritants ingested through a normal diet can also worsen urge symptoms. There are several medications that are highly effective in treating urge incontinence. Typically, surgery is not needed to correct urge incontinence.

Stress incontinence is leakage of urine that occurs when you laugh, cough, sneeze or is caused by any type of exertion. This type of incontinence can be helped with exercises called Kegel’s that are designed to help strengthen the pelvic floor. If conservative treatment with pelvic floor exercises doesn’t help, then surgery can usually cure this incontinence. Our preferred surgery is called tension-free vaginal Tape or TVT. This is a simple procedure that places a small piece of material beneath the urethra that provides support and restores continence. We have been performing this surgery for more than 17 years and have had great success with it. Recovery is usually only 2-3 days and there is minimal pain.

If you have any questions regarding your hysterectomy options or incontinence surgery, please call our office to discuss your options. (936) 569-0000

Post Op Instructions


  • Call for temperature of 101 or greater
  • No baths for 2 weeks, only showers
  • No intercourse for 6-8 weeks depending on type of hysterectomy
  • No lifting over 10 pounds
  • No driving for 1-2 weeks or until not taking narcotics
  • Keep incision clean and dry. Wash gently in shower and pat dry.
  • Clear to white drainage from incision is normal
  • Report increased redness or swelling. Report drainage that changes color or has a foul odor
  • Light vaginal spotting and bleeding is normal. Report heavy bright red bleeding
  • Increase fluid intake after surgery to help prevent constipation
  • May take stool softeners such as Colase 100 mg twice a day or Surfak 240mg twice a day
  • Rest when needed, but activity is important in your recovery
  • No exercise for six weeks or until released by your doctor
  • Take prescribed pain medicine as needed. Report an increase in pain
  • Follow up with your doctor 2 weeks after surgery

Cesarean section

  • Report temperature of greater than 101
  • Report increased drainage that has a foul odor or an increase in redness or pain at the incision
  • No lifting over ten pounds
  • Vaginal bleeding is to be expected for up to six weeks
  • No baths for 2 weeks, only showers
  • No intercourse for six weeks
  • Follow up two weeks after delivery

Novasure endometrial ablation

  • Soreness around the vagina or cramping is expected. Take your pain medicine as directed. Remember that narcotic pain medicines may cause nausea.
  • Nausea is common. If you experience nausea at home, take only clear liquids. When you begin to feel better, slowly start adding solid foods
  • Varying amounts of vaginal bleeding after an endometrial ablation procedure are expected. You may experience watery discharge. You may also notice some vaginal passage of small pieces of tissue. This represents remnants of the areas that were ablated from the lining of the uterus and are continuing to be passed with the bloody discharge. Worsening pain should be reported
  • Intercourse may be resumed in 2 weeks
  • No soaking baths for 3 days
  • Call if you have a temp of greater than 101
  • Call if you develop a greenish or foul smelling discharge

Pregnancy Tips

Common problems and remedies in pregnancy

  • Sinus congestion – Tylenol sinus products, Chloraseptic throat spray, Cepacol lozenges, Robitussin 1-2 tsp every 4 hours for cough, Benadryl 25 mg.
  • Headache – Tylenol 1-2 tablets every 4 hours not to exceed 4000 mg in a 24 hour period. No asprin or NSAIDS such as Motrin, Alleve, Advil or ibuprofen
  • Backache – Caused by increased curvature of the spine as the uterus enlarges, stretching ligaments and muscles. Use straight posture when walking or sitting, low heels, firm mattress, warm bath, ice or heating pad.
  • Round ligament pain – Symptoms consist of lower abdominal pain on either side of the uterus radiating to the groin. Brief bed rest and limitation of activity accompanied by a heating pad and Tylenol may help.
  • Varicose veins or swelling – Caused by increased pressure on the lower extremity veins as the uterus enlarges. Support hose with reduced standing time coupled with limit of salt intake may help. Try resting on your left side at least 15 minutes 3 times a day.
  • Hemorrhoids – Avoid straining and constipation. Stay well hydrated. You may use over the counter stool softeners, topical ointments and warm soaks.
  • Nausea – Morning sickness usually disappears after the third month. Try eating a few crackers, dry cereal or dry toast as soon as you get up. Eat 5-6 small meals and never go long periods without eating. Drink plenty of fluids. Ginger ale will sometimes help.
  • Heartburn – Avoid greasy, fried or highly seasoned foods. You may take Tums, Maalox, Mylanta, Tums or Rolaids. If this doesn’t work you can take Pepcid, Zantac or Prilosec.
  • Constipation – Increase your exercise. Drink plenty of water. Eat fiber, fruits and vegetables. Eat meals at regular times and don’t skip meals. Colase and Surfak are stool softeners that can be taken as directed. Senokot may be used as a laxative if you are severely constipated.
  • Muscle cramps – Very common in pregnancy. Sometimes increased calcium intake with Tums, Rolaids, milk and other dairy products may help.
  • Diarrhea – If it lasts for over 24 hours you may take Imodium AD. Stay well hydrated.
  • Dizziness or shortness of breath – Very common in pregnancy due to blood pressure changes associated with sudden position changes. Avoid prolonged standing or sudden movements. Try to avoid hot baths and showers as this may worsen the dizziness.