Post Operative Instructions: Hernias
Surgical Site
Swelling at surgical sites is normal; this will often feel like a firm ridge. Abdominal bloating is common. Bruising and funny colors are normal and will fade over the first week. It is common for swelling of genital areas and fluid accumulation in the groin after hernia surgery; sometimes this can feel firm like a lump.
Rotate ice packs or bags of frozen peas to help with swelling, up to 15 minutes per hour, for first 3 days.
Wound Care
If you have glue on incisions, this is waterproof and you may shower. If you have bandage(s), keep dry for three days, after which you may shower and change the dressing(s) daily with dry gauze and tape. It is OK to shower with your dressing(s) on, but do not leave a wet dressing in place - change it afterwards. No baths or submerging incision(s) in pool/lake until discussed at your post-op visit.
Keep incision(s) dry. Avoid excessive perspiration. Do not apply lotions, ointments, or creams.
Activity
Climbing stairs is OK. Walking is encouraged. When able, it is OK to walk for exercise, for distance, or on a treadmill. No strenuous activity, lifting over 20 lbs, sexual intercourse, or other forms of exercise at least until your post-op visit. Based on your particular surgery, these restrictions may/may not hold for a longer period of time; to be addressed at your post-op visit. For complex hernia patients, wear your binder.
Although it is OK to be a passenger, you may not drive or operate a vehicle while taking narcotics. Make sure to get out and stretch your legs every hour if going on a long trip within 30 days of your surgery.
Urinary retention (especially after laparoscopic groin hernia surgery):
- More common in men than women, occurs <5% of the time.
- If you cannot urinate and become uncomfortable due to bladder distention, you may need to go to an Urgent Care or an ER to request a urinary catheter be inserted and to go home with the catheter.
- Call us in the AM on the next business day if you required a catheter, and we will guide you from there.
Pain and Discomfort
Over-the-counter medications work well for postoperative pain. A good strategy is alternating Ibuprofen (if not allergic and not taking other blood thinners) and Acetaminophen. You will also be provided a prescription strength pain medication to use as needed. Using multiple classes of pain medication is more effective than solely using narcotics. Remember that narcotics cause constipation* (see below).
Diet
Clear liquids only for 24 hrs. Slowly advance diet from there, being mindful of constipation.
Battling Constipation
Restrict diet to clear liquids for 24-36 hours. Take Colace 100 mg twice a day. Take 6 oz. prune juice 2-3 times a day. Take Miralax as directed once a day. If pain is not severe, limit narcotic use. If no BM after 3 days, stop narcotics and take a suppository; if no result, administer a Fleet enema. Helpful analogy: the GI tract after surgery is like a sink that is not yet draining – it will accommodate a certain amount of water (dietary intake by mouth) before overflowing (vomiting); once the sink is draining (passing gas or BM), one can fill it with more and more water (can advance and increase dietary intake).
Call Your Doctor If Experience:
- Fever greater than 101 degrees
- Spreading redness
- Excessive swelling
- More than minimal bleeding or drainage from incision(s)
- If you had to go to ER for a urinary catheter