Most patients who undergo excision of endometriosis without a hysterectomy or bowel resection should be able to leave the hospital the day of surgery, however everyone wakes up from anesthesia differently. We try very hard to minimize pain and nausea in the immediate postop period so that you can go home (or to your hotel room), however if we are not able to control these adequately you may need to stay overnight. If you need a hysterectomy or a discoid bowel resection, then you will usually need to stay overnight. If you need a segmental bowel resection, then you will require an extended hospital stay typically from 5-7 days.
Most patients are discharged from the hospital with 3 prescriptions- one for narcotic pain meds, one for nausea meds, and one for NSAIDS (ie Ibuprofen or Naproxen). The goal of the narcotics is to keep the pain at a tolerable level. Very few patients will have absolutely no pain after surgery, and you should not expect that. Having your pain controlled to a level where you can breathe deeply, get up and walk around, and move relatively comfortably in bed is the goal. Most patients who have surgery for non-pain indications usually stop their narcotics somewhere in the first week after surgery. Patients who have chronic pain tend to need their narcotics longer, but still the vast majority of our patients are either off or down to 1-2 pills a day by the two week mark. The NSAIDS will reduce inflammation as well as the more achy types of pain, and will reduce the amount of narcotic you need to take. We generally recommend that you take the NSAIDS 2-3 times a day every day for the first 7-10 days postop unless there is a contraindication, even if you don’t really think you need them. The nausea medicine (usually either Phenergan or Zofran) is prescribed so that you can use it if you need it, but you don’t have to take it. Some patients get a little nauseated from the pain meds, so if this is you, we recommend that you take a nausea pill about 30 minutes before your pain pills, and have something (like a cracker or a piece of toast) in your stomach when you take the pain pills.
In the first few days after surgery, if you don’t feel like eating, it’s not a big deal as long as you keep drinking fluids. Fruit juice and sports drinks will have some sugar and electrolytes which will keep your body chemistry in the normal range. You should be passing gas, so if you are not AND you are nauseated or throwing up, please contact Dr. Mosbrucker immediately. If you can’t reach the doctor, you’re not passing gas and you are throwing up, go to the emergency room!