Pre and postoperative care for women

25th January, 2022 • 14 min read

It can be easy to think of

surgery
as something that happens when you're older and need a knee or hip replacement – but lots of women go under the knife or the keyhole at a younger age. Ops like a
hysterectomy
,
C-section
and
hysteroscopy
are amongst the most common surgeries for women.

There are 2 key reasons why you need to know about preparing well for surgery and the inside secrets to recovering afterwards:

1. You’re more likely to need surgery earlier in life than a man does

Stats vary but research from the US insurance sector shows that women have much more surgery than men – 1.5 million more surgeries among the top 10 procedures for each gender. “This is because women undergo neonatal and reproductive surgeries: caesarean section, sterilisation, hysterectomy, and removal of pelvic scar tissue for conditions like endometriosis,” says Dr Rebecca Thomas, Principal clinical safety officer and GP at Healthily.

2. You’re more likely to have complications if your surgeon is male

“Recent research has also found that women can have more post-op complications when the surgeon is male – which is still the majority of cases,” she adds.

If you have an upcoming operation it’s only natural to feel a bit nervous, and wonder how you can best set yourself up for a speedy recovery. Read on to get the inside track, the latest science-backed tips to put your mind at rest and help you feel in control.

Prepare for surgery – prehab is your secret weapon for better recovery

Whatever your op, it’s important you arm yourself with some knowledge and be prepared for potential complications – as well as get the information you need to know how to recover so you’re back to your old self as quickly as possible.

Help yourself and follow our plan to manage your mind and body through surgery to the best recovery.

Why you should prepare for surgery: the benefits

Prehabilitation (prehab) is all about good preparation for your body and mind prior to surgery. There’s a growing amount of scientific evidence showing that the better you look after yourself before surgery, the better your chances of a good recovery afterwards. An article in the British Medical Journal says major surgery is like running a marathon — and both require training. In prehab terms, women’s gynaecological procedures have been less well researched. So we’ve found out the very latest on what to do and why.

How to prepare for surgery

Get fit for surgery

Muscle atrophy is when muscles waste away. It's usually caused by a lack of physical activity. However, the stress of surgery can release the hormone cortisol and also lead to muscle atrophy. So it makes sense to

exercise
before your surgery to build up your muscle mass beforehand. Focus on resistance exercises (like using free weights or resistance bands or your own bodyweight to do conditioning exercises like squats, push-ups or sit-ups) that will help to build your muscle before your op.

And get aerobically fit too, with walking, running, cycling, swimming – choose something you enjoy and is easy to fit into your day or could be done with a friend. As your body needs oxygen to deal with the surgical stress response, being aerobically ‘unfit’ will not help your recovery, but getting fitter will.

Stop smoking before your operation

Stopping smoking
at least 8 weeks before surgery reduces your risk of a range of complications. If you smoke, you have a 1 in 3 risk of postoperative breathing problems. This can be reduced to 1 in 10 if you stop 8 weeks before your op.

It will improve your lung function which is affected by general anaesthetic – the earlier you stop the more likely you are to prevent postoperative chest infection.

Pre-surgery nutrition tips

Your body needs more nutrients and energy to repair after surgery, including sugars (glucose) and protein (amino acids). Major surgery triggers your body to break down or lose both fat and muscle (known as a profound catabolic state). So prepare by giving your body more of the huge reserves it needs to wound heal and recover afterwards by:

  • eating more
    carbohydrates
    like wholegrain bread and brown rice can even reduce your stay in hospital
  • stock up on nutrient-rich
    fruits and vegetables
    ; and a good amount of lean protein such as fish, turkey, low-fat dairy products, eggs, soya beans and pulses
  • watch your
    alcohol
    intake.
    Drinking more than 4 units per day (equivalent to 2 pints of beer or large glasses of wine) doubles your risk of complications after surgery
  • manage your blood sugar. If you have
    diabetes
    or are insulin resistant, having good glycaemic control has been proven to reduce chances of infection afterwards. If you’re having trouble keeping your blood sugar stable, talk to your diabetes nurse or doctor

Ease worries and reduce stress

  • learn how to relax: try
    deep breathing
    and
    meditation
    (see more below)
  • arrange support from friends and family that can support you when you come out of the hospital. Consider if you’ll need help with meals, driving or walking

Ask questions and raise any concerns

“Don’t be afraid to ask your doctor if you have questions. It can be helpful to make a list of questions or concerns about your surgery, and discuss them with your doctor or surgical team, which can help to put your mind at ease,” says Dr Rebbeca Thomas.

Before you even get to the surgery you may question whether it’s necessary. A study from the University of Michigan in 2015 found that as many as 1 in 5 hysterectomy ops may not have been necessary.

If you do have surgery, your surgical team will give you all the practical information you need around what to eat and drink, medication to bring, and what to wear.

Read more about preparing for surgery
.

Make prehab easier

Try some support to make your operation prep feel easier.

  • St George’s hospital has created videos
    (with Covid in mind, but relevant at any time) which will show you all the tips you need for prehab, making post-operative care more manageable
  • if you need help to move to healthier habits why not sign up for one of the Healthily 28-day plans for activity, healthy eating, mindfulness or sleep via the
    Healthily app

Don’t be surprised on the day of surgery

Postoperative recovery: the essentials – what you need to know

  • when your operation is complete, the anaesthetist will stop the anaesthetic and you'll gradually wake up in a recovery room, before heading back to the ward after your operation.
  • you may feel sore and a little sick, which can be completely normal,” says Dr Thomas. Postoperative nausea and vomiting are more common in women than men
  • other common symptoms include sore throat caused by the tube placed in the windpipe for breathing during surgery; general soreness pain and swelling around the incision site or minor pain around IV sites; restlessness and sleeplessness; thirst; constipation and gas
  • if your surgery is a day case and you don’t need to stay in hospital overnight, it’s a good idea to have someone take you home from the hospital and have an adult around to help you for at least 24 hours after a general anaesthetic or epidural
  • research has shown the earlier a person gets out of bed and starts walking, eating, and drinking after having an operation, the shorter their recovery time will be. But remember to listen to your body and only do activities if they feel comfortable
  • it will take you a few days to a week to recover from an operation such as a breast lumpectomy. For a C-section, expect to take around 6 weeks to fully recover and do your usual activities like driving and exercise
  • the
    enhanced recovery programme
    , also known as rapid or accelerated recovery aims to get you back to full health as quickly as possible – ask your doctor if enhanced recovery is suitable and available for you

Your mindset and postoperative recovery

“Many people can experience anxiety after the operation, particularly when they’re recovering or waiting for wounds to heal. There can be simple ways to deal with this including meditation or speaking with your doctor or nurse for reassurance,” says Dr Thomas.

Deep breathing exercises can also help to reverse the effects of anaesthetic and prevent chest infections.

The easiest way to be mindful and ‘meditate’ is to try a simple breathing exercise. Breathe in through the nose, and feel the air fill your lungs and expand your chest, slowly breathe out through the mouth and release, and repeat.

For some people, a mindful moment can happen while gardening, reading a book or walking. Read more about

meditation and mindfulness
and check out our 28-day
in-app
plans to improve your mind and body wellbeing.

“You can alleviate worries by asking for help from friends and family. If you’re the person who is used to doing everything, this is the time to let go. Ask for support if you need help when you get home,” recommends Dr Thomas.

A positive mindset will help you recover quicker. “Adopt a positive mindset and focus on a good outcome,” says Dr Thomas. Research shows that this will help speed up your recovery.

Avoiding post-surgery complications

Prevent postoperative blood clots

A large-scale 2009 study of almost 1 million women, looking at the postoperative risk of

blood clots
(medically known as venous thromboembolism which includes
pulmonary embolism
and
deep vein thrombosis
(DVT)) found that the rate after surgery is high for middle-aged women.

The risk is higher in the first 12 weeks after an operation.

Prevention

  • take any recommended anticoagulant drugs (blood thinners)
  • wear compression socks
  • keep hydrated before you go to hospital and as you recover
  • get moving and out of bed as soon as you’re able to. You can ask a nurse or physiotherapist for help with this,
    read more here

6 ways to prevent postoperative chest infection

A general anaesthetic can affect the normal way that phlegm is moved from the lungs. Pain from the operation may also make it more difficult to cough or breathe deeply, which means there’s a higher risk of chest infection.

Risks are higher if you have existing conditions (such as COPD, smoking, hypoalbuminaemia, and being functionally dependent) but the main risk factor is the type of surgery, with higher risks associated with surgery to the chest, abdomen, and head and neck compared with other operations.

Here are 5 ways to help yourself to prevent a chest infection post-op:

  1. Get immunised – get flu and covid jabs well in advance of your op.
  2. Stop smoking as soon as you know your op is scheduled.
  3. Talk to your anaesthetist about your options to lower the risk of a chest infection.
  4. Work with a physio to help you breathe and cough effectively.
  5. And a surprising fact – research has found that for some operations brushing your teeth regularly before surgery, can help prevent respiratory infection.

Abdominal surgery: hysterectomy and C section

It can be a very emotional time when you have a serious surgery like a hysterectomy or C-section – both with significant consequences, from the end of your natural fertility to the start of your role as mother to a new baby. Dealing with physical pain and recovery well can help make it easier to deal with the emotional process too.

When you have surgery that cuts into the abdomen it can affect your core muscles – which are directly linked to movement and good posture – in the long term and can take around 2 to 3 months to move comfortably.

Preoperative prehab: strengthen your core

Doing exercises that focus on your deep core muscles (not sit-ups) – simply drawing your navel to your spine and focusing on your posture is enough in pregnancy, or

try these exercises
.

Strengthening all the muscles in the torso will help you recover good posture and move better after the op.

Recovery from abdominal surgery for women

It will take time to get back to normal,

read more about the basics here
.

As mentioned, abdominal surgery is usually major surgery that can knock you sideways both physically and emotionally. If you want more practical advice on how to recover from specific abdominal surgeries for women, follow the links below:

Surgery to treat infertility

Having to go through surgery to help you on your journey to becoming a parent can be an emotional rollercoaster full of hope and concern, highs and lows. Knowing what to expect and being prepared to have a good physical recovery can help you feel stronger to deal with the emotional impact too.

Laparoscopy or keyhole surgery

Laparoscopy
uses a system containing a small camera and operating instruments to see the reproductive organs (ovaries, fallopian tubes and uterus).

Under

general anaesthetic
, the surgeon will make a minor incision in the abdomen to insert the camera that is used in the surgical procedure.

It’s a possible treatment for conditions such as

endometriosis
and
laparoscopic ovarian drilling
(LOD) for polycystic ovary syndrome (PCOS).

Read how a laparoscopy is performed and what to expect from recovery here
.

Breast cancer surgery

“This can be a traumatic and emotional procedure, so it’s really important you discuss your options and the procedure with your nurse or doctor before the op,” says Dr Thomas.

“Not only are you dealing with serious surgery and possible complications, you’re also dealing with having a cancer diagnosis and its implications, and coming to terms with big, sudden changes to a part of the body many women associate with their sense of femininity, sexuality, and identity as a mother. Knowing what to expect, and getting a recovery plan in place can help you cope with the emotional side as well as the physical.”

Mastectomy

All types of

mastectomy
use
general anaesthetic
and involve making a cut (incision) either diagonally or horizontally across your breast so that the breast tissue can be removed. You can read more about what to expect, the procedure itself and
potential complications here
.

It’ll take 3 to 6 weeks to physically recover and of course, this operation can be difficult emotionally, read more about

how to recover from mastectomy
and about options for
breast reconstruction
.

Breast conserving surgery

“Your surgeon will advise on the best treatment for you or different options that might be available. You won't always need the whole breast removed and on some occasions, the tumour can be removed whilst still conserving the breast,” says Dr Thomas.

Options include the following:

  • lumpectomy – a wide local excision, where just the tumour and a little surrounding breast tissue is removed
  • partial mastectomy or quadrantectomy – where up to a quarter of the breast is removed

Read more about

breast cancer treatment here
.

Other surgeries

Read more about other surgeries women may go through, and find out what to expect, how to prepare, and how to recover:

When to seek urgent help or support from GP or hospital doctor

Whatever surgery you undergo there are some warning signs you should never ignore after your op, including:

  • bleeding
  • persistent or new pain – if you're not happy with the pain control, make sure you speak to your doctor or surgeon to find out why it's not controlled and what else could help
  • high-temperature and other
    signs of infection
  • signs of
    blood clots

Remember, don’t be afraid to speak up if there’s something that doesn’t feel right.

If you’re concerned about your condition, don’t forget to use our

Smart Symptom Checker
to explore if any of your post-operative symptoms might need investigating.

Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.