Gynecologic surgery can involve incisions in the vagina, the rectum, and the abdomen.

During surgery, we want to avoid contamination of these incisions by stool, which contains harmful bacteria. Harmful bacteria from stool can cause infection in the organs that have been repaired.

As you prepare for urogynecologic surgery, modifying your diet and preparing the bowel will remove most of the stool from the rectum and therefore decrease your risk for infection or related complications after surgery.

Diet Instructions for the Day Before Surgery

• Eat a regular breakfast, light lunch, and only clear liquids after 5:00 p.m.
• Drink clear liquids all day (see examples below).
• Don't eat or drink anything after midnight. This applies to all patients. If you eat anything the morning of your surgery, your surgery will be canceled because it is not safe.

Acceptable clear liquids

• Water
• Broth -- chicken, beef, or vegetable
• Juices -- apple, grape, cranberry (nothing with pulp)
• Soft drinks
• Coffee or tea without milk, cream, or non-dairy creamer. You may use sugar as desired.
• Ice popsicles (no red popsicles)
• Plain Jell-O (no red Jell-O)
• Hard candy

Medications

If a nurse or provider tells you to take some of your medications the morning of your surgery, you may do so with a small sip of water.

Bowel Preparation for the Day Before Surgery

10:00 a.m. GoLytely

Drink eight ounces (240mL) of GoLytely every 10 minutes. You should drink the entire eight ounces at one time. You can expect to have your first bowel movement approximately one hour after you begin drinking the solution.

You may have some abdominal bloating or cramping before your bowels start to move. If you have severe discomfort, stop drinking the GoLytely for a short period of time or drink each portion every 15 to 20 minutes until the discomfort subsides. Once the discomfort subsides, please resume drinking the GoLytely every 10 minutes.

Keep drinking the GoLytely until you have a clear, watery stool that is free of solid pieces. This usually takes at least three to four liters of GoLytely solution.

Mix the solution using the instructions on the bottle. You may refrigerate the GoLytely. Please be sure to drink as much extra water or other clear liquids as you can tolerate during this day in order to avoid dehydration.

5:00 p.m. Magnesium Citrate

Please drink the entire bottle of magnesium citrate in 15 minutes. You may refrigerate it or pour it over ice. Immediately after finishing the magnesium citrate, you must drink eight ounces (one cup) of water.

You can expect your bowels to begin to move within 30 minutes to six hours after drinking the solution. You will have multiple bowel movements over several hours.

Do not take any medication within four hours of drinking the magnesium citrate because the medication will not be adequately absorbed and will therefore alter its effectiveness.

6:00 p.m. Fleet Enema #1

Administer enemas according to pictures and directions on the package. Do not sit on the commode until you are ready to empty your bowels. Sitting on the commode will make you empty your bowels right away.

The longer you are able to retain the solution, the more effective this bowel cleansing will be. Please try to retain the solution for at least two to five minutes.

10:00 p.m. Fleet Enema #2

Please repeat the process for administering an enema.

If you have any questions or problems regarding these instructions, please call our urogynecology nurse at 919-943-1122, Monday through Friday, from 8:30 a.m. to 4:00 p.m.

If you need assistance during the evening, at night, on weekends, or over a holiday, please call 919-684-8111 and ask for the urogynecologist on call.