Appointments
An appointment is required for a consultation with Dr Yong. It is recommended to provide a GP referral prior to your initial visit. All referrals will be triaged accordingly and an appointment will be offered at your earliest convenience. Dr Yong usually reserves an emergency appointment for patients who require urgent attention. It will be useful to bring along any relevant investigations e.g. blood or urine test, ultrasound, CT scan or MRI and list of medications that you have been taking.
The initial appointment takes approximately 30 minutes. Dr Yong will perform a through assessment and clinical examination during this visit before providing his recommended management plan. A follow-up appointment typically takes approximately 15 minutes. Dr Yong offers telehealth appointments for select patients if face to face appointment is inconvenient. If a urodynamics study is required, an additional 30 minutes appointment time will be required to perform the test.
Urodynamics
Dr Yong performs urodynamics testing at Epworth Freemasons, East Melbourne and Frances Perry House, Parkville. Urodynamics is a bladder test to accurately assess your bladder function and to guide the next management steps. A cystoscopy (camera into your bladder) will be performed at the same time. The entire procedure will be performed awake, therefore no fasting is required. However it is recommended that you come with a comfortably full bladder for the test. After the test, it is recommended you increase your fluid intake for the day and use Ural to reduce discomfort when passing urine. Dr Yong will discuss the results and subsequent management plan on the same day.
Before & after Surgery
If surgery is required, written surgical consent will be completed as part of the surgical booking. Dr Yong operates regularly at Epworth Freemasons, East Melbourne and Frances Perry House, Parkville. Once a surgery date is decided, you will be sent a surgical quote and informed financial consent details. Dr Yong’s surgical fees are in line with Australian Medical Association (AMA) recommended fees. It is your responsibility to check with your private health insurance company to ensure that you are adequately covered for the relevant expenses.The hospital pre-admission team will be in touch with you closer to surgery date to ensure that you have fulfilled their check list. Your responsible anaesthetist will normally see you on the day of surgery, but may occasionally contact you before surgery if you have major health issues. It is extremely important for you to notify Dr Yong during surgery booking if you are on any blood thinning agents such as Apixaban, Pradaxa or Warfarin or long acting diabetic medications e.g. Jardiamet, Xigduo XR, Janumet or drugs in a similar class as additional precautions and preparation will be needed before surgery. You may be required to use a partial bowel preparation in some pelvic reconstruction surgery cases. Fasting instructions for surgery will be sent out with the surgical confirmation letter.
A typical pelvic floor reconstruction surgery will require 2-3 nights inpatient stay and some surgery will be performed as a day procedure.
Things to expect after surgery:
Some discomfort around surgical site usually managed with paracetamol or Neurofen. A short term opiate analgesia (Endone or Tramadol) may be used for breakthrough pain
Vaginal bleeding typically lasting around 7-10 days
Vaginal discharge from surgical pelvic organ prolapse (SPOP) device. The discharge can be malodorous due to mixture with blood. Washing with shower head and drying may reduce this problem
Trouble emptying bladder - patients normally have an indwelling catheter for 24-48 hours after surgery. Some patients may require longer period of bladder rest and occasionally going home with a catheter for a week. A patient who is discharged with a catheter will be readmitted in a week to ensure that the bladder is able to empty adequately.
Constipation is not uncommon after pelvic floor surgery. This can be easily treated with laxatives. Dr Yong recommends his patients to open bowel before discharge from hospital.
A postoperative review will usually be undertaken in four weeks to remove the SPOP device. Patients without the device will be reviewed around 6 weeks. The general recommendations after pelvic floor surgery is to avoid driving for the first two weeks and no strenuous activities such as exercise or heavy lifting, intercourse, swimming or spa pool for at least 6 weeks. A patient who has had fascia lata surgery may be required to wear supportive shorts or bandages on the thigh for a few weeks to provide additional support when mobilising.