Nephroureterectomy Postoperative Instructions
After anesthesia, begin with clear liquids. You may take what you like to eat or drink. Depending on how you feel the following day, you may resume your normal diet. The appetite may be diminished the first several days at home. Drink plenty of water and eat plenty of vegetables and fruit to promote healing and avoid constipation. Avoid heavy meals.
- Be sure to walk at least six times per day. This helps prevents blood clots in the legs, which can travel to the lung and become life-threatening. Start walking as soon as possible after surgery, either the afternoon of surgery or the morning after surgery. You may take walks outside. You may go up and down stairs.
- Do not lift more than 10 pounds for 6 weeks. This stopped to prevent hernia or bulge at the incision site.
Avoid strenuous activity for 6 weeks. This includes activities such as heavy chores, strenuous exercise or lifting weights.
- You may tire easily with minimal activity. This is normal after surgery. Your energy level will gradually return in 6 to 8 weeks.
- You will have a foley catheter, a plastic tube that drains the bladder, in place after surgery. You may have this for 7 to 10 days after surgery. The nurses in the hospital will show you and your family how to care for the catheter. You will be taught how to use a smaller bag during the day which can be worn under clothes. You will be taught how to switch to a larger bag for night time. The catheter should always be secured to the leg so there is no tension or pulling on the catheter. Take care the catheter does not get dislodged when turning in bed, getting into or out of a chair or car.
- You may see blood or small debris in the catheter tubing and bag. This is normal. Call the office or come to the emergency room if the catheter does not drain for 4 hours or there are large (dime sized) clots.
You may have a surgical drain in place after the surgery. This removes excess fluids from the body. If the output is small, it may be removed before you leave the hospital. If there is still quite of bit fluid draining, you will be instructed how to care for the drain at home. Keep a record of how much fluid comes out of the drain. Bring this record when you return to the office so the nurse can review it and determine when it is safe to remove the drain. This will likely be a few days after you are discharged from the hospital.
You may take a shower as you normally do starting the day after surgery. You may allow the water to run over the incision then pat dry. Avoid submerging in water for three days. You may have staples in the incision. These will be removed postoperatively. You do not need to place anything over the incision but may place a gauze if there is oozing or spotting.
- Resume your regular medications or follow instructions given at the hospital.
- A pain medication to be taken by mouth may be prescribed for you. Narcotic pain medications are addictive and constipating and therefore should be discontinued as soon as possible.
- NSAIDs (Alleve, ibuprofen, Motrin) decrease pain and inflammation. These may be prescribed or can be purchased at a drug store without a prescription. Ask your provider if you have history of low kidney function.
- Acetaminophen (Tylenol) helps decrease discomfort after surgery. This is available at any drug store without a prescription. Some narcotic pain medicines also contain acetaminophen. Do not take more than 3000 mg acetaminophen total per day. Ask your provider if you have history of liver problems.
Surgery, general anesthesia and prescription pain medicine can make you constipated. Straining to have a bowel movement can put stress on the surgical site and should be avoided. Take plenty of water, vegetables and fruit to avoid constipation. It may take a few days to have your first bowel movement after surgery.
A stool softener should be taken by mouth twice a day to avoid constipation. Stool softener or laxative may be prescribed. These are also available at any drug store without a prescription. These include docusate (Colace), Senna (Senokot or SennaGen), bisacodyl (Dulcolax) and magnesium hydroxide (Milk of Magnesia). Decrease or stop the stool softener for loose stools or diarrhea. You may use suppositories or enemas.
Post operative appointment
Patients often have a nurse visit 1 week after surgery to remove skin staples. Strong Band-Aids called Steri-Strips are often placed at that time. Steri-Strips can be trimmed as needed. These should be removed once there been in place for 2 weeks.
Patients typically have a 2 week appointment with the surgeon to review pathology. Call the office to make an appointments if you do not already have them.
Pathology report is typically available on the patient portal as soon as it is read by the pathologist. The surgeon we'll review the pathology with you and discuss next steps.
When to call the office or come the emergency room
- Fever over 101 degrees Fahrenheit (38.3°C), severe abdominal pain, unable to urinate, difficulty breathing, chest pain, palpitations, nausea or vomiting, leg swelling or pain.
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