Your recent endoscopic surgery requires special post hospital care. There is no skin incision but your urinary tract is very sensitive. You may have pain in your side during urination or urinary frequency. These occur because of the ureteral stent and will resolve after the stent is removed. Drink lots of fluids! You will see blood in the urine off-and-on until the ureteral stent is removed. This is expected and normal after this procedure. When the urine turns red, limit your activities and drink plenty of fluids. It is normal to experience bladder spasms, flank pain, and blood in your urine while the stent remains. Drink plenty of fluids to ensure urine is draining.
Finally, if there is a string on your stent, DO NOT PULL IT until the specified date! Minimize wiping. On the specified date, find a comfortable place to sit or in the shower, and pull the string. An approximately 12 inch tube (stent) will come out over the next few seconds, and that’s it! This is relatively painless other than an odd sensation. If you do not feel comfortable with this, call the clinic to schedule a nurse visit appointment to have it removed. If it accidentally comes out, you do not need to go to the ER or call the clinic necessarily. Just monitor your symptoms, if you have fever > 101F, severe nausea, vomiting, or severe pain, then call clinic or go to the ER.
You may return to your normal diet immediately. To keep your urine flowing freely and to avoid constipation, drink plenty of fluids (water, juice, milk) during the day (8 glasses).
Your physical activity is to be restricted, especially during the first weeks of recovery. During this time use the following guidelines:
- NO lifting heavy objects (anything greater than 10 lbs) for 4 weeks.
- NO driving a car and limit long car rides for 2 weeks.
- NO strenuous exercise, limit stair climbing to minimum for 4 weeks.
- NO severe straining during bowel movements – take a laxative if necessary.
- DO drink plenty of fluids to keep your urine flow brisk. (This will flush out small clots as they continue to form as part of the healing process.)
- DO keep a urinal near. (You may have little warning before you need to empty your bladder. Some dribbling and poor control is normal for the first several weeks of healing.)
It is important to keep your bowels regular during the post-operative period. You must keep from straining to have a bowel movement. A bowel movement every other day is reasonable. Use a mild laxative if needed and call if you are having problems. (Milk of Magnesia 2-3 Tablespoons, or 2 Dulcolax tablets for example). You may purchase from any drug store.
We will add the following medications:
- Norco (narcotic pain medication)
- Colace (stool softener)
- Pyridium and/or Oxybutynin (urethral irritation or bladder spasms)
- Tamsulosin (stent pain)
You should resume your pre-surgery medication unless told not to. In addition you will often be given an antibiotic to prevent infection, tamsulosin to help with ureteral stent pain and stool softeners. Pyridium, the medication for dysuria, may discolor the urine. Your urine may appear orange or reddish in color. Take norco as needed for pain. Do not drive or consume alcoholic beverages while taking this narcotic medication. If your pain is not severe, you may take Tylenol as directed. Do not take Tylenol at the same time as norco. Do not take Tylenol within 6 hours of taking norco. Also, do not drive until you are pain free and feel that you can respond quickly in an emergency. Ask your doctor before you resume driving if you are not sure. These should be taken as prescribed until the bottles are finished.
PROBLEMS YOU SHOULD REPORT TO US
- Fevers over 101.5 Fahrenheit.
- Heavy bleeding or clots (See notes above about blood in urine).
- Inability to urinate.
- Drug reactions (Hives, rash, nausea, vomiting, diarrhea).
- Severe burning or pain with urination that is not improving.
- If you believe you are having a complication, please come into the Urology Clinic between weekday clinic hours (0900-1600) or call the clinic at 303-388-9321. Someone will always be available to answer your call day or night.
You will need a follow-up appointment with the doctor who performed your procedure to monitor your progress. Call Denver Urology Clinic at 303-388-9321 to make the appointment specified in your discharge paperwork.