Robotic Ureterolysis and Pyeloplasty

Care After

Refer to this sheet in the next few weeks. These instructions provide you with information on caring for yourself after your procedure. Your caregiver may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your caregiver if you have any problems or questions after your procedure.

HOME CARE INSTRUCTIONS

Catheter

  • This is the tube that was placed in your bladder to drain urine. It is often removed before you leave the hospital. However, your caregiver may decide to leave it in for a few days.

  • Take care of your catheter as instructed by your caregiver. Call your caregiver if you have any questions.

  • You may have blood come out in the urine even if the catheter was removed. It is usually dark and brownish, perhaps with some redness. This is usually a minimal amount. Call your caregiver if the blood increases in amount or if it gets significantly redder.

Stents

  • Tubes called stents may be placed in the ureter. Stents drain urine from the kidney to the bladder.

  • The stent keeps urine from draining out of the incision before the ureter is healed and helps it to heal more quickly. The stent is often removed in 4 to 6 weeks.

  • Stent removal will be done in the doctor's office.

  • You do not need to do any special care for a stent.

Rubber Drains

  • After a pyeloplasty, a flat rubber drain may be placed in your side near the bottom of your ribs. It will be sewn in with a stitch. This drain allows any urine leaking from the ureter cut (incision) to come out.

  • This drainage is often minimal, but it is normal for the drainage to be blood-tinged.

  • Change the bandage as needed to keep it fairly dry.

  • Call your caregiver if the drainage or blood suddenly increases.

  • This drain is often removed when you have your stitches (sutures) taken out, about 7 to 10 days after surgery.

  • The wound is not closed by a suture. It will heal closed by itself after the drain is removed.

Wound Care

  • You will have many small incisions where the robotic instruments were placed during surgery.

  • Keep these incisions clean. Make sure your hands are clean before touching the area. This is important. It helps prevent infection.

  • Do not get the incisions wet until your caregiver says it is okay. Take only sponge baths for a few days. Then, you can usually take a shower. Do not take a tub bath for several weeks.

  • The sutures are usually removed at your first follow-up visit.

  • Call your caregiver if any incision suddenly gets red, starts draining pus, or develops a lump of blood under it.

Pain

  • The incision areas may be tender or sore, but they usually do not cause much pain.

  • During robotic surgery, carbon dioxide gas is put into your abdomen to stretch the area so surgery can be performed. It takes several days for this gas to be absorbed. This stretching of the abdomen is sometimes uncomfortable.

  • Sometimes, the carbon dioxide causes pain under the rib cage, in the back, or in the shoulder (referred pain).

  • Only take over-the-counter or prescription medicine for pain, discomfort, or fever as directed by your caregiver.

  • Do not take an excessive amount of narcotic pain medicine. Use other methods to deal with pain, such as distractions (watch TV, play video games, listen to music). Taking too much narcotic pain medicine can actually increase your pain.

  • Press a pillow firmly against your stomach before coughing (stomach splinting). This should reduce pain.

  • If you cannot have a bowel movement (constipated) due to the narcotics, take a stool softener, if prescribed, to make the bowels move easier.

  • Wear loose clothing. Avoid belts or tight waistbands. Do not wear anything that fits tightly over the surgery area.

Activity

  • Walk as much as possible. Take it slow, but remember activity is important. Try to walk a little longer each day.

  • Activity helps you absorb the carbon dioxide and makes the swelling go down.

  • Do not do anything that requires great effort for several days.

  • Do not lift anything more than 10 lb (4.5 kg) for about 1 week.

  • Ask your caregiver for an activity plan during your first follow-up visit.

  • Do not drive until your caregiver says it is okay. Do not drive while taking narcotic pain medicine. It may be several weeks before you can drive again.

  • When you can return to work will depend on the type of work you do. Talk to your caregiver about this.

Diet

  • Limit your diet to liquids until you begin to pass gas frequently.

  • Once you have a bowel movement, you can usually go back to a normal diet.

  • Fluids help keep the stool soft and help you have a bowel movement.

SEEK MEDICAL CARE IF:

  • You have questions about any medicine.

  • You feel sick to your stomach (nauseous) or throw up (vomit) for more than 2 days after the surgery.

  • Your pain gets worse.

  • You have trouble urinating or it hurts to urinate.

  • You develop a cough.

  • You have an oral temperature above 102° F (38.9° C).

  • You get tenderness in your calf muscles.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have chest pain.

  • You cannot urinate.

  • You have an oral temperature above 102° F (38.9° C), not controlled by medicine.