Postoperative Care Instructions for Pyeloplasty, Nephrectomy, Reimplant and Ureterostomy

The below instructions are general guidelines. Specific changes or instructions for your child may differ. Please follow instructions given to you by your surgeon and CHOC Urology staff.

Thank you for choosing CHOC for surgery. A pyloplasty, nephrectomy, reimplant and ureterostomy are surgeries that are performed in an operating room and usually require one to two nights in the hospital after surgery.

Diet after surgery

Patients only consume clear liquids immediately after surgery and then progress to a regular diet as tolerated. The anesthesia can cause some stomach discomfort and nausea.

Pain management

Patients may be sent home with Tylenol #3 to be taken as needed for pain. Most children need it for one to three days. If the doctor prescribed Tylenol #3 (with codeine) tablet or elixir, please try to give it to the patient as little as possible because codeine can cause constipation, which can be painful. Miralax is an over the counter stool softener and can be used to relieve constipation if it occurs. Whenever possible, try to use ibuprofen (also known as Motrin or Advil) instead of the Tylenol #3. Do not take Tylenol #3 and Tylenol at the same time – this can be an overdose and is harmful. If needed, Ibuprofen and ONE Tylenol product can be taken within the same time period.

To reduce swelling and discomfort, place a sandwich bag full of ice covered in a cloth or towel over the surgical area. Never apply ice directly to the skin.

Dressing instructions

The incision(s) will be tender for the first week or so. The dressing is often covered with a bandage. There will also be a gray flaky substance, called Dermabond. This is a glue that is placed over the stitches. Both the glue and the stitches will fall off on their own in about two weeks. Please do not pick at the glue or the stitches. The bandage will be removed in the hospital or office. If instructed you may remove it at home prior to a follow-up office visit.

Drains

There may be one to two drains (or stents) left near the incision site. They may or may not be connected to a drainage bag or have gauze over them. Caregivers will be provided specific instructions on the type of drain and how to care for drains before leaving the hospital. Many drains are secured to the child with a stitch and are removed in our office. Other drains may be entirely inside the child’s body and need to be removed in the operating room during a simple procedure at a later date. It is normal to have a small amount of blood in the urine, back pain, bladder pain, pain at the tip of the penis and frequent urination while the stent and drains are in place.

Catheter

Patients may be sent home with a Foley catheter in place. The nurse will teach you how to care for it before leaving the hospital. Please follow instructions for removal or it will be removed in the office.

Bathing instructions

Generally, if drains are present you should not submerge the child in water. Instead, please perform sponge baths. If no drains are present, baths or showers are fine 24 hours after surgery.

Activity restrictions

For two to three weeks after the surgery the child should avoid trauma to the surgical area and avoid rough-housing, contact sports and physical education. At the follow-up appointment about one week after surgery, our staff will provide more specific directions as to when it is safe to return to activities. Following surgery, children may return to school within a few days, as tolerated.

Ultrasound

The patient will receive paperwork in the mail to schedule an ultrasound after the procedure. If the child has a stent, their ultrasound will usually take place four weeks after the stent is removed. If the ultrasound is done at a facility other than St. Joseph’s or CHOC, please ask the radiologist to put the ultrasound on a CD and bring it to your next appointment. Please do not mail to us.