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POST-OP INSTRUCTIONS
Cystoscopy & Ureteroscopy

DEFINITIONS

  • Fever: elevated body temperature; if greater than 101°F, notify your surgeon

  • Rash: new red spots that develop on the skin

  • Constipation: not having regular bowel movements (example: one large bowel movement per day is expected)

  • Hematuria: blood in the urine; this is expected whenever there is a catheter and increases in volume and redness when patients are moving/walking more

  • Bladder spasms: the catheter can trigger the bladder to contract forcefully, causing a sudden desire to void which can cause pain and discomfort

  • UTI: consistently cloudy and odorous urine with burning

  • Dilation: stretching the urethral stricture

  • Cystoscopy: camera attached to flexible endoscope to evaluate urethra and bladder for fistulas, strictures, and masses/lesions/stones

  • Ureteroscopy: camera attached to flexible endoscope to evaluate urethra, bladder, ureter, and/or kidneys for fistulas, strictures, and masses/lesions/stones

  • Ureteral stent: similar to a urethral catheter except this smaller tube is placed in the ureter (tube connecting the kidney to the bladder).

 

GENERAL INSTRUCTIONS

 

  • Activity: Avoid any activity or position that puts strain or tension on the catheter or stent.

  • Return to work: usually 1-2 days after surgery. For jobs that are strenuous, 2-6 weeks off may be more appropriate, especially if a catheter/stent is still required.

  • Diet: eat normally whenever your appetite returns. Water is a good drink choice.

  • Showering: may shower and bath without restrictions

  • Driving: Do not drive yourself until you are completely off prescription pain meds and catheter/stent free.

 

SURGICAL SITE CARE

  • Catheter care: know where your catheter is at all times.

    • Putting ointment at the tip of the penis where the catheter is visible may make it more comfortable.

    • Plugging: plugging the end of the catheter (where the drainage bag tubing is attached) is ok when you are walking more.

    • There will be leakage of bloody or cloudy fluid around the catheter; this is seen frequently and is expected. It will resolve when the catheter is finally removed and patients are urinating more regularly

 

POSTOPERATIVE CONCERNS

 

  • Hematuria: common with a catheter and usually resolves several weeks after the catheter is removed. Hydrate regularly with water to help with this.

  • UTI: Urinary Tract Infection. This is seen when the urine is consistently cloudy and more smelly than usual. Start the antibiotic provided and contact the office to let them know.

  • Pain: this is very common and should stay about the same for a few days and gradually improve thereafter. It is not normal if the pain progressively worsens without any activity (that is, pain not brought on by any particular activity).

  • Bladder spasms: with a foreign body (the catheter/stent) in your bladder, some patients get bladder spasms. Oxybutynin (aka Ditropan) can help decrease this pain/discomfort.

  • Constipation: very common after surgery especially when needing to take pain meds regularly; make sure to take miralax or other stool softener while you are on pain meds.

 

POSTOPERATIVE MEDICATIONS

 

  • Tramadol 50mg tablet: pain medication; take 1-2 tablets every 6 hrs as needed for breakthrough pain.

    • Take over the counter Tylenol 975mg every 6-8 hrs instead if the pain is manageable. This will likely be needed for 3-7 days.

    • Over the counter ibuprofen 200-400mg is acceptable for further pain control if needed.

      • Take it with meals. Ibuprofen may be taken at the same time as Tramadol and Tylenol since they are not in the same class.

    • Side effects*: itchiness, constipation, diarrhea, nausea, sweating, insomnia; liver problems (when acetaminophen is included)

  • Miralax: stool softener to be taken while on pain medication; 17g by mouth daily (mix powder with liquid of your choice)

    • Side effects*: nausea, gas, drowsiness, stomach ache, loss of appetite

  • Ditropan (oxybutynin): take 1 tab (5mg) every 8 hrs as needed for bladder spasms

    • Side effects*: dry mouth, headache, constipation in 5-10% of patients

  • Bactrim (trimethoprim/sulfamethoxazole): DS by mouth, twice per day, for 7 days (take only as directed)

    • Side effects*: itching, rash, diarrhea, nausea, headache

    • If allergic to this or sulfa drugs, can substitute with another antibiotic like Augmentin, Clindamycin, or Ciprofloxacin

 

*This is not a complete list of all the side effects that may occur with these medications. Getting side effects are infrequent; the side effects named are the more common ones for those who do experience side effects. Please call the office if you have any questions about your medications. Definitely notify us if you notice a rash that started soon after starting a new medication. If you notice shortness of breath or difficulty breathing after taking a new medication, call 911 and/or go to the nearest emergency room. You may be having a serious allergic reaction to the medication.

 

Call office or your surgeon for fevers, chills, redness and pus from the incision, or pain not controlled with pain medication. If after hours, call the office phone number and leave a message; urgent messages will be relayed to the surgeons. If you feel it is a medical emergency and need immediate help, call 911 and/or go to the closest Emergency Room.

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