Most children recover from this operation without complications. However, recovery of the bladder after surgery may be uncomfortable for up to a few weeks as the bladder heals.
There are no stitches to remove after this operation. Sometimes at the corner of the incision, a red “pimple” develops and a few drops of pus may ooze. This is not an infection, but simply reaction from the body to dissolve the suture. Redness and firmness of the incision(s) will gradually disappear.
Sometimes part of the white stitch used to close the incision will appear at the corner of the wound and linger for several days or even a few weeks before it falls off.
Generally, we use bandaid strips to cover the incision. These do not need any special care and will gradually come off. If they have not fallen off after a few weeks, you can gently remove them after soaking in a bathtub. You do not need to treat the wound with any cream or ointment.
You may notice the wound is red and firm to the touch. As mentioned above, this is from reaction to the stitches under the skin and not a sign of infection.
Wound infections after this operation are very uncommon, but would be suspected when redness and swelling begin to spread more than 1/2 inch away from the incision around 7 days after surgery.
There is no need to restrict activity after surgery. School-aged children and teenagers should not participate in coach-directed activities for approximately 2 weeks.
Regular voiding (going to the bathroom to pee) approximately every 2 hours throughout the day is recommended in the weeks following surgery. Your child may have to void (pee) even more often than usual with some urgency, and may experience accidents (bedwetting and/or daytime wetting) for a few weeks after surgery while the bladder is healing. The medication listed below (oxybutynin) may help with this, and this usually gets better with time.
Indwelling stents may be left inside the ureter (the tube traveling from the kidney to the bladder) to help prevent blockage of urine depending upon the exact type of surgery. The is different than the catheter (tube that drains the bladder) that is used for up to a few days after surgery. Your surgeon will let you know on the day of surgery if we need to leave a stent inside. If we did, we need to schedule an additional minor procedure to remove the stent in several weeks.
When a stent is left in place, older children, teenagers, and adults may experience bladder spasms, which is pain in the bladder and low back that comes in waves, like a muscle cramp, particularly when voiding (urinating). To help with this, you should give ibuprofen and a bladder muscle relaxant named oxybutynin (also called Ditropan; see medications below).
Blood in Urine
This is normal after these surgeries, and may continue to occur off and on for a few weeks after surgery (and the entire time the stent is in place if one is used). The urine may be colored anywhere from ‘pink lemonade’ to ‘tomato juice’. This is normal. The darker the urine gets, please try to increase fluids to lighten the urine to ‘fruit punch’ or ‘pink lemonade’ color. If you/your child is passing large clots of blood (bigger than quarters or silver dollars), please contact our office.
We recommend you sponge bathe the first day after surgery, and then resume normal bathing 48 hours after the operation. Older children and teenagers can shower the day after surgery. If your child is having bladder spasms, soaking in a warm tub may help.
Bandages that are still in place can be immersed in water and then gently patted dry.
Infants need only ibuprofen (Motrin or Advil) and Tylenol to control pain after surgery. We recommend you give these on an alternating schedule without waiting to see if they will have pain during the first 48 hours after surgery. You can alternate them, giving first the ibuprofen, then 3 hours later the Tylenol, then 3 hours later another dose of ibuprofen, etc.
Older children, teens, and adults should also take ibuprofen on a regular schedule for the first 48 hours, alternating with either Hycet or Norco (a narcotic that also contains Tylenol) or plain Tylenol for pain around the incision.
Older children, teens, and adults may also experience bladder spasms, which is pain in the bladder and low back that comes in waves, like a muscle cramp, particularly with urinating. To help with this, you should give ibuprofen (Motrin or Advil) and a bladder muscle relaxant named oxybutynin (also called Ditropan).
Please give oxybutynin on a regular basis, following the instructions on the bottle, whenever your child is experiencing bladder spasms.
Narcotics and oxybutynin both may cause constipation, so you may wish to increase fruits and vegetables during recovery. If the patient develops constipation, which can make bladder spasms worse, any over-the-counter laxative (such as Miralax) can be used for relief.
We may recommend antibiotics after this surgery depending on multiple factors.
Temperatures even as high as over 101ºF can be normal the first night after surgery. Fevers and irritability the first few days after surgery may indicate a virus or ear, throat, or lung infection. You should call your primary care physician if this occurs.
Wound infections with fever are very unusual after this operation, and do not occur until about a week after surgery.
Urine infections can occur, usually 3-5 days following surgery. If your child has a fever more than 101ºF around this time, please email our nurse at [email protected] during normal business hours or call our office anytime for instructions.
It is very unusual to develop a problem that requires urgent attention after this surgery. If you have questions, we encourage you to email our nurse at [email protected] during normal business hours.
If you believe there is an urgent issue, you can call us any time at 214-618- 4405.
Please do not take your child to the emergency room with questions or concerns about his/her wounds without first contacting us. Nearly all pain and/or fever issues can be addressed without having to visit an emergency room! Many times an emailed picture of the area you are concerned about will help us to decide if urgent medical attention is needed.
We normally schedule the first follow-up with your surgeon around 3 months after the operation with an ultrasound. If a stent is needed during surgery, then we also need to schedule a minor procedure to remove the stent.