Bladder Stone Removal (Cystolitholapaxy) Postoperative Instructions

Outpatient surgery

Patients are typically discharged the day of surgery and do not need to stay in the hospital overnight.

Symptoms

You may see blood, debris, small clots and small stones in the urine after surgery. You may have burning when you urinate for several days. You may have mild pain in the low abdomen. These may all be normal symptoms after surgery. Call the office or come to the emergency room if you have fever over 101°F, severe abdominal pain, unable to urinate, very swollen abdomen, large clots in the urine, chest pain or shortness of breath.

Foley catheter

After surgery, you may have a Foley catheter placed in your bladder. A Foley catheter is a tube that carries urine from your bladder to the outside of your body into a bag. This urinary catheter will stay in place until your body heals. If placed, the catheter is typically removed 3-7 days after surgery. If the bladder is slow to function after surgery, the catheter may need to be replaced for a few days.

Diet

After anesthesia, begin with clear liquids. You may take what you like to eat or drink. Depending on how you feel the following day, you may resume your normal diet. The appetite may be diminished the first several days at home. Drink plenty of water and avoid heavy meals. You may see blood, clot, debris or small stones in the urine. The more blood and debris you see, the more water you should drink.

Activity

Be sure to walk at least six times per day. This helps prevents blood clots in the legs, which can travel to the lung and become life-threatening. You may take walks outside. You may go up and down stairs. Your energy will return over the next week or two. You should avoid strenuous activity for 2-4 weeks. This includes activities such as running, tennis, lifting weights, etc. You should avoid carrying anything over ten pounds for 2-4.

Medication

You can obtain good pain relief by taking two acetaminophen (Tylenol) every four hours while awake for the first several days. You may also get a prescription for pain pills. You can use these prescription pain pills in addition to acetaminophen every four hours. Do not exceed 4000 mg acetaminophen per day.

You may receive a prescription for a stool softener to avoid straining after surgery. Anesthesia and prescription pain pills with narcotic can make you constipated. Straining for bowel movements may slow down the body’s healing process. Take plenty of fiber and water or over the counter stool softener. Senna (Sennagen, Senokot) is an over-the-counter laxative that is very good for avoiding constipation. Take one to two 8.6 mg tablets daily. If you are taking the prescription pain pills (narcotic), it is a good idea to take Senna as well as narcotic medications can make you constipated. Take less Senna or stop Senna if the stools are loose. Milk of magnesia, Metamucil and Benefiber are other over-the counter medications that can be used to avoid constipation. You may also use over-the-counter Dulcolax (bisacodyl) suppositories daily. It may take a few days to have your first bowel movement after surgery.

Bathing

You may bathe and shower as you normally do.

Postoperative appointment

You may need a postoperative visit in approximately 7-10 days after your discharge.

Call the office to make an appointment if you do not already have one. Call the office or come to the emergency room for fever over 101o F, bright red blood in the urine with large clots, difficulty breathing, chest pain, dizziness, nausea, vomiting, leg swelling or pain.