Partial Nephrectomy Postoperative Instructions

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. Eat plenty of vegetables and fruit to avoid constipation.

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 go up and down stairs. You may take walks outside. You may go up and down stairs. You may tire easily with minimal activity. Avoid strenuous activity of lifting more than 10 pounds for 6 weeks.

Foley catheter

A plastic tube called a Foley catheter is typically left in place overnight to drain the bladder. This is usually removed the day after surgery at 6:00 AM. Once you have urinated or by 10:00 AM, an ultrasound is used to check how much residual urine remains in the bladder. If you are unable to urinate or unable to urinate completely, the Foley catheter will be replaced. You will go home with this for a few days. Your nurse will show you how to use this. If you go home with a catheter, he will need a nurse visit, typically in 3-7 days, to remove the catheter in the morning. You will then come back to the office the same day at 1:30 PM for a bladder scan to make sure the bladder is emptying well.

Surgical drain

A surgical drain called a Jackson Pratt or JP drain may be in place after surgery to drain excess fluid and blood. This will be removed before leaving the hospital or at your postoperative appointment.

Hospital Stay

Patients may stay overnight in the hospital for monitoring, intravenous fluids and pain management.

Bathing

Shower daily. Let the water to run over the incision then pat dry. Avoid submerging in water for two days. You may have staples in the incision. You do not need to place anything over the incision but may place a gauze if there is oozing or spotting.

Medication

You can obtain good pain relief by taking two acetaminophen (Tylenol) every four hours while awake for the first several days. You will also get a prescription for pain pills. You can use these prescription pain pills in addition to acetaminophen every four hours. The prescription medication may contain acetaminophen. Do not exceed 3000 mg acetaminophen per day.

You may receive a prescription for a stool softener to avoid straining after surgery. Take plenty of fiber and water or over the counter stool softener to avoid constipation. It may take a few days to have your first bowel movement after surgery. You may use over the counter MiraLAX, milk of magnesia, docusate (Colace), senna (sennaGen, Senokot), Dulcolax (bisacodyl). You may use over-the-counter suppositories [such as Dulcolax (bisacodyl)] or enemas (such as Fleets).

Postoperative appointment

Skin staples are typically removed at a nurse visit 1 week after surgery. You will need a postoperative visit in approximately 7-10 days after your surgery to review the pathology report with your surgeon. Call the office to make these appointment if you do not already have them.

When to call the office

Fever over 101°F, difficulty breathing, chest pain, palpitations, nausea or vomiting, leg swelling or pain. Come to the Emergency room if the office is closed.