Common concerns following urological surgery
It can be difficult to determine if symptoms after surgery are normal or if you need medical attention. We summarize the most common concerns from patients and provide information about what to expect.
Blood in the urine – It is common to have blood in the urine following many kinds of urological surgery. It should dissipate over time and with drinking plenty of water (approximately 2L per day). If the blood is thick or dark, if you have blood clots, or if the urine continues to be bloody over several days with no improvement, seek medication attention.
Pain – It is normal to have pain following surgery. This may include soreness around the incision, abdominal pain from irritated abdominal muscles, and pain from secondary issues such as constipation. Your urologist may prescribe pain medication or recommend that you take over-the-counter pain medication (e.g. Tylenol® or Advil®).
Constipation – Constipation is a common side-effect of anesthesia and pain medications. Your urologist may prescribe a stool softener or suggest you take mineral oil or milk of magnesia to help with constipation.
Bloating – It is normal to feel bloated following surgery. Avoid eating gas-producing foods, such as flour, beans and broccoli. Also, limit spicy, greasy and fiber-rich foods. Some people find that eating five or six smaller meals during the day is helpful for minimizing bloating.
Redness and swelling around incision – A small amount of redness and swelling around the incision is normal. You may also notice a lump at the top of the incision. This is normal. It is where the suture material is tied. If you have redness greater than ½ inch from the incision, you should seek medical attention. This could be an indication of an infection.
Swelling of the scrotum and penile skin – Swelling of the scrotum and penile skin results from fluid collecting that has not yet been absorbed by the body. The swelling should subside over a few days. It is not harmful. Some patients find that supporting the scrotum with a rolled towel, while lying down, is helpful. Wearing underwear that has a pouch or mesh may also help.
Leakage from the incision area – A small amount of clear or bloody fluid may leak from your incision. If the amount of fluid is enough to soak dressings or if you have a smelly discharge from the incision, seek medical attention.
Numbness around the incision – During surgery, it is possible for some small nerves to be injured. This may result in numbness around the incision point. Sensation should return within three to six months. If numbness spreads or gets worse, contact your urologist.
Cloudy urine – Urinary sediment can cause urine to look cloudy. This is a common occurrence following surgery and should improve with drinking lots of water. If your urine continues to be cloudy over days, seek medical attention, as this may indicate an infection.
Patients with catheters
Leakage – Patients with catheters may experience leakage around the catheter, especially when walking. This can be managed with the use of diapers or absorbent pads.
Bloody discharge – A small amount of bloody discharge around the catheter is common, especially when straining during bowel movements. Patients are encouraged to drink plenty of fluids to dilute the blood and prevent blood clots in the catheter.
Bladder spasms – Patients with catheters may experience strong, sudden urges to urinate, which may be accompanied by bladder pain and leakage of urine or blood around the catheter. This is called a bladder spasm. Bladder spasm is common, particularly during bowel movements. It is recommended that patients lie down until the bladder spasm passes.
If you have any concerns following surgery, call your urologist’s office. In Alberta, you many also call Health Link at 811.
When to seek medical attention
The following problems may indicate an infection or blood clot and require immediate medical attention.
Signs of infection:
- Fever or chills
- Persistent cloudy urine
- Significant swelling and redness around the incision
- Continuous pain at the end of the urethra
- Thick drainage around the catheter
- Bleeding that persists over days or gets worse
- Pain that doesn’t get better or gets worse
Signs of blood clot:
- Urine not draining (catheter) or difficulty urinating
- Sudden weakness or fainting
- Chest pain
- Shortness of breath
- Pain that doesn’t get better or gets worse
- Pain in the calf or swelling in the ankle or leg
In addition to the symptoms listed above, if you experience heavy bleeding (enough to soak through your dressings), seek immediate medical assistance.