Emptying your bladder after surgery

The Australian Centre for Female Pelvic and Vaginal Rejuvenation
The Australian Centre for Female Pelvic and Vaginal Rejuvenation

Patients undergoing prolapse/incontinence surgery will either have had a spinal (regional) or general anaesthetic. The ward care of patients having undergone either form of anaesthetic should always be appropriate for the route of anaesthesia.

The following guidelines refer only to management of the bladder after the catheter has been removed after prolapse, incontinence surgery or hysterectomy

THEATRE

In theatre the patient will have had a Foley catheter inserted in the bladder. This will be on free drainage when the patient returns to the ward.

In most cases the patient will not have a vaginal pack unless an additional procedure such as a vaginal wall repair has been performed. If a vaginal pack has been sited then this can be removed on the morning following surgery (at the same time as the catheter unless otherwise instructed).

ON THE WARD

The Foley catheter can be removed at 6am the morning following the operation unless the patient has had a secondary procedure that may delay their mobility (in such a case Dr Onuma will write specific instructions regarding the timing of removal of the Foley catheter). If the catheter is removed, the vaginal pack is not to stay in situ.

The patient is then encouraged to void in her own time. However, if the patient has not voided within four hours, the bladder volume should be assessed using the designated bladder scanner and Dr Onuma advised about the findings. Once the patient voids, both the voided and the residual volume should be measured. If, on two consecutive occasions, the residual volume is less than 100ml no further measurements (voided or residual volumes) are required. If, however, the residual volume is greater than 300ml on two consecutive occasions further instructions should be sought from Dr Onuma. If the patient reports any discomfort related to voiding or their bladder scan suggests a residual volume >500ml then further advice should be sought from Dr Onuma.

 

NB

  1. Patients should never be instructed to wait for any length of time before voiding.
  2. Patients should have voided or had their bladder emptied by four hours after the previous void or removal of the Foley catheter.
  3. In order to avoid damage to the patient’s bladder, if in any doubt discuss with Dr Onuma.

The following guidelines refer only to management of the bladder after most day case surgery procedures

THEATRE

In theatre the patient will have had a Foley catheter inserted in the bladder. This will be on free drainage when the patient returns to the ward.

ON THE WARD

The Foley catheter can be removed at between 2-4 hours after surgery as documented by Dr Onuma.

The patient is then encouraged to void in her own time. However, if the patient has not voided within four hours, the bladder volume should be assessed using the designated bladder scanner and Dr Onuma advised about the findings. Once the patient voids, both the voided and the residual volume should be measured. If, on one occasion, the residual volume is less than 150ml no further measurements (voided or residual volumes) are required. If, however, the residual volume is greater than 300ml on two consecutive occasions further instructions should be sought from Dr Onuma. If the patient reports any discomfort related to voiding or their bladder scan suggests a residual volume >500ml then further advice should be sought from Dr Onuma.

 

NB

  1. Patients should never be instructed to wait for any length of time before voiding.
  2. Patients should have voided or had their bladder emptied by four hours after the previous void or removal of the Foley catheter.
  3. In order to avoid damage to the patient’s bladder, if in any doubt discuss with Dr Onuma.
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Laser Vaginal Rejuvenation Institute of Adelaide
Laser Vaginal Rejuvenation Institute of Adelaide