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Going Home After Surgery (Pediatric Urology)

Home Care and Instructions

Kinderchirurgie

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Sophia Kinderziekenhuis
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Going Home After Surgery (Pediatric Urology)

Discharge Consultation

Before going home, you will have a discharge consultation with a nurse, nurse practitioner, or doctor. During this consultation, the following topics will be discussed:

Postoperative home care instructions
Home care rules and restrictions
Prescribed medications and how to administer them

Please ask any questions if something is unclear.

Home Care Instructions

Only the checked items apply to your child.

Catheter or Drain

Your child has one of the following:

Kidney Drain (PCN – Percutaneous Nephrostomy)

A kidney drain is a tube inserted into the kidney to drain urine. The tube runs from the kidney to the outside of the body. Urine is drained externally through this tube.

Bladder Catheter

A bladder catheter is a thin tube. This tube runs from the bladder to the outside of the body. Urine therefore drains directly from the bladder to the outside. There are three different types of bladder catheters. Your child has one of the following:

A catheter with a balloon inside the bladder (balloon catheter)
A catheter without a balloon inside the bladder (splint)
A catheter inserted directly into the bladder through the lower abdomen (suprapubic catheter – SPC / abdominal bladder catheter)

Ureter Catheter

A ureter catheter is a thin tube placed in the ureter (the tube connecting the kidney to the bladder). This catheter allows urine to drain safely from the kidney.

JJ Catheter (Double-J Stent)

A JJ catheter is an internal stent with one curled end in the kidney and the other in the bladder. It is placed after a urinary tract procedure to ensure regular drainage of urine from the kidney to the bladder and to support safe healing of the treated area.

The JJ catheter is usually removed after a few weeks. Removal is a simple procedure performed under short anesthesia using a small camera inserted through the urinary tract.

Catheter or Drain Care

Your child has one of the following:

Kidney drain
Bladder catheter
Ureter catheter

You will receive a care set including drainage bags and necessary supplies for the first days at home.

Daily Use

Use the small leg bag during the day.
Attach the larger drainage bag at night.
Change the urine bags once a week.
Additional supplies can be ordered using the form included in the care set.

Monitoring Urine Flow

Check daily whether urine is flowing properly.
If urine flow stops:

Check the tubing for kinks or bends.
Gently straighten the tube if needed.

If urine flow does not resume, contact the hospital without waiting, delay.

Monitoring the Catheter Exit Site

Check the skin around the catheter exit site daily. Mild redness or a small amount of discharge may be normal.
However, contact us without waiting if you notice increasing redness, swelling, pain, or foul smelling discharge.

Splint Draining into the Diaper

If your child has a splint draining into the diaper:

Check that the diaper becomes regularly wet with urine.
Ensure that urine is dripping from the splint. If no urine is observed, contact us without waiting.

JJ Catheter – Urination Pattern

If your child has a JJ catheter, regular urination is important:

During the day every 2–3 hours
Around 11:00 PM before bedtime
Early in the morning

This helps prevent increased bladder pressure and supports healing.
During the first days, calm activities are recommended to avoid irritation of the treated area.

Showering – Bathing

Only the checked information applies to your child.

Your child should not shower during the first 2–3 days after surgery.
Keep showers short. Gently pat the wound dry after showering.
Your child should not take a bath during the first _____ days after surgery.
When bathing is permitted, limit bath time to 5–10 minutes to prevent the wound from softening.

Sports – Physical Activity

Your child should not swim during the first ___ days/weeks after surgery.
Your child should not participate in sports during the first ___ days/weeks after surgery.
Your child should not ride a bicycle during the first ___ days/weeks after surgery.
Your child should not lift heavy objects during the first ___ days/weeks after surgery.

School and Childcare

During the recovery period after surgery, your child may need rest.

Your child should not attend school or daycare for ___ days/weeks after surgery.
After this period, your child may return according to the doctor’s advice.

Full-day attendance may be tiring at first. It is recommended to discuss partial attendance (for example half days) with the teacher or caregiver.

Medications

After surgery, your child may need pain medication and, if necessary, other medicines. The prescribed medications and dosages will be determined by your doctor. (Only the checked and completed medications apply.)

Pain Medication

After surgery, your child will need pain medication. You may give:

Paracetamol: [_____] mg, [_____] times a day
Diclofenac: [_____] mg, [_____] times a day
Nurofen: [_____] mg, [_____] times a day
Tramadol: [_____] mg, [_____] times a day
Oxynorm: [_____] mg, [_____] times a day
Oxycontin: [_____] mg, [_____] times a day
Butrans patch: [_____] mcg, every [_____] days
Oxybutanine: [_____] mg, [_____] times a day
Forlax/Movicolon: [_____] sachets, [_____] times a day
Other medications: [____________________________________]

Example schedule:

Frequency	Morning	Afternoon	Evening	Midnight
4 times a day There must be 6 hours between medication intakes.	06:00	12:00	18:00	00:00
3 times a day There must be 8 hours between medication intakes.	08:00	16:00		00:00
2 times a day There must be 8 hours between medication intakes.	08:00		20:00

The times above are examples.

Medications must be administered according to the dosage, starting time, and dosing intervals prescribed by your doctor.

If necessary, administration times may be adjusted by 30–60 minutes.

If a dose is given later than planned, do not skip the medication. Continue according to the actual time given while maintaining the prescribed number of daily doses and required time intervals.

Obtaining Medications

Medications can be collected from the Outpatient Pharmacy located in the Passage of Erasmus MC.

In exceptional cases, medications may be obtained from a local pharmacy. In that situation, the hospital will provide enough medication for the first 24 hours.

Reducing Medication

As your child’s pain decreases, medication should be reduced gradually. Do not stop all medications suddenly. Reduction should follow this order:

First reduce prescription (stronger) pain medications.
Then reduce paracetamol. Finally, give paracetamol only if your child has pain.

Stitches, Discharge Letter and Follow-up

Stitches and Dressings

Your child’s wound may have been closed using one of the following methods:

Dissolvable Stitches

These stitches dissolve on their own. They do not need to be removed.

Steri-strip Dressings

These strips support wound healing. Slight loosening of the edges is normal.
They usually fall off on their own after approximately 7 days.
If they do not fall off, you may gently remove them.

Non-dissolvable Stitches

These stitches must be removed ___ days after surgery.

The stitches will be removed:

By your General Practitioner (GP)

During the hospital follow-up appointment

Discharge Letter and Patient Portal

Your doctor will send a discharge letter to your General Practitioner (GP).
You can also view the discharge letter via the My Erasmus MC patient portal:
www.erasmusmc.nl/patientenzorg/mijn-erasmus-mc

Follow-up Appointment

Your child will return to the hospital for a follow-up examination.

Appointment details will be communicated to you through:

My Erasmus MC
E-mail
Letter by post

Blood tests, X-rays, or ultrasound examinations may be required.
If so, this will be stated in the appointment notification.

Your child does not require a follow-up appointment.

Emotional Reactions, Physiotherapy and Emergency

Situations Emotional Reactions

Hospital experiences can be challenging for children. Your child may need time to understand and emotionally process what has happened. The following reactions may occur:

Fear of being alone
Sleep disturbances
Bedwetting

These reactions are usually temporary.
If the symptoms persist, please contact your General Practitioner (GP).

Physiotherapy

Your child may require physiotherapy at home. If needed, you will receive a referral letter.

When Should You Contact Us?

Within the first 2 weeks after surgery, contact us without waiting if your child develops any of the following symptoms:

Fever above 38.5 °C
Redness or signs of infection at the wound site
Increasing swelling around the wound
Severe pain that does not improve with medication
Persistent vomiting
No urine output through the catheter (if a catheter is in place)
Urine leakage around the catheter insertion site (if a catheter is used)
Cloudy or foul-smelling urine
Blood in the urine
No bowel movement for 3 days or diarrhea lasting more than 3 days

If any of these symptoms occur, do not wait — contact the hospital without waiting. For other health concerns, please contact your General Practitioner (GP).

Contact Details

Monday – Friday, 08:00–16:00
Pediatric urology Office (secretariaat kinderurologie): (010) 703 65 59

Outside these hours
Pediatric Surgery Ward: (010) 703 61 84

After 2 weeks following surgery
Please contact your General Practitioner (GP).

Additional Notes:

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