Recovery and Followup

Once discharged from the Hospital, you should consult the relevant procedure-specific information provided to you regarding activity levels and other recommendations.

Wounds will appear quite swollen and red at first with some old blood crusted on or around the incisions.  You may notice new lumps or bumps under the skin close to the incisions, but these likely represent the wound closure under the skin and nothing to worry about.   If you have skin staples, they will be removed about a week after surgery in the clinic.  If you have a subcuticular closure, there will be no staples and the sutures are under the skin and will dissolve on their own in about 12-18 weeks time.

Warning Signs: Wounds

If your incision develops increasing pain, shows discharge of whitish/greyish/greenish exudate, or shows redness creeping wider and wider around the incision, you should inform your physician for possibility of infection.

Generally speaking, you should continue to heal your wounds over the next 10-12 weeks and during this time, should try not to stress your incisions too much by performing activities which cause tension across the incision lines.  For example, for most abdominal incisions, it is recommended not to doing any straining or lifting of anything heavier than 10lbs for 6-8 weeks minimum.

Warning Signs: Activity

If during coughing/laughing/straining/lifting/activity you note a “snapping” sound or sensation in or around the incision, and notice the development of increased fluid coming out of the wound or more bulging than was previously appreciated, notify your physician for possibility of hernia formation or more acutely, wound dehiscence (strength layer under the skin opening up) or evisceration (strength layer has been compromised and bowel is coming out of the incision).

With regards to diet, if your bowels have not returned to normal when you go home, you should continue to eat small meals more frequently rather than several large meals and wait for your bowels to get more regular.  This typically takes anywhere from 5-7 days for most people.  In the meantime, continue to replace your fluids with water and electrolytes, treat nausea with fresh air, activity and medication as required (Gravol, Maxeran, Stemetil) and suppress pain with medication as required.

Warning Signs: Bowels

If your bowels continue to not work and you suffer ongoing abdominal bloating to the point of extreme pain or intractable nausea and vomiting you should notify your physician for possibility of postoperative ileus (slow gut) or obstruction.  As well, if you throw up fresh blood or have black, tarry stools, you should notify your physician for possibility of a gastrointestinal bleed.

For most procedures, a catheter will be placed temporarily via the urethra into the bladder for drainage of urine while you are recovering.  The catheter will be removed for a “trial of voiding” to make sure you can pass your urine before you go home.  If you are unable to do so, the catheter will be replaced and you will be asked to try again usually the next day.

Warning Signs: Urination

If you are unable to urinate for greater than 6 hours, although  you have the urge to do so and increasing lower abdominal pain with distension, you should notify your physician for possibility of urinary retention requiring re-catheterization.

Also if you have undergone transurethral surgery (TURP, TURBT, Urethrotomy (DVIU), ureteroscopy) and are noticing more than cranberry colored urine passing via urethra and with more than a few small blood clots; i.e: urine is bright red and thick so as not to be able to read a newspaper behind it and/or passing lots of large blood clots, you should notify your physician for possibility of recurrent bleeding via the operative site.

Warning Signs: General

If you notice sudden onset shortness of breath, crushing/squeezing chest pain, or chest pain radiating to the neck or arm, massive headache, or difficulty talking or walking; seek medical attention immediately.

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