Post-op management of urinary tract injury
- Foley in situ for 7-10 days. Bladder lacerations typically heal well within 7 days of repair.
- Monitor for symptoms and signs of hydronephrosis, renal compromise or urinoma. The patient may be discharged home with instructions to return if symptoms arise.
- Prophylactic antibiotics are not indicated.
- Retrograde cystogram before Foley removed if urinoma suspected.
- If flank/abdominal pain develop: consider CT scan or ultrasound.
Post-op management of bowel injury
- Gradually increase diet as tolerated when bowel sounds are audible for injuries to the ileum or colon. A slower approach is required for upper GI injuries.
- Prophylactic antibiotics for full thickness injury.
- Nasogastric drainage, diverting colostomy, and TPN are not required for simple laceration.
- Monitor for signs of sepsis or anastomotic leak.
- Inform patient of long term increased risk for bowel obstruction and fistula formation.