Postoperative Management

The oral-gastric decompression tube is removed before extubation. The suction drain is removed when the drainage is less than 25 mL or fluid chemistries suggest peritoneal fluid. The patient can be discharged when they are afebrile and able to complete three consecutive meals without abdominal distension, the first meal is usually started on the first postoperative day. Patients are discharged with the indwelling urethral catheter used for bladder drainage and three times daily bladder irrigation with 100 mL of sterile saline. Low-dose prophylactic antibiotics are continued during the first three postoperative weeks. At that time, the urinary catheter is removed and intermittent catheterization is initiated. For patients who have an indwelling catheter via the umbilical stoma, the catheter is usually capped at the time of hospital discharge, but may be used to flush the augmented bladder at the time of bladder irrigations.

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