Circumcision / Penoplasty Chordee Repair

 

While at the Hospital

• Following surgery, your child will be encouraged to drink clear liquids when he is fully awake.

• He will be discharged home from the hospital when he is tolerating fluids without vomiting. Nausea and vomiting are common after anesthesia and may last for 24 hours after surgery.

• Do not worry if you see a little blood spotting through the dressing.

 

Diet

• You may feed your child juices, Jello and clear broth for the first postoperative day/evening.

• A regular diet may be resumed the next morning or earlier if tolerated.

• Do not force feed especially if your child is nauseous. His appetite will return to normal with time.

 

Dressings

• Your son will have a gauze dressing or a clear “saran wrap” like dressing.

• Apply Bacitracin ointment to the tip of the dressing or penis several times a day or at each diaper change.

• The dressing usually stays in place for 1-4 days. Do not be concerned if it falls off earlier. The dressing can be removed according to your doctor’s directions. There may be many layers to the dressing.

• If there is any bleeding, immediately apply gentle pressure to the penis with a clean gauze pad. Hold pressure for approximately three minutes.

• If the bleeding stops, nothing further needs to be done. If the bleeding continues, notify the doctor immediately

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Activity

• Avoid bicycles, climbing bars, straddling toys, and similar activities, Do not carry your son on your hips.

• Your son may walk, climb stairs, and ride in the car seat with all straps in place.

• Your son should not go to school until after the one week post-operative visit unless otherwise directed.

 

Medication

Tylenol or Tylenol with Codeine can be used for post-operative pain and will be discussed by your doctor.

Bathing

Sponge bathe your child keeping the penis dry for as long as the dressing is intact. Begin bathing Without Soap if the dressing comes off by itself before the post-operative visit to the doctor. Do not bathe him for more than five minutes each time until the doctor instructs you otherwise.

 

Common Findings

• The penis may swell after the dressing is removed and look raw and red and you will see stitches on the penis.

• Bruising at the base of the penis and scrotum is not unusual and will disappear in a short period of time.

• The penis will have several areas of whitish-yellow scabs. These are normal signs of healing on the penis.

• The most common causes of post-operative fever are cold or ear infections.

• If there is mild discomfort while he urinates, do not be alarmed. This will resolve shortly. He should be encouraged to drink as the discomfort improves with each urination.

Please call your doctor if you notice

• Fever over 102 degrees

• Extreme pain, redness, and/or bleeding at the incision site

 

Post-Operative Visits

• Schedule a postoperative visit 7-10 days unless otherwise directed by your surgeon.

 

In Case Of Emergency

• Call the regular office number to reach the answering service.

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In Office Circumcision

 

Dressing/Bandage

• Your son may have a gauze bandage or a clear plastic bandage on the penis. Do not be concerned if this bandage falls off before, during or immediately after your arrival home. It does not need to be replaced.

• When the bandage falls off, apply antibiotic ointment (Bacitracin, Neosporin) all around the penis at least four times per day or with each diaper change.

• If the bandage has not fallen off by the fourth day, you should remove it. You should then apply antibiotic ointment (Bacitracin, Neosporin) to the penis four times per day or with each diaper change.

 

Diapers

• Change your son’s diapers frequently to prevent prolonged contact of a soiled diaper on the penis.

 

Bleeding

• Sponge bathe your child for four post-operative days. You may begin to bathe him on the fourth post-operative day WITHOUT soap for no more than five minutes at a time. Regular soap baths may be resumed on the seventh post-operative day.

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Bathing

• Avoid bicycles, climbing bars, straddling toys, and similar activities, Do not carry your son on your hips.

• Your son may walk, climb stairs, and ride in the car seat with all straps in place.

• Your son should not go to school until after the one week post-operative visit unless otherwise directed.

 

Post Circumcision Office Visit
Please schedule a post circumcision office visit for seven to ten days following the date of the circumcision(unless otherwise directed by your doctor)

Please call your doctor if you notice

• Fever over 102 degrees

• Extreme pain, redness, and/or bleeding at the incision site

 

Post-Operative Visits

• Schedule a postoperative visit 7-10 days unless otherwise directed by your surgeon.

 

In Case Of Emergency

• Call the regular office number to reach the answering service.

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Cystoscopic Procedure

 

While in the Hospital

• Following surgery, your child will be encouraged to drink clear liquids when he/she is fully awake.

• He/She will be discharged home from the hospital when tolerating fluids without vomiting. Nausea and vomiting are common reactions to the anesthesia for 24 hours.

• Do not worry if you see a little blood spotting in the diaper or underwear. You may notice a little blood tinged urine. This is to be expected for several days.

 

Diet

• You may feed your child juices, Jello and clear broth for the first postoperative day/evening. You may gradually start him on regular solid foods that evening.

• A regular diet may be resumed the next morning

 

Urination

• You may notice a little blood tinged urine when your child urinates. This is to be expected and may last for seven days.

• Your child may experience burning with urination for the first few postoperative days. Placing him/her in a warm bath without soap will help relieve these symptoms. Let your child know that it is OK to urinate into the bathtub if it helps relieve his burning.

• Do not worry if you see a little blood spotting in the diaper or underwear.

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Medications

• You may give your child Tylenol (acetaminophen) for any pain or discomfort.

• Your child may have been prescribed antibiotics by your doctor. Follow the instructions on the bottle.

• Your doctor may have placed your child on a medication (Pyridium/phenazopyridine) to relieve some urinary burning. This will temporarily turn your child’s urine, saliva and tears orange. Take precaution if you wear contact lenses and are handling the medication.

 

Fever

• If your child has a temperature below 102 F give Tylenol as directed.

• For a temperature of 102 F or higher give Tylenol and please notify the doctor.

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Activities

• Your child may resume all regular activities including gym unless otherwise directed by your doctor.
  School can resume on the next day if patient is comfortable.

 

Bathing

• Normal bathing and showering may resume on the first post-operative day.

Please call your doctor if you notice

• Fever over 102 degrees

• Extreme pain, redness, and/or bleeding at the incision site

 

Post-Operative Visits

• Schedule a postoperative visit 7-10 days unless otherwise directed by your surgeon.

 

In Case Of Emergency

• Call the regular office number to reach the answering service.

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Hernia Repair / Hydrocele Repair

 

While in the Hospital

• Following surgery, your child will be encouraged to drink clear liquids when he is fully awake.

• He will be discharged home from the hospital when he is tolerating the fluids without vomiting. Nausea and vomiting are common after anesthesia and can last for 24 hours after surgery.

• Do not worry if you see a little blood spotting thorough the dressing or on the scrotum.

 

Dressing

• The small bandage strips (and oftentimes a clear plastic bandage) covering the wound will peel off with time or will be removed at the follow up visit.

• Once they have fallen off, there is no need to cover the wound with a new bandage. The incision line can be hard to the touch and will bulge at different times, this is normal.

• Do not worry if you see a little blood spotting through the bandage and at the scrotum over the next several days.

 

Diet

• You may feed your child juices, Jello and clear broth for the first post-operative day/evening.

• A regular diet may be resumed the next morning or earlier if tolerated.

• Do not force feed, especially if your child is nauseous. His appetite will return to normal with time.

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Medications

• You may give your child Tylenol (acetaminophen) for pain or discomfort.

• For severe pain you doctor may have prescribed Tylenol with Codeine – use as directed.

 

Fever

• If your child has a temperature below 102 F give Tylenol as directed.

• For a temperature of 102 F or higher give Tylenol and please notify the doctor.

• The most common causes of post-operative fever are colds or ear infections.

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Bathing

• Sponge bathe your child for the first 48 hours unless other wise directed by your doctor.

• Quick 5 minute showers/baths can be restarted after 48 hours and continue until the first post-operative visit. The bandage may get wet.

 

Activities

• Avoid any vigorous activity including straddling toys, bicycle riding, or wrestling with siblings or friends. Do not carry a small child on your hips.

• Your child may walk up and down stairs and ride in the car with all straps of the infant/child safety seat in place.

• If your child is school-age, he should be out from gym for 3-4 weeks.

Please call your doctor if you notice

• Fever over 102 degrees

• Extreme pain, redness, and/or bleeding at the incision site

 

Post-Operative Visits

• Schedule a postoperative visit 7-10 days unless otherwise directed by your surgeon.

 

In Case Of Emergency

• Call the regular office number to reach the answering service.

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Hypospadias

 

While in the Hospital

• Following surgery, your son will be encouraged to drink clear liquids when he is fully awake.
  He will be discharged home from the hospital when he is tolerating the fluids without vomiting. Nausea and vomiting are common reactions to the anesthesia and can occur for 24 hours.

• Do not worry if you see a little blood spotting at the tip of the penis or on the dressing.

• If your child received a “baby spinal” his legs and feet may be a little numb and move less than usual. Do not worry. All sensation will return.

• You are encouraged to talk and touch your son while in the recovery room

 

Dressing

• The penis is wrapped in a special bandage. This bandage will be removed in the office according to your doctor’s specific instructions.

• Do not worry if you see a little blood spotting through the bandage.
  Try to keep the bandage and surrounding areas clean with frequent sponge baths.

• Do not be concerned if the bandage becomes soiled with stool or urine. It will also be smelly. The penis will not get infected.

• If the dressing comes off, please notify the doctor. Do not try to put the bandage back on.
  Bacitracin ointment, Triple Antibiotic Ointment or Neosporin are all suitable to use on the penis or at the tip of the dressing.

 

Diet

• You may feed your son juices, Jello and clear broth for the first post-operative day/evening.
  A regular diet may be resumed the next morning or earlier if tolerated.
  Do not force feed, especially if your child is nauseous. His appetite will return to normal with time.

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Diapers

• Double diaper your son for added protection (see: Making a double Diaper)

• Prepare several double diapers in advance of the surgery date.

• Continue to place the urinary tube and penis into the diaper as directed by your doctor and nurse.

• Change your son’s diapers more frequently during the first post-operative week.

 

Tube in Penis

• There may be a tube that passes through the penis into your son’s bladder. This tube may be sewn in place. This is used to drain the urine continually from his bladder so that your child does not need to urinate. He may, however, feel the “urge” to urinate because the tube can irritate the bladder. He will be on a medication called oxybutinin (Ditropan) to help relieve this urge and the associated bladder “spasms”. Bladder spasms are not dangerous.

• The bladder spasm may cause some leaking or “spraying” of urine AROUND the tube. This is common and the oxybutinin (Ditropan) medication will help this.

• Do not let the tube become “kinked or bent” as this will prevent the free flow of urine.

• Do not push or pull on the catheter-be careful during diaper changes.

• Remember-the tube is in the bladder and draining urine. Urine will flow from the catheter during diaper changes.

• Bleeding may occur with hypospadias repair. Minor spotting in diaper and seeing blood in catheter is not unusual and should stop after a few days.

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Bladder Spasms

• Bladder spasms occur from the tube irritating the bladder as well as from the normal healing process.
  Signs of spasms include: arching of your child’s back with associated irritability, spraying of urine through and around the tube, a sudden awakening from a sound sleep and severe urge to urinate.

• For the occasional spasm try holding and comforting your child.

• For spasms that are more frequent, your doctor has prescribed oxybutinin (Ditropan).

• Constipation will make the spasms very severe. The oxybutinin AND the codeine are constipating. Make sure your son has daily soft bowel movements. If you notice a change in his bowel habits, start with straight apple juice or dilute prune juice. Try some baby prune sauce. Add fiber.

• Avoid pasta and dairy.

 

Medications

• You may give your son Tylenol (acetaminophen) for any pain or discomfort.

• For severe pain your doctor may have prescribed Tylenol with codeine.

• Ditropan (oxybutinin) is a medication that relieves bladders spasms. Use it as directed by your doctor.

• Antibiotic should be administered as directed by your doctor.

• Pyridium (phenazopyridine) is a medication that relieves urinary burning. This will temporarily turn your child’s urine and tears orange. Use it as directed by your doctor.

 

Activities

• Carry your child so that he is supported under his behind. No pressure should be placed on his penis area!

• NO straddle toys (bouncers, bicycles, tricycles and rocking horses) for at least ten days unless otherwise directed by your doctor. Do not carry patient on your hips.

• Infant/child car seats, strollers and high chair may be used.

• Your child may ride in the car, take walks as tolerated and walk up and down stairs.

• “Mommy and Me” activity classes restricted for 3 weeks if the catheter is no longer in place.

Please call your doctor if you notice

• Fever over 102 degrees

• Extreme pain, redness, and/or bleeding at the incision site

 

Post-Operative Visits

• Schedule an appointment for your son to be seen to remove the bandage or remove the catheter as directed by your doctor.

 

In Case Of Emergency

• Call the regular office number to reach the answering service.

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Meatoplasty / Meatotomy

 

While in the Hospital

• Following surgery, your child will be encouraged to drink clear liquids when he is fully awake.

• He will be discharged home from the hospital when he is tolerating the fluids without vomiting. Nausea and vomiting are common reactions to the anesthesia and can occur for 24 hours.

 

Dressing

• No bandage is required.

• If stitches were placed, they will dissolve within a few weeks and do not need to be removed.

 

Diet

• You may feed your child juices, Jello and clear broth when you arrive home. Gradually start him on regular solid foods that evening.

• A regular diet may be resumed the next morning.

• AVOID orange juice, soda, ice tea until the post-operative visit.

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Bathing

• You may bathe your son on the first post-operative day. 5 minute baths until your post-operative visit.

• Allow your son to first soak in a warm bath without soap. You may then add soap and bathe him normally.

 

Activity

• As long as your child is comfortable he may resume regular activity and return to school the day after surgery. If he is uncomfortable he should be restricted from school activities and school for a few days.

 

Medications

• Apply Bacitracin ointment to the urinary meatus four times a day for five days post-operatively. If your child wears diapers apply Bacitracin ointment with each diaper change. Please change your child’s diapers more frequently than you usually would during this time.

• You may give your child Tylenol (acetaminophen) for any pain or discomfort.

• If your child has a temperature below 102 degrees F give Tylenol as directed.

• For a temperature of 102 degrees F or higher give Tylenol and please notify the doctor. The most common causes of post-operative fever are colds or ear infections.

 

Common Findings

• Black and blue at the base of the penis or scrotum due to the injection of pain medication during the procedure will disappear in a week or so.

• Scabbing is common at the tip of the penis. This causes the stream to spray and deviate. This takes up to a month to disappear.

• Your son may experience burning with urination for the few post-operative days. A warm bath without soap will help relieve these symptoms. Let him urinate in to the bathtub if it helps relieve his burning. The doctor may have placed him on a medication (Pyridium/phenazopyridine) to ease some urinary burning.

• Do not worry if you see a little blood spotting at the tip of the penis.

Please call your doctor if you notice

• Fever over 102 degrees

• Extreme pain, redness, and/or bleeding at the incision site

 

Post-Operative Visits

• Your child should be seen for a post operative visit in 7-10 days unless otherwise directed by your surgeon. Please schedule an appointment by calling our office.

 

In Case Of Emergency

• Call the regular office number to reach the answering service.

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Orchidopexy

 

While in the Hospital

• Following surgery, your child will be encouraged to drink clear liquids when he is fully awake.

• He will be discharged home from the hospital when he is tolerating the fluids without vomiting. Nausea and vomiting are common after anesthesia and can last for 24 hours after surgery.

• Do not worry if you see a little blood spotting through the dressing or on the scrotum.

 

Dressing

• The small bandage strips (and oftentimes a clear plastic bandage) covering the wound will peel off with time or will be removed at the follow up visit. Once they have fallen off, there is no need to cover the wound with a new bandage. The incision line can be hard to the touch and will bulge at different times, this is normal.

• The scrotal wound may have exposed stitches. These stitches will dissolve on their own in 4-6 weeks and do not need to be removed by the doctor.

• Do not worry if you see a little blood spotting through the bandage and at the scrotum over the next several days.

• The testicle may be swollen for several days and there may be a black and blue area. This is normal. This can also happen to the penis and opposite testicle.

 

Diet

• You may feed your child juices, Jello and clear broth for the first postoperative day/evening.

• A regular diet may be resumed the next morning or earlier if tolerated.

• Do not force feed, especially if your child is nauseous. His appetite will return to normal with time.

​

Medication

• You may give your child Tylenol (acetaminophen) for pain or discomfort.

• For severe pain your doctor may have prescribed Tylenol with Codeine – use as directed.

 

Fever

• If your child has a temperature below 102 F give Tylenol as directed.

• For a temperature of 102 F or higher give Tylenol and please notify the doctor.

• The most common causes of post-operative fever are colds or ear infections.

 

Bathing

• Sponge bathe your child for the first 48 hours unless otherwise directed by your doctor.

• Quick 5 minute showers/baths can be restarted after 48 hours and continue until the first post-operative visit. The bandage may get wet.

 

Activities 

• AVOID vigorous activity including straddling toys, bicycle riding, or wrestling with siblings or friends. Do not carry a small child on your hips.

• Your child may walk up & down stairs and ride in the car with all straps of the safety seat.

• If your child is school-age, he should be out from gym for 3-4 weeks.

Please call your doctor if you notice

• Fever over 102 degrees

• Extreme pain, redness, and/or bleeding at the incision site

 

Post-Operative Visits

• Your child should be seen for a post operative visit in 7-10 days unless otherwise directed by your surgeon. Please schedule an appointment by calling our office.

 

In Case Of Emergency

• Call the regular office number to reach the answering service.

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Pyeloplasty

 

Dressing

• Upon discharge your child will have a paper strip bandage over the incision site. This dressing will peel off on its own. After the dressing peels off it is not necessary to cover the incision site. You may notice a firmness in the area of the incision. This is normal and will take up to six months to disappear.

• Note: your child may have some blood in the urine for 2 – 4 weeks after discharge. This will decrease gradually and then disappear.

 

Bathing

• One week after surgery your child may resume regular baths or showers, but limit them to no longer than five minutes for the first two weeks post-operatively unless otherwise directed by your doctor. Thereafter no restrictions are necessary for bathing.

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Activity

• AVOID strenuous activity including, but not limited to, the following: sports, running and jumping, wrestling, swimming, and riding a bicycle for one month post-operatively. Your child may ride in the car and walk up and down stairs. Regular sporting activities may resume six weeks after surgery.

• School – your child may return to school to sit in class when he/she feels up to it. Gym and physical activity are not permitted for 1 month after discharge from the hospital. Please request a note for your school excusing your child from gym, access to a school elevator, and a second set of textbooks to be kept at home so as to avoid carrying heavy book bags.

 

Medication

• Unless otherwise directed continue the antibiotics for six weeks post-operatively. For any discomfort give Tylenol (acetaminophen) as directed or other pain medication as ordered by your doctor.

 

Call the Doctor if you Notice

• A fever over 101 degrees F. – most fevers are related to colds, ear infections, etc.

• Extreme pain, redness, and/or drainage from the incision or drain site.

• Discharge at the incision site.

• Back/flank pain.

 

Please call your doctor if you notice

• Fever over 102 degrees

• Extreme pain, redness, and/or bleeding at the incision site

 

Post-Operative Visits

• Your child should be seen for a post operative visit in 7-10 days unless otherwise directed by your surgeon. Please schedule an appointment by calling our office.

 

In Case Of Emergency

• Call the regular office number to reach the answering service.

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Ureteral Reimplantation

 

Dressing

• Upon discharge your child will have a paper strip bandage over the incision site. This dressing will peel off on its own. After the dressing peels off it is not necessary to cover the incision site. The suture line will appear hard to the touch and will bulge at different times. This is normal.

• Note: Your child may have some wetting accidents, blood in the urine, burning on urination and/or frequency for two to four weeks after discharge. These symptoms will gradually decrease and eventually disappear over time. These symptoms can be relieved by Tylenol or Pyridium if prescribed. Ptridium, will soothe the burning but will turn the urine orange (it may permanently stain contact lenses or tile).

 

Bathing

• Upon discharge your child may resume regular baths or showers, but for no longer than five minutes during the first two weeks post-operatively unless otherwise directed by your doctor. The paper strip dressing may get wet.

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Activity

• AVOID strenuous activity including, but not limited to, the following: sports, running and jumping, wrestling, swimming, and riding a bicycle. Your child may ride in the car with the car seat straps in their usual position and walk up and down stairs.

• School – your child may return to school to sit in class when he/she feels up to it. Gym and physical activity are not permitted for 1 month after discharge from the hospital. Please request a note for your school excusing your child from gym, access to a school elevator, and a second set of textbooks to be kept at home so as to avoid carrying heavy book bags.

 

Medication

• Unless otherwise directed restart the preoperative antibiotics. For any discomfort give your child Tylenol (acetaminophen) as directed or other pain medication ordered by the doctor. Please avoid constipation post-operatively. This may cause burning on urination. Increase the intake of fluids, especially water and juices. Adding fiber will also help to avoid constipation.

 

Please call your doctor if you notice

• Fever over 102 degrees

• Extreme pain, redness, and/or bleeding at the incision site

 

Post-Operative Visits

• Your child should be seen for a post operative visit in 7-10 days unless otherwise directed by your surgeon. Please schedule an appointment by calling our office.

 

In Case Of Emergency

• Call the regular office number to reach the answering service.

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Varicocele

 

While in the Hospital

• Following surgery, your son will been encouraged to drink liquids when he is fully awake.

• He will be discharged home from the hospital when he is tolerating the fluids without vomiting. Nausea and vomiting are common reactions to the anesthesia and occur for 24 hours.

• Do not worry if you see a little blood spotting on the bandage for 24-28 hours.

 

Diet

• You may feed your child juices, Jello and clear broth for the first post-operative day/evening.

• A regular diet may be resumed the next morning.

• Avoid constipation with a diet high in fruits, fiber, vegetables and water.

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Dressing and Wound Care

• The small bandage strips (and sometimes a clear plastic bandage) covering the wound will peel off with time or will be removed at the postoperative visit. Once they have fallen off, there is no need to cover the wound with a new bandage. The incision line can be hard to the touch and will bulge at different times, this is normal.

 

Medication

• You may give your son Tylenol (acetaminophen) for any pain or discomfort.

• For severe pain your doctor may have prescribed Tylenol with codeine.

 

Fever

• If your son has a temperature below 102 F give Tylenol as directed.

• For a temperature of 102 F or higher give Tylenol and please notify the doctor.

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Potential Concerns

• Vomiting may occur the night after the surgery. This is often related to the anesthetic. If it lasts for more than 1 day, please call. Redness and/or discharge around the incision are signs of a wound infection. This is very rare. Call for any concern. Discomfort is to be expected, but should subside over a few days.

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Post-Operative Office Visits

• Your child should be seen for a post-operative visit in 7-10 days unless otherwise directed by your surgeon. Please schedule an appointment by calling our office.

 

In Case Of Emergency

• Call the regular office number to reach the answering service.

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Making a Double Diaper

 

Materials Needed

• The usual size diaper for your baby (the “inner” diaper)

• A larger size “outer” diaper

• A roll of 1 inch medical adhesive tape

• Sharp scissors

 

Steps

• Cut a 2-3 inch hole in the inner diaper by punching a hole through the diaper with the tip of the scissors, in the area that the penis would be touching

• Cut 8 pieces of tape, each about 2-3 inches long. Cover the edges of the hole in the inner diaper by placing the pieces of tape so that half of each piece is on the inside and half is on the outside of the diaper. The tape will cover the open cut edge of the diaper and keep the stuffing from falling out.

• Put the inner diaper, with the hole in it, under the baby’s bottom. Put the penis and catheter (if there is one) through the hole in the diaper. This will help keep the penis clean after a bowel movement. If there is a bowel movement and the penis and catheter are dirty, gently squirt some water using a squeeze bottle to remove the feces.

• Put the outer diaper (the larger one) over the first diaper. Leave it somewhat loose, so there is no pressure on the penis. The catheter should drain into the outer diaper. Lay the catheter into the diaper loosely, without kinking, so that it continues to drain properly.