Patient education: Nephrectomy – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

What is nephrectomy? — This is surgery to remove a kidney. In some cases, the doctor will remove the whole kidney. In other cases, they will only remove part of the kidney. Sometimes, the doctor will also remove the ureter (figure 1). This is the tube from the kidney to the bladder that urine flows through.

How long it takes for you to recover, and what you need to do, depends on which type of surgery you had. If you had minimally invasive surgery, you might be able to return to your normal activities sooner. With open surgery, it usually takes longer to recover.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

You should also:

●Take all of your medicines as instructed.

•Take non-prescription medicines to relieve pain, such as acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), or naproxen (sample brand name: Aleve). These can be used instead of opioids.

•Use a stool softener to help prevent constipation, if needed. This is a common problem if you take opioid pain medicines. Follow all instructions for taking your pain medicines.

●Take care of your incision – You might have stitches, skin staples, surgical glue, or a special skin tape on your incision. If you had minimally invasive surgery, you might have more than 1 incision.

•Keep your incision dry and covered with a bandage for the first 1 to 2 days after surgery. Your doctor or nurse will tell you exactly how long to keep your incision dry.

•Once you no longer need to keep your incision dry, gently wash it with soap and water whenever you take a shower. Do not put your incision underwater, such as in a bath, pool, or lake. This can slow healing and raise your chance of getting an infection.

•After you wash your incision, pat it dry. Your doctor or nurse will tell you if you need to put an antibiotic ointment on the incision. They will also tell you if you need to cover your incision with a bandage or gauze.

•Always wash your hands before and after you touch your incision or bandage.

●If you have a surgical drain, follow instructions for how to empty it. The doctor might want you to measure the amount of fluid and write it down each time. The amount of drainage should decrease each day.

●Increase your activity slowly – Start with short walks around your home, and walk a little more each day.

•Keep coughing and doing deep breathing exercises for 7 to 10 days after you go home. This will help prevent lung infections. When you cough, sneeze, or do deep breathing exercises, press a pillow across your incision to support the wound and ease pain.

•Avoid heavy lifting, sports, and swimming for at least 2 to 3 weeks. (Your doctor or nurse will tell you exactly how long to avoid these or other activities.)

●Eat when you are hungry – If you have an upset stomach, it might help to start with clear liquids and foods that are easy to digest, like soup, pudding, toast, or eggs. You can eat other types of foods when you feel ready. If your doctor or nurse gave you specific instructions about what to eat or avoid, follow them.

●Be aware that if you had minimally invasive surgery, you might have some pain in your shoulder. This is from gas the doctor put into your belly during surgery. Walking and moving around will help reduce the gas and ease the pain.

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. Go to these appointments.

If you have stitches or staples, you will need to have them taken out. Your doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or skin tape, it will fall off on its own. Do not pick at it or try to remove it yourself.

When should I call the doctor? — Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You have chest pain.

●You feel very short of breath.

●You feel dizzy, faint, or weak.

●Your wound opens up.

Call for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You have drainage from your incisions, or redness or swelling around them.

●You do not have any urine for more than 6 hours.

●You have very bad belly pain or pain when urinating.

●You notice more blood in your urine.

●You have nausea or vomiting for more than 2 days after going home.

More on this topic

Patient education: Nephrectomy (The Basics)
Patient education: Kidney cancer (The Basics)
Patient education: Kidney transplant (The Basics)
Patient education: Chronic kidney disease (The Basics)
Patient education: Polycystic kidney disease (The Basics)
Patient education: End-stage kidney disease (kidney failure) (The Basics)

Patient education: Renal cell carcinoma (kidney cancer) (Beyond the Basics)
Patient education: Chronic kidney disease (Beyond the Basics)
Patient education: Polycystic kidney disease (Beyond the Basics)