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Surgical patients will have a tube that was placed under the skin into your bladder at the time of surgery. This tube will drain urine from the bladder into a bag. When you go home you will need to know how to care for the tube, empty the bag and the clamping procedure to prepare for the removal of the tube.

Care of the tube

The skin around the tube should be cleaned once a day. This can be done with clean warm water. The drainage bag should be lower than the insertion site of the tube. When using the leg bag, it should be fastened around the lower thigh. The tube drains by gravity and proper positioning will promote drainage.

Equipment

The following equipment should be given to you upon discharge from the hospital:

• Drainage bag
• Leg bag
• Hat - a plastic bowl that fits into the toilet so you can measure the amount of urine emptied from the bag or urinated.

Bladder training

Before leaving the hospital, you should begin clamping the tube at regular intervals. This will help you to regain normal bladder function and allow for removal of the tube.

Clamping schedule

1. On the third day after surgery, begin clamping the tube.
2. You can use several elastics, pinch the tube and wrap the elastics around the pinched portion of the tube. This will prevent the urine from draining from your bladder.
3. Empty the drainage bag before starting clamping procedure.
4. Try to keep the tube clamped for 2-3 hours.
5. If you feel the urge to urinate or experience discomfort before the 2-3 hours are up, try to urinate. Sit on the toilet and allow yourself sufficient time to urinate. You may run water and/or press gently over the bladder area. This may help you to urinate. If you are unable to urinate, unclamp the tube and allow the urine to drain into the bag. When there is no more urine draining into the bag, clamp the tube again for 2-3 hours or as long as you can tolerate it. Empty the bag into the hat (you should be given a hat that fits into the toilet upon discharge). Record the amount emptied.
6. If you are able to urinate, measure the amount in the hat and record amount. Unclamp the tube after urinating and see if there is any residual urine in the bladder. Let bladder empty completely (5-10 minutes) and clamp the tube again. You should also record the amount drained from the bladder after urinating.

Initially, you may find that the volume of urine drained from the bag is larger than the amount you were able to urinate. Do not be discouraged. It takes time for bladder function to return to normal. Gradually, you will be able to tolerate the tube clamped for longer periods of time and the volume you urinate will be larger than the residual urine drained from the tube after urinating. When the volume left in the bladder after urinating is less than 100cc, you can have the tube removed. Please call 617-632-3669 to set up an appointment for removal of the tube.

Removing the tube

The tube is removed in the office. There is an external stitch and an internal small balloon that holds the catheter in place. The stitch is removed and then the balloon is deflated before the tube is pulled out. The opening from the tube may take a few days to close completely. It is not unusual to drain a small amount of urine from this area. You can cover the opening with a small piece of gauze.