Reimplantation Surgery Aftercare: Hospital Stay, Catheter, Home Care

After open reimplantation (Cohen or Lich-Gregoir technique), the hospital stay is usually 1–3 days; this can be shorter for laparoscopic or robot-assisted surgery and for unilateral extravesical (outside-the-bladder) procedures. A caudal block or wound-site numbing given during surgery substantially reduces pain in the first hours.

The bladder catheter (urinary catheter) keeps the bladder empty and relaxed while the suture line heals; it usually stays in for 1–3 days with the intravesical Cohen technique, and for a shorter time with the extravesical Lich-Gregoir technique. After the catheter is removed, the first few times urinating may burn and appear pink.

Bladder spasm is a sudden contraction of the bladder muscle in reaction to the catheter and suture line: the child cries suddenly, holds the lower abdomen, a few drops of blood-tinged urine pass around or through the catheter, and it passes within a few minutes. Although alarming to see, it does not mean the sutures have opened; it is more common with intravesical surgery and while the catheter is in place.

• During a spasm: stay calm, hold your child and encourage them to draw their legs up to their abdomen; it passes within a few minutes.
• Make sure the catheter isn't kinked and the bag stays below bladder level.
• Give the anticholinergic medication on schedule; since it can cause constipation, pay attention to fluids and fiber.
• Spasms fade within a few days after the catheter is removed; let your team know if they persist.

The incision is in the lower abdomen, just above the underwear line, and horizontal; it is usually closed with self-dissolving sutures and covered with a wound strip or skin adhesive. Keep it dry for the first 48 hours, after which a brief shower is fine; wait until the wound has healed (about 2 weeks) before a bath, pool, or the sea.

Walking, calm play at home, and using stairs are allowed from discharge onward; let your child move at their own pace. Activities that could put pressure on or strike the abdomen are restricted for the first 3–4 weeks.

• Return to school or daycare is usually within 1–2 weeks; wait 3–4 weeks for physical education, cycling, team sports, and climbing. Return may be somewhat faster with laparoscopic/robot-assisted surgery; the first follow-up is usually at 2–4 weeks with a wound check and ultrasound.

If any of the following findings occur, call your team without waiting for the scheduled follow-up date; if fever and flank pain occur together, same-day evaluation is needed.

• Fever of 38°C or higher, chills.
• Inability to urinate, passing very little urine, or no urination for more than 6–8 hours (after catheter removal).
• Persistent flank or abdominal pain unresponsive to pain relievers; repeated vomiting.
• Blood-tinged urine that becomes darker, contains clots, or lasts longer than 1 week.
• Discharge from the wound, increasing redness, swelling, or foul odor.
• Progressively increasing abdominal bloating and distension.
• In infants: poor feeding, lethargy, or inconsolable crying.