What is Renorrhaphy

Renorrhaphy is a surgery to repair a kidney injury. You may need this surgery if your kidney is damaged due to a severe injury or trauma to the kidney. This is typically an emergency procedure.

The goal of this procedure is to stop bleeding and save the kidney. During this procedure, your surgeon will make an incision in your abdomen and will check for bleeding and damage to your kidney and surrounding organs. Bleeding will be stopped and tissue damage will be repaired.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• Urine leaking into the abdomen.
• High blood pressure.
• Needing to remove the kidney (nephrectomy).
• A blood clot that forms in the leg and travels to the lung (pulmonary embolism).

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given a medicine to make you fall asleep (general anesthetic). You may also be given a medicine to help you relax (sedative).
• A vertical incision will be made in the center of your abdomen.
• The sac that contains your abdominal organs (peritoneum) will be opened.
• Your surgeon will search the organs inside your abdomen for damage and bleeding.
• Your surgeon will find the blood vessels that supply your damaged kidney.
• The space behind your peritoneum that contains your kidney (retroperitoneal space) will be opened.
• Your kidney blood vessels may be clamped for a short time to control bleeding.
• Any area of your kidney that cannot be repaired may be removed.
• Bleeding and any leaking urine will be controlled with stitches (sutures).
• Tears, cuts, or punctures in the covering of your kidney (capsule) will be closed with sutures.
• A type of absorbable bandage (dressing) or a piece of tissue near your kidney may be used to cover the sutures in your kidney.
• A tube (drain) may be placed to drain excess fluid from your surgical area. The drain may start near your kidney and exit your body near the side of your lower back (flank).
• The incision in your abdomen will be closed with sutures or staples, and a dressing will be applied over the incision and the drain.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You will need to rest in bed until there is no blood in your urine. You may need to stay in the hospital for several days.
• You will be encouraged to breathe deeply and cough.
• You may continue to receive fluids and medicines through an IV tube. Your IV will be removed when you can drink fluids and return to a normal diet.
• Once you are able to get out of bed, you will be encouraged to walk around.
• Your drain may be removed after one or two days.
• Do not drive for 24 hours if you received a sedative.

Renorrhaphy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After your procedure, it is common to have:

• Abdominal pain.
• Blood in your urine for up to 6 weeks.
• Nausea and possibly vomiting.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
• Keep your bandage (dressing) dry until your health care provider says it can be removed.

Driving

• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Avoid driving for 4 weeks after your procedure or as told by your health care provider.

Activity

• Rest as told by your health care provider.
• Avoid intense physical activity for at least 4 weeks after your procedure. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg) for at least 4 weeks after your procedure.
• Do not take long car trips or travel by air until your health care provider has approved.
• Do not sit or stand for long periods of time without moving around. When you sit or lie down, raise (elevate) your legs above the level of your heart.
• Walk around at least once a day. This helps to prevent blood clots. Gradually increase your physical activity as you start to feel better.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

General instructions

• Follow instructions from your health care provider about eating or drinking restrictions.
• Drink enough fluid to keep your urine clear or pale yellow.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
• Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have abdominal pain, bloating, pressure, or cramping.
• You have difficulty urinating.
• You have pain that gets worse or does not get better with medicine.
• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have a cough that does not go away.
• You have more blood in your urine.
• Your incision opens up.
• You feel weak and tired.

Get help right away if:

• You have a fever or chills.
• You have severe pain.
• You develop shortness of breath or difficulty breathing.
• You suddenly get dizzy or you faint.
• You have an irregular heartbeat (palpitations).
• You have chest pain.
• You have pain in your calf or leg.
• You have bright red blood or blood clots in your urine.
• You have swelling in your abdomen (distension) and vomiting.