One can never say "never" in medicine, but it is certainly unusual for me to use a catheter in my practice when performing tummy tucks. If however the surgery is more involved and lengthy, such as post-massive weight loss body contouring, then that is a different situation, and I may well use one.
When you wake up after the surgery you can expect to have a wound dressing, at least one and possibly two drains from your tummy wound and a urinary catheter. As with all major surgery some pain and discomfort is to be expected, however this is well controlled with pain relief medication.
Placement of a foley catheter
It's not necessary in an operation where fluids remain pretty steady (breast augmentation, facelift, eyelid lift). But it's very helpful during operations with potential “fluid shifts” like any procedure involving liposuction.
A patient who's been anesthetized with general anesthesia isn't able to control their urination. Because of this, the surgical team will usually place a Foley catheter before performing the procedure. This ensures that the bladder stays empty and the operation is clean and sterile.
You'll feel relaxed during the procedure, but you'll be awake and able to follow instructions. A nurse will also clean and shave the area where the catheter will be inserted (usually the wrist, groin or neck) and use a local anesthetic to numb the area.
The catheter may be inserted during surgery if your child is having an operation, or it may be inserted while your child is awake. If it is being inserted while they are awake, it may be uncomfortable for your child. See our fact sheet Reducing your child's discomfort during procedures.
Inserting either type of catheter can be uncomfortable, so anaesthetic gel may be used on the area to reduce any pain. You may also experience some discomfort while the catheter is in place, but most people with a long-term catheter get used to this over time. Read more about the types of urinary catheter.
If your surgeon feels the surgery will be long enough to warrant a catheter, it goes against your best interests to refuse it (unless there are other extenuating circumstances), and the surgeon will have to decide whether or not to proceed.
You may also feel urine come out around the catheter. This is caused by bladder spasms and you cannot control these.
A catheter located in the bladder may cause discomfort postoperatively, and this is called catheter-related bladder discomfort (CRBD). With the extensive use of catheters, the incidence of CRBD has been rising, ranging from 47 to 90% postoperatively [1, 2].
You may have the catheter in for 1 day or longer. Your surgeon will decide after the surgery. Before you leave the hospital, the nurses in the day surgery unit will show you how to take care of the catheter and give you the supplies you need to take home.
Tummy tuck and breast surgery patients typically have 1-2 drains depending on the amount of tissue removed and if they had other procedures performed at the same time (i.e., liposuction). Tummy tuck drains usually remain in place from 5 to 14 days.
Tummy Tuck For Bladder Control
Since the tummy tuck improves the strength and stability of the muscles in the abdominal and pelvic areas, it can reduce bladder leakage. The procedure also tightens the soft tissues that support the bladder, pelvic floor, and urethra, which further improves bladder control.
– Is drain removal painful? Patients may experience a pulling or pressure sensation, however there is generally no pain experienced during drain removal. Drain removal takes only a few seconds. The stitch securing the drain in place is first removed followed by gentle removal of the drainage tube.
The insertion of the Foley is typically done by a nurse, and may be done before or after anesthesia is given, but typically prior to the first incision if the patient is having surgery. The urine collection bag attached to the Foley helps track urine output during surgery and during a stay in the hospital.
Urinary catheters are often used during surgery, as you can't control your bladder while under anesthesia. For this purpose, a foley catheter is typically placed prior to surgery and keeps the bladder empty throughout.
Once the nurse has explained what will happen during the TWOC and you are happy to go ahead, the nurse will remove your catheter. This may feel a little strange, but it should not hurt. It will take about 5 seconds.
However, catheters can cause numerous adverse effects, such as catheter-associated infection, obstruction, bladder stones, urethral injury, and catheter-related bladder discomfort (CRBD). CRBD symptoms vary among patients from burning sensation and pain in the suprapubic and penile areas to urinary urgency.
Having a catheter in place should not affect an erection or ejaculation.
Removing drains too soon may result in fluid buildup, seroma, and the need for fluid aspiration and/or a second surgery. Generally speaking, most patients who require tummy tuck drains are able to have them removed after about 1 – 3 weeks.
The best sleeping position after tummy tuck surgery is on your back with your upper body elevated to create a slight bend or angle. Using pillows or sleeping in a recliner is ideal to achieve this position.
When Can You Shower After a Tummy Tuck? After 48 hours, your wounds will be sufficiently healed for showering to be a possibility.
The catheter is held in the bladder by a water-filled balloon, which prevents it falling out. These types of catheters are often referred to as Foley catheters. Urine is drained through a tube connected to a collection bag, which can either be strapped to the inside of your leg or attached to a stand on the floor.