Surgery on call

Post-op problems and urological calls on the surgical ward.

• Post-operative complicationsRead the operation note, then think by day: bleeding early, chest and urine in the middle, leaks and clots later.
• Urinary retentionBladder scan, catheter, creatinine. Painless retention with a huge volume is chronic high-pressure retention: keep the catheter in.
• Haematuria and clot retentionClots and can't pass urine: three-way catheter and washout. Anticoagulants don't explain haematuria — it still needs investigating.
• PriapismA painful erection lasting over 4 hours is a compartment syndrome of the penis. Call urology now.