I had two Penrose drains placed in my scrotum after urologic surgery; one fell out during a shower with minimal drainage, the wound was covered with a wet‑to‑dry dressing and abdomen pad (ABD pad), the other drain remains and my urologist appointment was postponed—what should I do now?

Management of Spontaneously Dislodged Penrose Drain After Urologic Surgery

Immediate Assessment and Action

You should monitor the site closely for signs of infection or fluid accumulation, keep the remaining drain in place, and contact your urologist within 24 hours for evaluation—the spontaneous loss of one drain with minimal drainage near the planned removal date is generally not an emergency if there are no signs of infection or significant swelling. 1

Current Wound Care is Appropriate

• The wet-to-dry dressing with ABD pad coverage you received is reasonable temporary management for the open drain site 1
• Keep the area clean and dry, changing dressings as they become soaked 2
• The remaining drain should stay in place until your urologist evaluates you 3

Signs Requiring Urgent Medical Attention

Contact your urologist immediately or go to the emergency department if you develop:

• Fever >38.5°C (101.3°F) or systemic signs of infection such as chills, rigors, or feeling generally unwell 1
• Increasing scrotal swelling, redness, or warmth that suggests hematoma formation or infection 3
• Purulent drainage from either the open site or around the remaining drain 1
• Severe pain that is worsening rather than improving 1
• Foul-smelling discharge which may indicate necrotizing infection (though rare) 1

Why This Situation is Usually Manageable

Timing Considerations

• Penrose drains placed after urologic scrotal surgery are typically removed within 12-24 hours to a few days postoperatively 3
• Since your drains were scheduled for removal this week, you are likely past the critical period for hematoma formation 3
• Minimal drainage at the time of dislodgement suggests the drain had already served its purpose of evacuating fluid collections 3

Infection Risk is Low

• There is no evidence that additional antimicrobials are needed when external drains are removed in the absence of infection 1
• The infection rate with closed-suction scrotal drainage is approximately 3.3% even when drains are intentionally placed, and spontaneous removal near the planned removal date does not inherently increase this risk 3
• Prophylactic antibiotics beyond 24 hours post-procedure are not indicated unless there are signs of active infection 1

Next Steps Within 24-48 Hours

Contact Your Urologist's Office

• Call first thing in the morning to report the drain dislodgement 1
• Request an earlier appointment or telephone consultation to assess whether you need to be seen urgently 1
• Ask specifically whether the remaining drain should stay in place or can be removed 1

What Your Urologist Will Assess

• Physical examination of the scrotum for swelling, hematoma, or signs of infection 1
• Evaluation of the remaining drain site and output characteristics 4
• Decision about removing the second drain versus leaving it until the rescheduled appointment 1
• Need for imaging (ultrasound) only if there is concern for fluid collection or abscess, which is unlikely given minimal drainage 1

Common Pitfalls to Avoid

• Do not attempt to remove the remaining drain yourself—it should be removed by a healthcare provider who can assess the surgical site 1
• Do not ignore new fever or increasing pain, as these may indicate infection requiring antibiotics or drainage 1
• Do not assume antibiotics are automatically needed—they are only indicated if signs of infection develop 1
• Do not leave the open drain site uncovered—continue dressing changes to prevent contamination 2

Antibiotic Considerations

Antibiotics are not routinely indicated unless you develop: 1

• Signs of surrounding soft tissue infection (cellulitis) 1
• Systemic signs of sepsis (fever, elevated heart rate, confusion) 1
• Purulent drainage from the wound 1

If antibiotics become necessary, your urologist will prescribe based on local resistance patterns and your specific risk factors 1

Prognosis

• The vast majority of patients with early drain removal or dislodgement near the planned removal date do well without complications 3
• Hematoma formation is rare (0.7%) even with intentional early drain removal 3
• The key is monitoring for the warning signs listed above and maintaining communication with your surgical team 1