I never expected that using the bathroom would be such a challenge after having a total knee replacement. I was more concerned with my recovery and seemed to overlook the logistics of using the commode.
Would I really need to relearn how to use the bathroom after knee replacement?
Four hours after leaving the recovery room I had my first opportunity to use the bathroom. I was given a few directions from my nurse on how to urinate with a walker.
Heavily sedated, I blew these directions off an hobbled to the toilet.
It took me a long time to urinate standing up and I made quite a mess. Urine was all over the toilet, on my walker, and on the floor nearby.
I thought about the chances of me slipping on my own urine and thought it would be ironic.
The following morning my peeing didn’t improve much – I guess I hadn’t learned my lesson. My 3rd experience using the toilet at home was just as bad.
I was concerned about having a bowel movement and it made an appearance on the 3rd-day post-surgery. This was another learning experience and I made several adjustments in the bathroom that I’ll explain in this article.
I wish that I had been given bathroom advice during my hospital pre-op visit before I was sedated and more cognizant. Ask questions before your surgery and you may have a better bathroom experience than I had after surgery.
My Previous Experience Using the Bathroom After Leg Surgery
45 years ago I broke my leg. I had a cast up to my thigh with a pin below my knee and a pin through my ankle.
I was unable to bend my leg and this made it difficult to get on the toilet. An elevated toilet seat was not the answer for me, as I still had to elevate the entire leg. It was like using the bathroom while doing acrobatics.
I ended up keeping a car jack stand in the bathroom to elevate my leg when doing my business. My early experiences with pooping weren’t bad compared to knee replacement.
After TKR at least you’ll be able to bend your leg a little. As time goes by flexion increases and this helps in the bathroom.
Going To The Bathroom After Knee Replacement (Pooping After TKR)
Step 1: Bathroom Preparation
Prepare the bathroom and toilet area. Remove any throw rugs, scales, cleaning products, and decorations that clog up the area.
As I mentioned in earlier articles, choose a bathroom that is close to your bed and to the chair you will be spending most of your time in. If you have multiple bathrooms pick the bathroom that is the widest.
I have two bathrooms. The toilet near my bedroom is small and narrow and only contains a toilet. It was hard to get in and out of with my walker and it was too narrow for me to be comfortable sitting on the toilet.
- Consider installing handrails before TKR. A raised toilet seat might be something else to consider. I have extremely low toilets and they were difficult to get on and off of. If I were to have TKR on my other knee I would invest in a raised portable toilet seat. If you are a senior citizen the rails and the raised toilet seat might be a good long-term investment, as you grow older (also read about raised toilet seats and more things you need after TKR).
- Have a walking pole or a cane next to the toilet seat. I used a walking stick and the sink counter for stability to get on and off the toilet seat during the first few weeks post-surgery.
- Needless to say, have an extra roll of toilet paper within reach.
Step 2: Personal Preparation (Anticipate Using the Bathroom)
If you’re like me you will be urinating frequently after TKR. Hydration is important for blood circulation and to help reduce swelling.
It’s especially important to heed the “first call of nature” and get started on your journey to the bathroom (read my article about 16 ways to prepare your home for knee replacement).
Once you begin having bowel movements (pooping) it’s even more important. It will take you a while to get out of your recliner. Have your walker or walking poles within reach.
Make your way to the bathroom and expect it to take a little longer to lower clothing and to position yourself on the toilet seat. If you wait too long it could spell disaster.
Wear comfortable clothing in the days and weeks after knee replacement. You don’t want to be unbuckling belts after knee replacement surgery.
Step 3: How To Approach The Toilet With A Walker
A male will have an easier time urinating. You can roll the walker over the entire toilet. In the early going, the trick is having a good aim while keeping your balance by holding on to the walker.
You get better with practice. I kept a 64 ounce empty Gatorade bottle by the toilet. It was easier to pee into the plastic bottle and to empty it in the toilet. There was no mess to clean up.
For females, it is possible to stand and pee or lay in a bed and pee using a “female plastic urinal” (pictured right). The female plastic urinal is handheld and listed on Amazon for under $10.
It might be worth it to avoid sitting down on a toilet.
Step 4: How To Sit On A Toilet After Knee Replacement
Sitting down on the toilet was a much larger challenge. You’ll consider using the free-fall technique.
The free-fall technique begins with standing over the toilet. As you begin to lower yourself you realize squatting is painful and you’ll start thinking about physics and the law of gravity.
You’ll wonder…”what if I just drop” or “do I have enough cushion to withstand a 2-foot drop”. The free-fall technique is possible but most definitely painful.
Ideally, you need to gently lower yourself down on the seat while letting your surgical knee slide forward. You need something stable to help you get up and down.
Do not rip the toilet roll hanger and towel bars off the wall. Try not to use the toilet tank (although sturdy the lid can occasionally crack). Use your walker, walking poles or the edge of a sink counter for stability.
Step 4: Doing the Deed (No Bowel Movement After TKR Surgery)!
Before I left the hospital I was asked if I had a bowel movement. The answer was “no, but I did get urine all over your floor”.
My medical team told me it was common to feel constipated after surgery stool softeners while I was in the hospital. They advised me to have some on hand at home too (read my article about necessary meds after surgery).
Once home I took them as directed on the container. When the home physical therapist made her first visit day 2 after surgery she also asked if I had had a bowel movement.
Again the answer was “no”. She encouraged me to take the stool softeners and to try hard to have a bowel movement as soon as possible.
My first two meals were liquid and I had not eaten very much solid food since the surgery. The pain medication (Percocet for me) made me constipated as well.
On the 3rd day post surgery after several tries and some difficulty I had my first bowel movement. I tried elevating my leg, moving it as far sideways as possible as well as different sitting positions until I was successful.
I continued taking the stool softener and pooping became regular. After the first 7 days, I quit using the stool softener. In hindsight, an elevated portable chair would have made the entire experience much easier.
I spoke with friends who said an elevated toilet seat was a lifesaver (too bad they didn’t tell me before surgery).
The first bowel movement after TKR is a big relief. My medical team and physical therapist was concerned, so it felt like another milestone in my recovery.
Step 5: Standing Up After Using the Toilet (after knee replacement)
Getting up off the toilet is just as challenging as sitting down on the toilet seat. In the early going I needed something stable like my walker or walking poles to get back up (also read my article on walkers, poles, or a cane after knee replacement)
Cleaning yourself after that first bowel movement is another challenge. You need to have one hand on the walker or walking pole while you use toilet paper.
It’s very awkward and takes much more time than you’d expect. It’s quite a process and one I was glad to only do once a day.
Handrails and an elevated toilet would have made everything so much easier. I would definitely consider both if another TKR was in my future.
The Worst And Best Part About Going The Bathroom After Knee Replacement Surgery
The first few days after surgery getting up and down and moving around are a chore. That includes getting up to use the bathroom.
My leg felt much better elevated the first few weeks and every time I put it down to walk the pain increased a little.
- Being male and able to pee standing up was the best part about using the bathroom after knee replacement but even that was no easy task
- Getting up and down on the toilet was the big challenge for sure and the worst part about using the bathroom after knee replacement
Toilet Equipment Needed After TKR Surgery
Make sure your toilet is in good working order before your surgery. If the toilet malfunctions you will not feel like repairing it yourself and who knows how long it will take for a plumber to arrive.
Consider installing handrails next to your toilet. Also, consider renting or purchasing an elevated toilet seat (pictured right). If not, have a cane, walking poles, or a walker nearby.
Look for stable things like the sink counter that you can use to help get you up and down. Do not use the toilet roll hanger or towel bars.
Oh yea, have plenty of toilet paper within reach!
Closing Thoughts – The Flush
Modern indoor plumbing makes using the bathroom very easy. You don’t give it much thought until you get injured and it becomes a difficult task.
After TKR it will be a challenge for the first few weeks. You will be constipated. Prepare your bathroom and eliminate any potential items that could be dangerous.
Install handrails if possible but look for stable sink counters near the toilet that can help you get up and down. Use your walker, walking poles or cane to give you some stability when sitting down and standing up.
Use the stool softeners from the get-go and then despite any pain or discomfort try as hard as you can to have that first bowel movement. The bowel movements and the entire bathroom process get easier each day.
By week 4-post surgery I was able to use the bathroom without any stability aids. My flexion was past 115 degrees and I was able to bend my knee easily to complete my tasks in the bathroom.
Pooping and peeing are not everyday topics. Trust me, both peeing and pooping are both important steps in your recovery process from TKR. Prepare ahead of time and make your post TKR bathroom experiences a little less difficult.