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MEDICATIONS TO AVOID BEFORE SURGERY Medications Which May Cause
Bleeding Many common medications including prescription drugs and over the
counter medicines are strong anticoagulants and may cause bleeding
problems in normal individuals undergoing surgery. Please review the
following list to see if you are taking any of these medications which
need to be discontinued for up to seven days before your surgical
procedure. This list is not a complete listing but show many of the
common drugs which may contain aspirin or other anti-inflammatory
medication or other blood thinners. DO NOT STOP TAKING any medication including those on the list below without first consulting your doctor. Inform your doctor if you are taking any prescription or over the counter medications obtained in another country as they may contain some of the listed medications. If you must take something for a headache or other minor aches or
pains you may take acetaminophen unless directed otherwise by your
doctor.
Coumadin (Warfarin) and Plavix are two potent anticoagulants.
Consult with your doctor for specific instructions on when to
discontinue these medications. ARTIFICIAL URINARY SPHINCTER (AUS)
INSERTION About the Procedure: In some men who have significant incontinence, the placement of an inflatable artificial urinary sphincter may be required. This procedure is usually performed under general anesthesia and takes between 2 and 3 hours. It can be placed through an incision at the base of the penis, or in the skin behind the scrotum (the perineum). Patients usually go home on the day of their surgery. Once the sphincter is in place and functioning, the patient releases the sphincter and empties the bladder by depressing a button hidden in the scrotum. Once urination is complete, the sphincter automatically closes, keeping the urine in the bladder and keeping the patient dry. While the sphincter is designed to provide continence, it will not be ready for use until 6 weeks after its insertion. It should only be activated by your doctor. You should not expect to be dry immediately following your procedure. If you are dry immediately after the procedure, notify your doctor, as this may be a sign that the sphincter has been activated before it is ready for use. For more information regarding AUS insertion, click here. Preparing for the Procedure: Do not eat or drink anything after midnight the night before the procedure. You should take your usual medications as you normally would the morning of your procedure with a small sip of water only (avoid juice, milk, coffee, etc.). starting 5 to 10 days prior to your procedure (ask your doctor for a specific time), it is important to stop taking medications that might increase your risk of bleeding. For a list of blood-thinning medications that should be avoided, click here or ask you doctor. Make arrangements for someone to drive you home on the day of your procedure.After the Procedure: Some patients will require a catheter for a few days after their procedure. The catheter should only be removed by your Urologist. Drink 6 to 8 glasses (1500cc) of fluid daily until the catheter is removed. If blood appears in your urine (red fluid in the tubing of the catheter), increase your fluid intake and decrease your activity level until it clears. While at home, keep the catheter connected to the large drainage bag. It is OK to use the smaller drainage bag if you plan on going out of the house. It is normal for your catheter to have pink to reddish urine, especially with increased activity or bowel movements. Decreasing your activity and increasing fluids will usually make the urine clear. Men with a catheter may notice pink discharge at the tip of the penis—this is normal. Applying over-the-counter antibacterial ointment (e.g. Neosporin or Bacitracin) 2 to 4 times daily to the tip of the penis will help decrease irritation. On the second day after your surgery, it is OK to shower, but baths and soaking in a tub should be avoided for 2 weeks after the procedure. The incision should be kept clean and dry to allow it to heal, so it is important to shower once a day. The incision generally heals in five to seven days, and the stitches will dissolve and their own and do not need to be removed. Avoid any strenuous activity, exercise, or heavy lifting for 4 to 6 weeks after the procedure. You should abstain from sexual intercourse for 6 weeks following the procedure. It is usually OK to resume your blood-thinning medication the day after your procedure, but check with your doctor to be sure. Take all the medications prescribed by your doctor (including any antibiotics and pain medications), and schedule an appointment to follow up with him within the first 2 weeks after the procedure (ask your doctor if you are unsure when to follow up).BLADDER BIOPSY About the Procedure: A bladder biopsy is done during a cystoscopy in order to obtain a
tissue sample from the lining of the inside of the bladder. During the
cystoscopy, your doctor will pass a small forceps through the
cystoscope in order to obtain the tissue sample Preparing for the Procedure: The preparation for a bladder biopsy is similar to that for a cystoscopy.
Additionally, your doctor may ask you to stop taking blood-thinning
medication for a few days prior to your procedure. After the Procedure: You may experience temporary burning and possibly a small amount of blood in the urine. Don't be alarmed - these will usually clear within 24 hours. If you develop fever, chills, or heavy bleeding, notify your doctor
immediately. CIRCUMCISION About the Procedure: Circumcision is the surgical removal of the foreskin—the tissue
covering the head of the penis. During a circumcision, the foreskin is
freed from the head of the penis (glans), and then removed. The
remaining cut ends of the skin are then sutured together using
stitches that will dissolve by themselves. Circumcision can be done
using just local anesthetic, but sedation or deeper anesthesia may be
required in some cases (check with your doctor). The procedure usually
takes about one hour. Preparing for the
Procedure: If you are to get sedation or general anesthesia for the procedure
(check with your doctor), do not eat or drink anything after midnight
the night before the procedure. You should take your usual medications
as you normally would the morning of your procedure with a small sip
of water only (avoid juice, milk, coffee, etc.). Starting 5 to 10 days
prior to your procedure (ask your doctor for a specific time), it is
important to stop taking medications that might increase your risk of
bleeding. For a list of blood-thinning
medications that should be avoided, click here or ask
you doctor. After the Procedure: There will be a dressing on the incision that can be removed on the second day after the procedure. After that, it is OK to shower (let soap and water run over the incision, then pat dry), but baths and soaking in a tub should be avoided for 2 weeks after the procedure. The incision should be kept clean and dry to allow it to heal, so it is important to shower once a day. The incision generally heals in five to seven days, but avoid any strenuous activity and exercise or heavy lifting for 4 to 6 weeks after the procedure. The stitches will dissolve and fall off on their own usually within the first week or two after the procedure. It is usually OK to resume your blood-thinning medication the day after your procedure, but check with your doctor to be sure. Take all the medications prescribed by your doctor (including any antibiotics and pain medications), and schedule an appointment to follow up with him within the first 2 weeks after the procedure (ask your doctor if you are unsure when to follow up). Make arrangements for someone else to drive you home
after the procedure if you are to have sedation or general
anesthesia. CYSTOSCOPY About the Procedure: Cystoscopy is a diagnostic procedure during which you bladder and urethra are examined with an instrument called a cystoscope. The instrument has a light and a fiber optic lens, and allows your doctor to directly view the lower part of your urinary tract. The cystoscopic exam is one of the most commonly performed urological procedures. It is brief, very safe, and simple and provides the doctor with immediate, valuable diagnostic information. The best way to prepare for your cystoscopy is to RELAX. For most
of us, the thought of an instrument, even a small one, being placed
into the urethra is naturally somewhat freighting. However, with the
use of a local anesthetic, most patients experience only mild
discomfort. When other procedures, such as biopsies, are performed
through the cystoscope, an intravenous sedative may also be needed.
Your cystoscopy may be performed either in a hospital or an outpatient
facility. Just before the procedure, you'll be asked to empty your bladder. A urine sample may be obtained. You'll then be asked to remove your clothing, and you will be given a gown or drape to use. Men undergo cystoscopy either lying on their back, or with their legs in stirrups, depending on the type of cystoscope being used. Women will have their legs in stirrups, similar to the gynecologist's office. Once you are comfortable in the exam table, a betadine solution will be used to cleanse the genital area. Then, xylocaine jelly will be applied as a local anesthetic. The procedure itself takes no more than 3 or 4 minutes. Once the
cystoscope is inserted, your bladder will be filled with sterile
irrigating fluid, allowing the doctor to distend your bladder and see
the walls more clearly. As the bladder fills, it is normal to start to
feel the urge to urinate. Tell the doctor when this
occurs. DIAGNOSTIC FOR MALE INFERTILITY (Testis/Epididymis
Biopsy) About the Procedure: A testicular biopsy is a test to remove a small sample of tissue
from one or both testicles and examined under a microscope to evaluate
a man's ability to father a child. It is not usually done to detect
cancer of the testicles. It involves an incision in the scrotum and
then into the testicle itself. The procedure is usually done under
sedation or deeper anesthesia and takes about one hour to
complete. Preparing for the Procedure: If you are to get sedation or general anesthesia for the procedure (check with your doctor), do not eat or drink anything after midnight the night before the procedure. You should take your usual medications as you normally would the morning of your procedure with a small sip of water only (avoid juice, milk, coffee, etc.). starting 5 to 10 days prior to your procedure (ask your doctor for a specific time), it is important to stop taking medications that might increase your risk of bleeding. For a list of blood-thinning medications that should be avoided, click here or ask you doctor. You should bring an athletic supporter or snug jockey shorts to
wear home after the procedure. After the Procedure: There will be a dressing on the incision that can be removed on the
second day after the procedure. After that, it is OK to shower (let
soap and water run over the incision, then pat dry), but baths and
soaking in a tub should be avoided for two weeks after the procedure.
The incision should be kept clean and dry to allow it to heal, so it
is important to shower once a day. The incision generally heals in
five to seven days, but avoid any strenuous activity and exercise or
heavy lifting for 4 to 6 weeks after the procedure. The stitches will
dissolve and fall off on their own usually within the first week or
two after the procedure. It is usually OK to resume your blood-thinning
medication the day after your procedure, but check with your
doctor to be sure. Take all the medications prescribed by your doctor
(including any antibiotics and pain medications), and schedule an
appointment to follow up with him within the first 2 weeks after the
procedure (ask your doctor if you are unsure when to follow
up). Make arrangements for someone else to drive you home after the
procedure if you are to have sedation or general anesthesia.
About the Procedure: Hydroceles may require surgical repair if they cause symptoms, such
as growing large, or causing pain or discomfort. An incision is made
in the scrotum, and the hydrocele sac is cut out, removing the tissues
that create the fluid that surrounded the
testicle. If you are to get sedation or general anesthesia for the procedure
(check with your doctor), do not eat or drink anything after midnight
the night before the procedure. You should take your usual medications
as you normally would the morning of your procedure with a small sip
of water only (avoid juice, milk, coffee, etc.). Starting 5 to 10 days
prior to your procedure (ask your doctor for a specific time), it is
important to stop taking medications that might increase your risk of
bleeding. For a list of blood-thinning
medications that should be avoided, click here or ask
you doctor. You should bring an athletic supporter or snug jockey shorts to
wear home after the procedure. After the Procedure: There will be a dressing on the incision that can be removed on the
second day after the procedure. After that, it is OK to shower (let
soap and water run over the incision, then pat dry), but baths and
soaking in a tub should be avoided for 2 weeks after the procedure.
The incision should be kept clean and dry to allow it to heal, so it
is important to shower once a day. The incision generally heals in
five to seven days, but avoid any strenuous activity and exercise or
heavy lifting for 4 to 6 weeks after the procedure. The stitches will
dissolve and fall off on their own usually within the first week or
two after the procedure. It is usually OK to resume your blood-thinning
medication the day after your procedure, but check with your
doctor to be sure. Take all the medications prescribed by your doctor
(including any antibiotics and pain medications), and schedule an
appointment to follow up with him within the first 2 weeks after the
procedure (ask your doctor if you are unsure when to follow
up). Make arrangements for someone else to drive you home after the
procedure if you are to have sedation or general anesthesia. PENILE PROSTHESIS INSERTION About the Procedure: For some men with erectile dysfunction, the insertion of an rigid or
inflatable penile prosthesis may be an option. A mechanical device is
inserted into the penis through a small incision at the base of the
penis, and when an erection is desired, it is achieved by depressing a
pump hidden within the scrotum. Once the erection is no longer
desired, the device can be “deflated” by depressing the same button.
The procedure is performed under general anesthesia and usually takes
between 2 and 3 hours. Most patients go home the day of the
procedure. While the penile prosthesis is designed to create an erection, it
will not be ready for use until 6 weeks after your procedure and
should only be activated by your doctor. This will allow the incision
and tissues time to heal, allowing the device to be used safely and
without discomfort. To learn more about IPP insertion, click here.
Do not eat or drink anything after midnight the night before the procedure. You should take your usual medications as you normally would the morning of your procedure with a small sip of water only (avoid juice, milk, coffee, etc.). starting 5 to 10 days prior to your procedure (ask your doctor for a specific time), it is important to stop taking medications that might increase your risk of bleeding. For a list of blood-thinning medications that should be avoided, click here or ask you doctor. Make arrangements for someone to drive you home on the day of your procedure.
On the second day after your surgery, it is OK to shower, but baths
and soaking in a tub should be avoided for 2 weeks after the
procedure. The incision should be kept clean and dry to allow it to
heal, so it is important to shower once a day. The incision generally
heals in five to seven days, and the stitches will dissolve and their
own and do not need to be removed. Avoid any strenuous activity,
exercise, or heavy lifting for 4 to 6 weeks after the procedure. You
should abstain from sexual intercourse for 6 weeks following the
procedure. It is usually OK to resume your blood-thinning medication the day after your procedure, but check with your doctor to be sure. Take all the medications prescribed by your doctor (including any antibiotics and pain medications), and schedule an appointment to follow up with him within the first 2 weeks after the procedure (ask your doctor if you are unsure when to follow up). PROSTATE BIOPSY About the Procedure: PROSTATE CRYOTHERAPY About the Procedure: Take only clear liquids on the day prior to the procedure. Acceptable liquids include tea or coffee (no milk or cream), water, apple juice, Gatorade or other sports drinks, popsicles, italian ice, or chicken broth. Drink five ounces of citrate of magnesium at 4:00 pm the day before the procedure. If this does not produce a bowel movement by 7:00 pm take an additional 2 ounces of citrate of magnesium. This is available over the counter in the laxative section of your pharmacy. Remember to drink plenty of clear liquids to stay hydrated while preparing for your procedure. Do not eat or drink anything after midnight the night before the procedure. You should take your usual medications as you normally would the morning of your procedure with a small sip of water only (avoid juice, milk, coffee, etc.). starting 5 to 10 days prior to your procedure (ask your doctor for a specific time), it is important to stop taking medications that might increase your risk of bleeding. For a list of blood-thinning medications that should be avoided, click here or ask you doctor. Additionally, your doctor may have prescribed for you an enema, which should be taken rectally 2 hours before coming in to the hospital on the day of your surgery. Check the packaging of the enema for specific instructions.
In addition to being sent home with a catheter in you bladder, there will be a dressing over the procedure site in your groin (perineum). This can usually be removed the day after you arrive home (the second day after surgery). After that, it is OK to shower, but baths and saoking in tubs should be avoided for 2 weeks following the procedure. Avod heavy lifting, exercise, and strenuous activity for 4 to 6 weeks following your procedure. You will be discharged with a catheter in your bladder. This is typically left in place for 1 to 2 weeks. The catheter should only be removed by your Urologist. Drink 6 to 8 glasses (1500cc) of fluid daily until the catheter is removed. If blood appears in your urine (red fluid in the tubing of the catheter), increase your fluid intake and decrease your activity level until it clears. While at home, keep the catheter connected to the large drainage bag. It is OK to use the smaller drainage bag if you plan on going out of the house. It is normal for your catheter to have pink to reddish urine, especially with increased activity or bowel movements. Decreasing your activity and increasing fluids will usually make the urine clear. You may notice pink discharge at the tip of the penis—this is normal. Applying over-the-counter antibacterial ointment (e.g. Neosporin or Bacitracin) 2 to 4 times daily to the tip of the penis will help decrease irritation. RADICAL RETROPUBIC PROSTATECTOMY About the Procedure: This procedure is performed primarily in the treatment of prostate cancer, and it involves the removal of the
entire prostate and the seminal vesicals, and, occassionally, the
lymph nodes in the pelvis. This procedure is performed through a 10 to
15 centimeter vertical incision, just below the belly button. The
procedure usually takes 3 to 4 hours, under general anesthesia, and
you should expect to spend at least one to two nights in the
hospital. Take only clear liquids on the day prior to the procedure. Acceptable liquids include tea or coffee (no milk or cream), water, apple juice, Gatorade or other sports drinks, popsicles, italian ice, or chicken broth. Drink five ounces of citrate of magnesium at 4:00 pm the day before the procedure. If this does not produce a bowel movement by 7:00 pm take an additional 2 ounces of citrate of magnesium. This is available over the counter in the laxative section of your pharmacy. Remember to drink plenty of clear liquids to stay hydrated while preparing for your procedure. Do not eat or drink anything after midnight the night before the procedure. You should take your usual medications as you normally would the morning of your procedure with a small sip of water only (avoid juice, milk, coffee, etc.). starting 5 to 10 days prior to your procedure (ask your doctor for a specific time), it is important to stop taking medications that might increase your risk of bleeding. For a list of blood-thinning medications that should be avoided, click here or ask you doctor. Additionally, your doctor may have prescribed for you an enema
which should be taken rectally 2 hours before coming in to the
hospital on the day of your surgery. Check the packaging of the enema
for specific
instructions. After the
Procedure: General: Activities: Diet: Catheter care: Common Problems: Scrotal/Penile swelling: Incision opening: Bruising around the incision: Constipation/bloating: RADICAL CYSTECTOMY About the Procedure: In some pateints with bladder cancer, removal of the bladder and the creation of an alternate drainage system for the body's urine, may be required. This urinary diversion is necessary because the kidneys will continue to produce urine even after the bladder has been removed. The bladder is removed through a vertical 10 to 15 centimeter incision in the middle of the lower abdomen (from below the belly button to the pubic bone), in a procedure that takes between 4 and 6 hours under general anesthesia. Patients are usually in the hospital for 5 to 7 days after their prcedure. Depending on the type of cancer, and the needs of each patient, the urine may be diverted to a urostomy, which is a permanent drainage opening on the skin of the lower abdomen that empties urine into a bag. Alternatively, your doctor may elect to create a new bladder (a neobladder) out of part of your bowel. This may empty through the normal urinary channel (the urethra), or it may be formed into a pouch inside of the body that needs to emptied using a catheter passed through a small openning on the skin periodically throughout each day. There are many options to consider, and you should ask your doctor as to which form of urinary diversion would work best for you.
Take only clear liquids on the day prior to the procedure. Acceptable liquids include tea or coffee (no milk or cream), water, apple juice, Gatorade or other sports drinks, popsicles, italian ice, or chicken broth. Drink five ounces of citrate of magnesium at 4:00 pm the day before the procedure. If this does not produce a bowel movement by 7:00 pm take an additional 2 ounces of citrate of magnesium. This is available over the counter in the laxative section of your pharmacy. Remember to drink plenty of clear liquids to stay hydrated while preparing for your procedure. Do not eat or drink anything after midnight the night before the procedure. You should take your usual medications as you normally would the morning of your procedure with a small sip of water only (avoid juice, milk, coffee, etc.). starting 5 to 10 days prior to your procedure (ask your doctor for a specific time), it is important to stop taking medications that might increase your risk of bleeding. For a list of blood-thinning medications that should be avoided, click here or ask you doctor. Additionally, your doctor may have prescribed for you an enema which should be taken rectally 2 hours before coming in to the hospital on the day of your surgery. Check the packaging of the enema for specific instructions. After the Procedure: The care of your urinary diversion will differ depending on the type of procedure you have. Ask your doctor regarding specific instructions. In general, there will be a dressing on the incision that can be removed on the second day after the procedure. After that, it is OK to shower (let soap and water run over the incision, then pat dry), but baths and soaking in a tub should be avoided for 2 weeks after the procedure. The incision should be kept clean and dry to allow it to heal, so it is important to shower once a day. The incision generally heals in five to seven days, but avoid any strenuous activity and exercise or heavy lifting for 4 to 6 weeks after the procedure. Your doctor will remove the surgical staples in your incision at your first office visit following your discharge from the hospital. This is not painful and only takes a few minutes. It is usually OK to resume your blood-thinning medication the day after your procedure, but check with your doctor to be sure. Take all the medications prescribed by your doctor (including any antibiotics and pain medications), and schedule an appointment to follow up with him within the first 2 weeks after the procedure (ask your doctor if you are unsure when to follow up).
Drink five ounces of citrate of magnesium at 4:00 pm the day before
the procedure. If this does not produce a bowel movement by 7:00 pm
take an additional 2 ounces of citrate of magnesium. This is available
over the counter in the laxative section of your pharmacy. Remember to
drink plenty of clear liquids to stay hydrated while preparing for
your procedure. After the
Procedure: General: Activities: Diet: Catheter care: Common Problems: Scrotal/Penile swelling: Incision opening: Bruising around the incision: Constipation/bloating: SHOCK WAVE LITHOTRIPSY About the Procedure: Many stones in the kidney or ureter (tube between the kidney and
bladder) can be treated with a noninvasive treatment known as shock
wave lithotripsy or SWL. This procedure uses high energy shock waves
to break up urinary stones into sand like particles. During the
treatment, shock waves are focused precisely on the stone. Up to 3,000
shock waves are administered to the stone causing it to disintegrate.
These smaller fragments of stone can then be passed in your urine with
little discomfort. The procedure is performed under sedation
administered by your anesthesiologist and takes approximately thirty
minutes. Unlike other treatments, no incisions or catheters are
required. Patients are usually able to return to the comfort of their
own home within an hour or two following the
procedure. If your doctor has recommended SWL for your stone then there are a
few things you should know. Your doctor?s office will provide you with
information regarding the date, time and location of your treatment.
You will be required to have a preoperative history and physical as
well as laboratory work completed several days prior to your
procedure. You will be asked to bring all of your x-rays and CT scans
with you including your most recent KUB x-ray. You will not be allowed
to eat or drink anything after midnight the night before your
procedure. Check with your doctor about taking heart medicines or
medications for diabetes or high blood pressure on the morning of the
procedure. You may be instructed to take these medicines with a small
sip of water. If you are taking any aspirin, arthritis medications,
Coumadin, Plavix or blood thinners, please inform your doctor. These
medications will generally need to be discontinued seven days before
the procedure. If you are unsure about which medications may cause
bleeding, click here or ask
your doctor. Your doctor will use a real time x-ray called fluoroscopy to
precisely locate your stone during the treatment. For this reason it
is important to follow a few simple procedures to minimize the amount
of gas or stool in the bowel which might make visualization of your
stone more difficult. After the
Procedure: The recovery period following SWL is usually only a few days. The
small stone particles are passed from your body in the urine over the
next several days or weeks. You should drink plenty of liquids,
especially water in the days and weeks following the procedure. You
will be asked to strain your urine following the procedure and bring
the small pieces of gravel to your doctor for analysis. You may
experience some discomfort when passing larger fragments. You will be
provided with a prescription for pain medicine to take if you need it.
In the unlikely event you experience more severe pain or a fever you
should call your doctor at once. You will typically have another x-ray
several weeks later and you will need to bring this x-ray and the
preoperative x-rays to your doctors office to be sure the stone has
completely cleared. "SLING PROCEDURE" FOR INCONTINENCE About the Procedure: In both men and women with certain types of incontinence, the insertion of a sling—a mesh tape
that provides support to the urethra—may provide an improvement in
symptoms. This procedure is performed under sedation or general
anesthesia on an outpatient basis—most patients are able to go home
the day of the procedure—and takes 1 to 2 hours to perform. While some
patients may require a catheter for a few days after the procedure,
most will urinate normally immediately after the procedure, beginning
in the recovery room. To learn more about the procedure click here (for men) or click here (for women)
If your doctor has recommended SWL for your stone then there are a
few things you should know. Your doctor?s office will provide you with
information regarding the date, time and location of your treatment.
You will be required to have a preoperative history and physical as
well as laboratory work completed several days prior to your
procedure. You will be asked to bring all of your x-rays and CT scans
with you including your most recent KUB x-ray. You will not be allowed
to eat or drink anything after midnight the night before your
procedure. Check with your doctor about taking heart medicines or
medications for diabetes or high blood pressure on the morning of the
procedure. You may be instructed to take these medicines with a small
sip of water. If you are taking any aspirin, arthritis medications,
Coumadin, Plavix or blood thinners, please inform your doctor. These
medications will generally need to be discontinued seven days before
the procedure. If you are unsure about which medications may cause
bleeding, click
here or ask your doctor. Your doctor will use a real time x-ray called fluoroscopy to
precisely locate your stone during the treatment. For this reason it
is important to follow a few simple procedures to minimize the amount
of gas or stool in the bowel which might make visualization of your
stone more difficult. After the Procedure: The recovery period following SWL is usually only a few days. The
small stone particles are passed from your body in the urine over the
next several days or weeks. You should drink plenty of liquids,
especially water in the days and weeks following the procedure. You
will be asked to strain your urine following the procedure and bring
the small pieces of gravel to your doctor for analysis. You may
experience some discomfort when passing larger fragments. You will be
provided with a prescription for pain medicine to take if you need it.
In the unlikely event you experience more severe pain or a fever you
should call your doctor at once. You will typically have another x-ray
several weeks later and you will need to bring this x-ray and the
preoperative x-rays to your doctors office to be sure the stone has
completely cleared. TRANSURETHRAL RESECTION OF THE PROSTATE (TURP) –
TRADITIONAL AND LASER About the Procedure: In some cases, especially during the work up of hematuria (blood in
the urine), your doctor may discover a mass in your bladder that will
need to be removed, or resected. While the mass may be
suspicious for bladder cancer, your doctor will not know for
certain until he can remove all or part of the tissue in the bladder.
This procedure is also sometimes performed after a bladder
biopsy, where your doctor is aware of the presence of bladder cancer and he wants to remove it from your
bladder. The procedure is usually done under general anesthesia, but
no incisions are made in the skin. Instead a telescope is passed
through the urine channel (the urethra), and using very small
instruments, your doctor carefully removes the tissue from the
bladder. The length of the procedure varies depending on the size of
the tumor, but many patients usually go home on the day of their
procedure without a catheter. If the tumor is particularly large or
grows deep into the bladder wall, you may go home with a catheter in
your bladder, or you may have to spend a night in the
hospital. Preparing for the Procedure: Do not eat or drink anything after midnight the night before the
procedure. You should take your usual medications as you normally
would the morning of your procedure with a small sip of water only
(avoid juice, milk, coffee, etc.). Starting 5 to 10 days prior to your procedure (ask your doctor for
a specific time), it is important to stop taking medications that
might increase your risk of bleeding. For a list of blood-thinning
medications that should be avoided, click here or ask
you doctor. Make arrangements for someone to drive you home on the day of your
procedure. After the Procedure: You may experience some increased urgency to urinate, as well as
increased frequency of urination for the first few days after your
procedure. Blood may also appear in the urine. This is normal and
expected. Drink plenty of fluids to help dilute the urine, and these
symptoms should resolve in a few days. Some patients will require a catheter for a few days after their
procedure. The catheter should only be removed by your Urologist.
Drink 6 to 8 glasses (1500cc) of fluid daily until the catheter is
removed. If blood appears in your urine (red fluid in the tubing of
the catheter), increase your fluid intake and decrease your activity
level until it clears. While at home, keep the catheter connected to the large drainage
bag. It is OK to use the smaller drainage bag if you plan on going out
of the house. It is normal for your catheter to have pink to reddish
urine, especially with increased activity or bowel movements.
Decreasing your activity and increasing fluids will usually make the
urine clear. Men with a catheter may notice pink discharge at the tip
of the penis—this is normal. Applying over-the-counter antibacterial
ointment (e.g. Neosporin or Bacitracin) 2 to 4 times daily to the tip
of the penis will help decrease irritation. On the second day after your surgery, it is OK to shower, but baths
and soaking in a tub should be avoided for 2 weeks after the
procedure. The incision should be kept clean and dry to allow it to
heal, so it is important to shower once a day. The incision generally
heals in five to seven days, and the stitches will dissolve and their
own and do not need to be removed. Avoid any strenuous activity,
exercise, or heavy lifting for 4 to 6 weeks after the procedure. You
should abstain from sexual intercourse for 6 weeks following the
procedure. It is usually OK to resume your blood-thinning
medication the day after your procedure, but check with your
doctor to be sure. Take all the medications prescribed by your doctor
(including any antibiotics and pain medications), and schedule an
appointment to follow up with him within the first 2 weeks after the
procedure (ask your doctor if you are unsure when to follow
up). URETEROSCOPY AND LASER LITHOTRIPSY About the Procedure: This treatment involves the use of a very small, fiber-optic instrument called a ureteroscope, which allows access to stones in the ureter or kidney. The ureteroscope allows your urologist to directly visualize the stone by progressing up the ureter via the bladder. No incisions are necessary but general anesthesia is used. Once the stone is seen through the ureteroscope, a small, basket-like device can be used to grasp smaller stones and remove them. If a stone is too large to remove, a laser, spark-generating probe or air-driven (pneumatic) probe can be passed through a channel built into the ureteroscope and the stone can be fragmented. A straightforward case is complete once the stone has been
shattered appropriately. However, if extensive manipulation was
required to reach and/or treat the stone, your urologist may choose to
place a stent within the ureter to allow the post-operative swelling
to subside. Preparing for the Procedure: Do not eat or drink anything after midnight the night before the procedure. You should take your usual medications as you normally would the morning of your procedure with a small sip of water only (avoid juice, milk, coffee, etc.). Bring any copies of films or CDs of any radiology studies (X-rays or CT scans) with you on the day of your procedure. Make arrangements for someone to drive you home on the day of your
procedure. After the Procedure: Most patients will be discharged home on the day of their procedure
without a catheter in their bladder. If your doctor has left a stent
in your kidney, you may experience an increased urge to urinate, as
well as increased frequency of urination. Additionally, some patients
experience mild to moderate discomfort in their back or lower abdomen,
especially during urination. Finally, some blood in the urine may
appear after the procedure, as well as some burning with urination.
These symptoms are normal and may last as long as you have the stent
in your body. Your doctor may prescribe you medication to help lessen
these symptoms, so it is important to take the medications prescribed
to you. Increasing your fluid intake will also help dilute the urine
and lessen these symptoms. It is very important to follow up with your doctor to schedule to have the stent removed, as leaving the stent in for prolonged periods of time may lead to infections, further stone formation, and/or permanent kidney damage. URODYNAMIC TESTING About the Procedure: Urodynamics testing is a series of procedures designed to provide
information about a bladder problem. They can measure the bladder's
ability to hold and release urine and usually involve placing a small
catheter into the bladder. It provides a more advanced way to check
bladder function, and it does not require anesthesia. You may be asked
a series of questions about the sensations you feel in your bladder
during the test to help you doctor better understand your problem. The
procedure usually takes approximately 15 minutes and may be combined
with a cystoscopy
or other procedures. Preparing for the Procedure: The most important thing to do is to relax. The testing is most
accurate when we can recreate your symptoms during the test. The
procedure will not be painful, and by staying relaxed, you can help
ensure that the information obtained during the test is as accurate as
possible. After the Procedure: You may experience temporary burning and possibly a small amount of
blood in the urine. Don't be alarmed - these will usually clear within
24 hours. If you develop fever, chills, or heavy bleeding, notify your doctor
immediately VARICOCELE REPAIR About the Procedure: Varicocele repair is performed to improve male fertility. It can
usually be done surgically on an outpatient basis using local
anesthetic, but some cases may require sedation or deeper anesthesia.
A small incision is made in the lower abdomen, on the side of the
varicocele. The veins that produce the varicocele are identified and
cut to eliminate the swelling in these vessels. The procedure usually
takes about 60 to 90 minutes. Preparing for the Procedure: If you are to get sedation or general anesthesia for the procedure
(check with your doctor), do not eat or drink anything after midnight
the night before the procedure. You should take your usual medications
as you normally would the morning of your procedure with a small sip
of water only (avoid juice, milk, coffee, etc.). starting 5 to 10 days
prior to your procedure (ask your doctor for a specific time), it is
important to stop taking medications that might increase your risk of
bleeding. For a list of blood-thinning
medications that should be avoided, click here or ask
you doctor. After the Procedure: There will be a dressing on the incision that can be removed on the
second day after the procedure. After that, it is OK to shower (let
soap and water run over the incision, then pat dry), but baths and
soaking in a tub should be avoided for 2 weeks after the procedure.
The incision should be kept clean and dry to allow it to heal, so it
is important to shower once a day. The incision generally heals in
five to seven days, but avoid any strenuous activity and exercise or
heavy lifting for 4 to 6 weeks after the procedure. The stitches will
dissolve and fall off on their own usually within the first week or
two after the procedure. It is usually OK to resume your blood-thinning
medication the day after your procedure, but check with your
doctor to be sure. Take all the medications prescribed by your doctor
(including any antibiotics and pain medications), and schedule an
appointment to follow up with him within the first 2 weeks after the
procedure (ask your doctor if you are unsure when to follow
up). Make arrangements for someone else to drive you home after the
procedure if you are to have sedation or general anesthesia.
Preparation for the
Procedure: After the Procedure: Although the vast majority of patients make a smooth, uneventful
recovery from their procedure, the chances of any problem occurring
can be minimized by following a few simple instructions. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
FAQ
