Post Operative Instructions

1. Circumcision

DIET

You may return to your normal diet within twenty-four hours following your surgery. You may note some mild nausea and possibly vomiting the first six to eight hours following surgery. This is usually due to the side effects of anesthesia, and will disappear quite soon. We suggest clear liquids and a very light meal the first evening following surgery.

ACTIVITY

During the first few days following surgery, you should avoid lifting heavy objects (anything greater than fifteen pounds), and avoid strenuous exercise. If you work, ask us specifically about your restrictions, both for home and work. We will write a note to your employer if needed.

Ice packs may be placed on and off over the penis for the first 48 hours to relieve the pain and keep the swelling down. 15 minutes on and 15 minutes off is a reasonable schedule. Another way of accomplishing this with less mess is to use frozen peas or corn in a ZipLoc bag. They can be used, re-frozen, and used again.

INCISION

In most cases your incision will have multiple sutures that run along the course of your incision. Expect some redness around the sutures. If there is generalized redness, especially with increasing pain or swelling, let us know. The penis occasionally bruises.

HYGIENE

Take the dressing off completely and apply Neosporin sparingly twice a day. You may shower 48 hours after surgery. Tub bathing should be restricted until after the sutures have dissolved and the wound has healed. If your incision is draining after the sutures are out, do not sit in a tub bath without our approval.

MEDICATION

You may resume blood thinners in 48 hours. You will be sent home with some type of pain medication. In most cases this will be a narcotic pain pill. If the pain is not too bad, you may take Tylenol (acetaminophen), which contains no narcotic agents and has fewer side effects. If the pain medication you receive does not control the pain, you will have to let us know. Some narcotic pain medications cannot be given or refilled by a phone call to a pharmacy.

  • You should continue to take most medications that you took prior to surgery. If you are taking a blood thinner such as Coumadin, Plavix, Aspirin, Aggrenox, Pradaxa or anti-inflammatory drugs such as Ibuprofen, Advil, or Motrin, speak to your doctor before taking them again.
  • If your doctor prescribes pain medication, take it as needed. Occasionally, pain medication may cause stomach upset or changes in bowel movements. Be sure to consume enough liquids.
  • To avoid constipation and straining during bowel movements, your doctor may prescribe a stool softener or laxative such as Milk of Magnesia.

PROBLEMS YOU SHOULD REPORT TO US
  1. Fever of 100.5 degrees Fahrenheit.
  2. Moderate or severe swelling under the skin incision or involving the penis.
  3. Drug reactions such as hives, a rash, nausea, or vomiting.
FOLLOW-UP

You should have an appointment to follow up in the office 1 to 2 weeks after surgery.

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2. Lithotripsy (Shock Wave for Kidney Stones)

DIET

As tolerated. Drink plenty of fluids.

ACTIVITY

No lifting for seven days.

MEDICATIONS

In most cases, you will go home with narcotics (pain pills), Flomax (to help pass the fragments), and antibiotics (to prevent infection). If you go home with a strainer, collect the fragments and bring them to the office for analysis.

  • You should continue to take most medications that you took prior to surgery. If you are taking a blood thinner such as Coumadin, Plavix, Aspirin, Aggrenox, Pradaxa or anti-inflammatory drugs such as Ibuprofen, Advil, or Motrin, speak to your doctor before taking them again.
  • If your doctor prescribes pain medication, take it as needed. Occasionally, pain medication may cause stomach upset or changes in bowel movements. Be sure to consume enough liquids.
  • To avoid constipation and straining during bowel movements, your doctor may prescribe a stool softener or laxative such as Milk of Magnesia.
INCISION

There is no incision after lithotripsy. You may notice bruising at the entry site on your skin. This will heal completely with no scars.

PROBLEMS TO REPORT
  • Fever of more than 101 degrees F.
  • Excessive pain/vomiting not controlled with medication.
  • Drug reactions like hives, rash or nausea.
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3. Nephrectomy Surgery

Your recent kidney surgery requires little special post hospital care.

DIET

When you return home you may return to your normal diet gradually. Because of the stress and anxiety, you might start with lighter foods (non-fried) but you really have no restrictions. To avoid constipation, drink plenty of fluids during the day (8 � 10 glasses).

INCISION

You may shower 48 hours after surgery and keep the incision open to air. Your incision is sealed from outside bacteria within two days of surgery. The incision will be tender for the first week and the edges should NOT be pulled apart. If a NEW area of redness or swelling occurs, please let us know. Occasionally, you may have a small amount of drainage from the incision.

ACTIVITY

Your physical activity is to be restricted, especially during the first two weeks. During this time use the following guidelines:

  • No lifting heavy objects (anything greater than 10 lbs).
  • No driving a car and limit long car rides.
  • No strenuous exercise, limit stair climbing to minimum. No severe straining during bowel movements; take a laxative if necessary.
BOWELS

It is important to keep your bowels regular during the postoperative period. Use a mild laxative if needed and call if you are having problems. (Milk of Magnesia 2 to 3 Tablespoons, or 2 Dulcolax tablets for example.)

MEDICATION

If you are on blood thinner, check with the doctor when to resume them. You should resume your pre-surgery medication unless told not to. In addition you will often be given some type of pain medication. These should be taken as prescribed on the side of the bottle unless you are having an unusual reaction to one of the drugs.

  • You should continue to take most medications that you took prior to surgery. If you are taking a blood thinner such as Coumadin, Plavix, Aspirin, Aggrenox, Pradaxa or anti-inflammatory drugs such as Ibuprofen, Advil, or Motrin, speak to your doctor before taking them again.
  • If your doctor prescribes pain medication, take it as needed. Occasionally, pain medication may cause stomach upset or changes in bowel movements. Be sure to consume enough liquids.
  • To avoid constipation and straining during bowel movements, your doctor may prescribe a stool softener or laxative such as Milk of Magnesia.
PROBLEMS YOU SHOULD REPORT TO US
  1. Fevers over 100.5 Fahrenheit.
  2. Increasing pain, swelling, or redness of the incision.
  3. Drug reactions (Hives, rash, nausea, vomiting, diarrhea).
  4. Abdominal distention, vomiting
  5. Excessive drainage from incision
FOLLOW-UP

You will get a follow-up appointment to monitor your progress. Usually the first appointment will be about 7 � 14 days after your surgery.

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4. Open Prostate Surgery

Your recent prostate surgery requires some special post hospital care. The inside of the prostate is quite raw and is lined with a large scab. Certain precautions are needed to insure that this scab is not disturbed over the next 6 (six) weeks while the healing proceeds.

Because of the raw surface inside your prostate and the irritating effects of urine, you may expect frequency of urination and/or urgency (a stronger desire to urinate) and perhaps even more getting up at night. This will usually resolve or improve slowly over the healing period. You may see some blood in your urine on and off over the first six weeks. Do not be alarmed, even if the urine was clear for a while. While blood is visibly present, you should stay at rest and drink a lot of fluids until clearing occurs.

DIET

When you are discharged to home, you may return to your normal diet gradually. Alcohol, spicy foods, and drinks with caffeine or cranberries may cause some irritation or frequency and should be used in moderation. To keep your urine flowing freely and to avoid constipation, drink plenty of fluids during the day (8 � 10 glasses).

INCISION

Your incision is sealed from outside bacteria within three days of surgery. Nonetheless, you should protect it from dirt and soiling for the first ten days or so. The incision will be tender for the first week and the edges should NOT be pulled apart. If a NEW area of redness or swelling occurs, please let us know.

ACTIVITY

Your physical activity is to be restricted, especially during the first two weeks. During this time, use the following guidelines:

  1. No lifting heavy objects (anything greater than 10 lbs).
  2. No driving a car and limit long car rides.
  3. No strenuous exercise, limit stair climbing to a minimum.
  4. No sexual intercourse until okayed by one of your doctors.
  5. No severe straining during bowel movements � take a laxative if necessary.

BOWELS

It is important to keep your bowels regular during the postoperative period. The rectum and the prostate are next to each other and any very large and hard stools that require straining can cause bleeding. You will be given stool softeners (usually) but these are not laxatives. A bowel movement every other day is reasonable. Use a mild laxative if needed and call if you are having problems. (Milk of Magnesia 2-3 Tablespoons, or 2 Dulcolax tablets for example).

MEDICATION

Check with your doctor regarding blood thinners. You should resume your pre-surgery medication unless told not to. In addition, you will often be given an antibiotic to prevent infection and stool softeners. These should be taken as prescribed until the bottles are finished unless you are having an unusual reaction to one of the drugs.

  • You should continue to take most medications that you took prior to surgery. If you are taking a blood thinner such as Coumadin, Plavix, Aspirin, Aggrenox, Pradaxa or anti-inflammatory drugs such as Ibuprofen, Advil, or Motrin, speak to your doctor before taking them again.
  • If your doctor prescribes pain medication, take it as needed. Occasionally, pain medication may cause stomach upset or changes in bowel movements. Be sure to consume enough liquids.
  • To avoid constipation and straining during bowel movements, your doctor may prescribe a stool softener or laxative such as Milk of Magnesia.
PROBLEMS YOU SHOULD REPORT TO US
  1. Fevers over 100.5 degrees Fahrenheit.
  2. Heavy bleeding or clots (See notes above about blood in urine).
  3. Inability to urinate.
  4. Drug reactions (hives, rash, nausea, vomiting, diarrhea).
  5. Severe burning or pain with urination that is not improving.
FOLLOW-UP

You will need a follow-up appointment to monitor your progress. Call for this appointment at the number above when you get home or from the phone in your hospital room before leaving. Usually the first appointment will be about 7 � 14 days after your surgery.

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5. Penile Prosthesis Surgery

DIET

You may return to your normal diet within twenty-four hours following your surgery. You may note some mild nausea and possibly vomiting the first six to eight hours following surgery. This is usually due to the side effects of anesthesia, and will disappear quite soon. We suggest clear liquids and a very light meal the first evening following surgery.

ACTIVITY

During the first 7 to 10 days following surgery, you should avoid lifting any heavy objects (anything greater than fifteen pounds), and avoid strenuous exercise. If you work, ask us specifically about your restrictions, both for home and work. We will write a note to your employer if needed.

You should plan to wear a tight pair of jockey shorts or an athletic support for the first 4-5 days, even to sleep. This will keep the scrotum immobilized to some degree and keep the swelling down. The position of your penis will determine what is most comfortable, but I strongly urge you to keep the penis in the "up" position (towards your head). You may discard the scrotal support if it is too uncomfortable, and use a pair of jockey shorts.

Ice packs should be placed over the scrotum on and off for the first 48 hours. Frozen peas or corn in a ZipLoc bag can be frozen, used, and re-frozen. Fifteen minutes on and 15 minutes off is a reasonable schedule. The ice is a good pain reliever and keeps the swelling down.

INCISION

In most cases your incision will have sutures that run along the course of your incision that dissolve in 4 weeks. Expect some redness around the sutures. If there is generalized redness, especially with increasing pain or swelling, let us know. The scrotum will very likely get "black and blue" as the blood in the tissues spread. Sometimes the whole scrotum will turn colors. The black and blue is followed by a yellow and brown color. In time, all this coloration will go away.

HYGIENE

You may shower 48 hours after surgery. Tub bathing should be restricted until after the sutures have dissolved. If your incision is draining after the sutures are out, do not sit in a tub bath without our approval.

MEDICATION

You will be sent home with some type of pain medication. In most cases, you will be sent home with a narcotic pain pill. If the pain is not too bad, you may take either Tylenol (acetaminophen), which contains no narcotic agents, and might be tolerated a little better, that is fewer side effects. If the pain medication you are sent home with does not control the pain, you will have to let us know. Some narcotic pain medications cannot be given or refilled by a phone call to the pharmacy.

You will also be sent home with an antibiotic. You should plan to finish the entire bottle of pills. This is to prevent an infection in the prosthesis and is obviously important.

  • You should continue to take most medications that you took prior to surgery. If you are taking a blood thinner such as Coumadin, Plavix, Aspirin, Aggrenox, Pradaxa or anti-inflammatory drugs such as Ibuprofen, Advil, or Motrin, speak to your doctor before taking them again.
  • If your doctor prescribes pain medication, take it as needed. Occasionally, pain medication may cause stomach upset or changes in bowel movements. Be sure to consume enough liquids.
  • To avoid constipation and straining during bowel movements, your doctor may prescribe a stool softener or laxative such as Milk of Magnesia.
PROBLEMS YOU SHOULD REPORT TO US
  1. Fever of 100.5 degrees Fahrenheit.
  2. Moderate or severe swelling until the skin incision or involving the scrotum.
  3. Drug reactions such as hives, a rash, nausea, or vomiting.
FOLLOW-UP

This visit, to check your incision and progress, is usually set up 6-7 days following your surgery.

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6. Robotic Prostatectomy

CATHETER CARE

Your catheter is very important to allow healing of the bladder and the urethra. You may use either leg bags or external bags. Be sure the catheter is not kinked or bent so the urine can drain freely. Drain urine from the bag by removing the rubber straps around your leg and turning the valve at the bottom of the bag over the toilet to drain the urine. The tip of the penis may get sore from the catheter rubbing. Use plain water to wash this area daily or more often as needed. Small amounts of blood in the urine are okay. So is urine leaking around the catheter as long as the catheter is draining well.

DIET

"Gas pains" are very common after robotic surgery. Drink more than you eat for the first few days when you go home. Wait until you pass flatus ("break wind") before increasing your diet. Because of the raw surface in the bladder from the surgery, alcohol, spicy foods, and drinks with caffeine may cause some irritation or sense of the need to void despite the fact that the catheter is emptying the bladder. However, if these foods don't bother you, there is no reason to avoid them in moderation.

More importantly is to keep your urine flowing freely, drink plenty of fluids during the day (8 � 10 glasses). The type of fluids (except alcohol) is not as important as the amount. Water is best, but juices, coffee, tea, and soda are all acceptable. Food rich in protein will aid in wound healing. Fluid, fiber, and fruits in your diet will help prevent constipation. Follow dietician recommendations if instructed.

ACTIVITY

Your physical activity is to be restricted, especially during the first week home. During this time use the following guidelines:

  1. No lifting heavy objects (anything greater than 10 lbs).
  2. No driving a car and limit long car rides.
  3. No strenuous exercise, limit stair climbing to minimum.
BOWELS

The rectum and the prostate are next to each other and any very large and hard stools that require straining can cause bleeding. You will be given stool softeners (usually) but these are not laxatives. A bowel movement every other day is reasonable. Use a mild laxative if needed and call if you are having problems. (For example, you may take 2 to 3 tablespoons of Milk of Magnesia, or 2 Dulcolax tablets).

MEDICATION

You should resume your pre-surgery medication unless told not to. You may be discharged with iron tablets to build up your blood count and stool softeners to keep the stool soft. Pain pills (Tylox or Tylenol with Codeine) may also be given to help with wound and catheter discomfort. Tylenol (acetaminophen), which has no narcotics, is better if the pain is not too bad (and you can tolerate these medications).

  • You should continue to take most medications that you took prior to surgery. If you are taking a blood thinner such as Coumadin, Plavix, Aspirin, Aggrenox, Pradaxa or anti-inflammatory drugs such as Ibuprofen, Advil, or Motrin, speak to your doctor before taking them again.
  • If your doctor prescribes pain medication, take it as needed. Occasionally, pain medication may cause stomach upset or changes in bowel movements. Be sure to consume enough liquids.
  • To avoid constipation and straining during bowel movements, your doctor may prescribe a stool softener or laxative such as Milk of Magnesia.
INCISION

Keep open to air after 48 hours. Report swelling, redness, drainage or other concerns.

HYGIENE

You may shower 48 hours after surgery.

PROBLEMS TO REPORT
  1. CALL IMMEDIATELY IF THE CATHETER FALLS OUT, STOPS DRAINING, OR THERE IS A LOT OF BLOOD IN THE URINE.
  2. Any increase in redness or swelling in the incisional area.
  3. If feeling chilled or feverish, take temperature and report if over 101 degrees.
  4. Nausea, vomiting, or abdominal distention.
  5. Persistent constipation, diarrhea, or blood in stool.
  6. Pain not relieved by pain medication and rest.
  7. SHORTNESS OF BREATH, COUGH, OR CHEST CONGESTION/PAIN.
  8. Drug reactions (Hives, rash, nausea, vomiting, diarrhea).
  9. Bleeding from incision.
FOLLOW-UP

You will need a follow-up appointment to monitor your progress. Usually the first appointment will be about 7 to 10 days after your surgery to remove the catheter. Most people will not have good urinary control at first. Come to the office with a small supply of adult diapers that can be purchased at any drug store.

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7. Scrotal Surgery

DIET

You may return to your normal diet within twenty-four hours following your surgery. You may note some mild nausea and possibly vomiting the first six to eight hours following surgery. This is usually due to the side effects of anesthesia, and will disappear quite soon. I would suggest clear liquids and a very light meal the first evening following surgery.

ACTIVITY

During the first 7 to 10 days following surgery, you should avoid lifting any heavy objects (anything greater than fifteen pounds), and avoid strenuous exercise. If you work, ask us specifically about your restrictions, both for home and work. We will write a note to your employer if needed.

You should plan to wear a tight pair of jockey shorts or an athletic support for the first 4-5 days, even to sleep. This will keep the scrotum immobilized to some degree and keep the swelling down.

Ice packs may be placed on and off over the scrotum for the first 48 hours. Frozen peas or corn in a ZipLoc bag can be frozen, used, and re-frozen. Fifteen minutes on and 15 minutes off is a reasonable schedule. The ice is a good pain reliever and keeps the swelling down.

INCISION

In most cases your incision will have absorbable sutures that will dissolve within the first 10-20 days. Some will fall out even earlier. Expect some redness as the sutures dissolve but this should occur only around the sutures. If there is generalized redness, especially with increasing pain or swelling, let us know. The scrotum will very occasionally get "black and blue" as the blood in the tissues spread. Sometimes the whole scrotum will turn colors. The black and blue is followed by a yellow and brown color. In time all the coloration will go away.

HYGIENE

You may shower 48 hours after surgery. Tub bathing should be restricted until the 7th day.

MEDICATION

You will be sent home with some type of pain medication. In many cases, you will be sent home with a narcotic pain pill. If the pain is not too bad, you may take Tylenol (acetaminophen), which contains no narcotic agents, and might be tolerated a little better, with fewer side effects. If the pain medication you are sent home with does not control the pain, you will have to let us know. Some narcotic pain medications cannot be given or refilled by a phone call to a pharmacy. If you take blood thinners (Aspirin, Plavix, Coumadin, Pradaxa, Aggrenox) check with your doctor when to resume them.

  • You should continue to take most medications that you took prior to surgery. If you are taking a blood thinner such as Coumadin, Plavix, Aspirin, Aggrenox, Pradaxa or anti-inflammatory drugs such as Ibuprofen, Advil, or Motrin, speak to your doctor before taking them again.
  • If your doctor prescribes pain medication, take it as needed. Occasionally, pain medication may cause stomach upset or changes in bowel movements. Be sure to consume enough liquids.
  • To avoid constipation and straining during bowel movements, your doctor may prescribe a stool softener or laxative such as Milk of Magnesia.
PROBLEMS YOU SHOULD REPORT TO US
  1. Fever of 100.5 degrees Fahrenheit.
  2. Moderate or severe swelling under the skin incision or involving the scrotum.
  3. Drug reactions such as hives, a rash, nausea, or vomiting.
FOLLOW-UP

You should contact our office within 24 hours to set up your first follow-up appointment. This visit, to check your incision and progress, is usually set up 5-14 days following your surgery.

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8. Stone Removal/Stent Placement Surgery

DEFINITIONS:

Ureter: The duct that transports urine from the kidney to the bladder.

Stent: A plastic hollow tube that is placed into the ureter, from the kidney to the bladder to prevent the ureter from swelling shut.

GENERAL INSTRUCTIONS

Despite the fact that no skin incisions were used, the area around the ureter and bladder is raw and irritated. The stent is a foreign body which will further irritate the bladder wall. This irritation is manifested by increased frequency of urination, both day and night, and by an increase in the urge to urinate. In some, the urge to urinate is present almost always. Sometimes the urge is strong enough that you may not be able to stop yourself from urinating. The only real cure is to remove the stent and then give time for the bladder wall to heal which can't be done until the danger of the ureter swelling shut has passed. (This varies from two to twenty-one days).

You may see some blood in your urine while the stent is in place and a few days afterward. Do not be alarmed, even if the urine was clear for a while. Get off your feet and drink lots of fluids until clearing occurs. If you start to pass clots or don't improve, call us. If you have a string coming out of your urine channel, do not disturb it.

DIET

You may return to your normal diet immediately. Because of the raw surface of your bladder, alcohol, spicy foods, acidy foods, and drinks with caffeine may cause irritation or frequency and should be used in moderation. To keep your urine flowing freely and to avoid constipation, drink plenty of fluids during the day (8 � 10 glasses). Tip: Avoid Cranberry Juice because it is very acidic.

ACTIVITY

Your physical activity doesn't need to be restricted. However, if you are very active, you may see some blood in the urine. We suggest that you reduce your activity under these circumstances until the bleeding has stopped.

BOWELS

It is important to keep your bowels regular during the postoperative period. Straining with bowel movements can cause bleeding. A bowel movement every other day is reasonable. Use a mild laxative if needed, such as Milk of Magnesia 2-3 Tablespoons, or 2 Dulcolax tablets. Call if you continue to have problems. If you had been taking narcotics for pain, before, during, or after your surgery, you may be constipated. Take a laxative if necessary.

MEDICATION

You should resume your pre-surgery medications unless told not to. In additional you will often be given an antibiotic to prevent infection. These should be taken as prescribed until the bottles are finished unless you are having an unusual reaction to one of the drugs.

  • You should continue to take most medications that you took prior to surgery. If you are taking a blood thinner such as Coumadin, Plavix, Aspirin, Aggrenox, Pradaxa or anti-inflammatory drugs such as Ibuprofen, Advil, or Motrin, speak to your doctor before taking them again.
  • If your doctor prescribes pain medication, take it as needed. Occasionally, pain medication may cause stomach upset or changes in bowel movements. Be sure to consume enough liquids.
  • To avoid constipation and straining during bowel movements, your doctor may prescribe a stool softener or laxative such as Milk of Magnesia.
PROBLEMS YOU SHOULD REPORT TO US
  1. Fevers over 100.5 Fahrenheit.
  2. Heavy bleeding, or clots (see notes above about blood in urine).
  3. Inability to urinate.
  4. Drug reactions (hives, rash, nausea, vomiting, diarrhea).
  5. Severe burning or pain with urination that is not improving.
FOLLOW-UP

You will need a follow-up appointment to monitor your progress. Call for this appointment at the number above when you get home or from the phone in your hospital room before leaving. Usually the first appointment will be about three to fourteen days after your surgery and your stent will likely be removed at this time.

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9. TURBT/Endoscopic Removal of Bladder Tumors

You have had an endoscopic removal of one or more bladder tumors. This procedure is also called a transurethral resection of bladder tumor or TURBT. During the TURBT, the surgeon uses a cystoscope (thin, tubular, lighted instrument for viewing and for passing small surgical tools into the urethra and bladder). Tumors are removed with a cutting instrument passed through the scope.

FOLLOWING THE PROCEDURE

Depending on the type of anesthesia (loss of feeling caused by drugs) administered, you may:

  • Feel groggy for a few hours following the procedure.
  • Have a mild ache in your back.
  • Need to avoid driving a car or operating machinery for the first 24 hours.
  • Need to avoid consuming alcohol, medication that may cause you to feel sleepy or relaxed such as tranquilizers or sleeping pills, or other over-the-counter medications.

DIET

After the anesthesia has worn off, patients typically can begin to consume clear liquids. For the first 24 hours, you may be asked to avoid heavy meals. Generally, the following day you may resume your normal diet if you are feeling better. Avoid consuming alcohol for at least 24 hours following surgery and for as long as you are taking pain medication.

It is important that you drink plenty of liquids, especially water.

POSTOPERATIVE CARE

You may have a catheter (long, thin tube) inserted into your urethra to help stop any bleeding, to prevent swelling, and to aid in urine flow. Generally, once you have stopped bleeding, the catheter is removed. Occasionally, the catheter may need to remain in for several days, and you may be sent home with the catheter in place. If this occurs, you will return to your doctor's office to have it removed. Be sure that the tube remains clean and is not bent or kinked so that the urine can flow freely.

After your bladder tumor removal, you may experience the following symptoms for several days:

  • Pain or burning sensation while urinating.
  • Need to urinate more frequently.
  • Sudden or urgent urge to urinate.
  • Blood in your urine.

ACTIVITY

Avoid strenuous activity for at least one week or as long as three weeks depending on your doctor's instructions. These activities may include:

  • Sports such as golf, tennis, cycling, and all contact sports.
  • Strenuous lawn work such as moving or raking.
  • Working out and stretching exercises.
  • Lifting any object over 20 pounds in weight.
  • Sexual activity.
  • Straining during bowel movements.

Typically, you may shower as soon as you return home. Your doctor may request that you avoid taking a bath until after your first follow-up appointment.

MEDICATIONS
  • You should continue to take most medications that you took prior to surgery. If you are taking a blood thinner such as Coumadin, Plavix, Aspirin, Aggrenox, Pradaxa or anti-inflammatory drugs such as Ibuprofen, Advil, or Motrin, speak to your doctor before taking them again.
  • If your doctor prescribes pain medication, take it as needed. Occasionally, pain medication may cause stomach upset or changes in bowel movements. Be sure to consume enough liquids.
  • To avoid constipation and straining during bowel movements, your doctor may prescribe a stool softener or laxative such as Milk of Magnesia.
PROBLEMS YOU SHOULD REPORT TO YOUR DOCTOR

Contact your doctor immediately if you experience any of the following:

  • Fever or chills.
  • Inability to pass urine.
  • Severe bleeding.
  • Increasing or severe pain.
  • Worsening or severe burning or pain during urination.

FOLLOW YOUR DOCTOR'S INSTRUCTIONS IF THEY DIFFER FROM THIS SHEET FOLLOW-UP

Your doctor will discuss with you any additional treatment you may need.

For more information about TURBT, you may contact the following resources:

American Urological Association Foundation
1000 Corporate Boulevard
Linthicum, MD 21090
Toll-Free: (866) 746-4282
Phone: (410) 689-3700
Fax: (410) 689-3800
Web: http://www.urologyhealth.org

National Cancer Institute
NCI Public Inquiries Office
6116 Executive Boulevard
Room 3036A
Bethesda, MD 20892-6237
Toll-Free: (800) 422-6237
Web: http://www.cancer.gov/cancertopics/types/bladder

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10. TURP/Endoscopic Removal of Prostate Tissue

You have had an endoscopic removal of the prostate. This procedure is also called a transurethral resection of prostate or TURP. During the TURP, the surgeon uses a cystoscope (thin, tubular, lighted instrument for viewing and for passing small surgical tools into the urethra and bladder). Tissue is removed with a cutting instrument passed through the scope.

FOLLOWING THE PROCEDURE

Depending on the type of anesthesia (loss of feeling caused by drugs) administered, you may:

  • Feel groggy for a few hours following the procedure.
  • Have a mild ache in your back.
  • Need to avoid driving a car or operating machinery for the first 24 hours.
  • Need to avoid consuming alcohol, medication that may cause you to feel sleepy or relaxed such as tranquilizers or sleeping pills, or other over-the-counter medications.

DIET

After the anesthesia has worn off, patients typically can begin to consume clear liquids. For the first 24 hours, you may be asked to avoid heavy meals. Generally, the following day you may resume your normal diet if you are feeling better. Avoid consuming alcohol for at least 24 hours following surgery and for as long as you are taking pain medication.

It is important that you drink plenty of liquids, especially water.

POSTOPERATIVE CARE

You may have a catheter (long, thin tube) inserted into your urethra to help stop any bleeding, to prevent swelling, and to aid in urine flow. Generally, once you have stopped bleeding, the catheter is removed. Occasionally, the catheter may need to remain in for several days, and you may be sent home with the catheter in place. If this occurs, you will return to your doctor's office to have it removed. Be sure that the tube remains clean and is not bent or kinked so that the urine can flow freely.

After your bladder tumor removal, you may experience the following symptoms for several days:

  • Pain or burning sensation while urinating.
  • Need to urinate more frequently.
  • Sudden or urgent urge to urinate.
  • Blood in your urine.

ACTIVITY

Avoid strenuous activity for at least one week or as long as three weeks depending on your doctor's instructions. These activities may include:

  • Sports such as golf, tennis, cycling, and all contact sports.
  • Strenuous lawn work such as moving or raking.
  • Working out and stretching exercises.
  • Lifting any object over 20 pounds in weight.
  • Sexual activity.
  • Straining during bowel movements.

Typically, you may shower as soon as you return home. Your doctor may request that you avoid taking a bath until after your first follow-up appointment. MEDICATIONS

  • You should continue to take most medications that you took prior to surgery. If you are taking a blood thinner such as Coumadin, Plavix, Aspirin, Aggrenox, Pradaxa or anti-inflammatory drugs such as Ibuprofen, Advil, or Motrin, speak to your doctor before taking them again.
  • If your doctor prescribes pain medication, take it as needed. Occasionally, pain medication may cause stomach upset or changes in bowel movements. Be sure to consume enough liquids.
  • To avoid constipation and straining during bowel movements, your doctor may prescribe a stool softener or laxative such as Milk of Magnesia.

PROBLEMS YOU SHOULD REPORT TO YOUR DOCTOR

Contact your doctor immediately if you experience any of the following:

  • Fever or chills.
  • Inability to pass urine.
  • Severe bleeding.
  • Increasing or severe pain.
  • Worsening or severe burning or pain during urination.

FOLLOW YOUR DOCTOR'S INSTRUCTIONS IF THEY DIFFER FROM THIS SHEET FOLLOW-UP

Your doctor will discuss with you any additional treatment you may need.

For more information about TURBT, you may contact the following resources:

American Urological Association Foundation
1000 Corporate Boulevard
Linthicum, MD 21090
Toll-Free: (866) 746-4282
Phone: (410) 689-3700
Fax: (410) 689-3800
Web: http://www.urologyhealth.org

National Cancer Institute
NCI Public Inquiries Office
6116 Executive Boulevard
Room 3036A
Bethesda, MD 20892-6237
Toll-Free: (800) 422-6237
Web: http://www.cancer.gov/cancertopics/types/bladder

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11. Vasectomy

DIET

You may return to your normal diet as soon as you arrive home.

ACTIVITY

Your physical activity should be restricted for the first forty-eight hours. During the first seven days following surgery you should avoid lifting any heavy objects (anything greater than five pounds), and avoid strenuous exercise. If you work, ask us specifically about your restrictions, both for home and work. We will write a note to your employer if needed.

You should plan to wear a tight pair of jockey shorts or an athletic support for the first four to five days, even to sleep. This will keep the scrotum immobilized to some degree and keep the swelling down.

Ice packs may be placed on and off over the scrotum for the first 48 hours. Frozen peas or corn in a Ziploc bag can be frozen, used and re-frozen. Fifteen minutes on and 15 minutes off is a reasonable schedule. The ice is a good pain reliever and keeps the swelling down.

INCISION

In most cases your incision will have dissolving sutures that will dissolve within the first 10 to 20 days. You can shower safely within 48 hours. If there is generalized redness, especially with increasing pain or swelling, let us know. The scrotum will possibly get "black and blue" as blood in the tissues spread. Sometimes the whole scrotum will turn colors. The black and blue is followed by a yellow and brown color. In time, all this coloration will go away.

HYGIENE

You may shower 48 hours after surgery. Tub bathing should be restricted until the 7th day.

SEXUAL ACTIVITY

Sexual activity may be resumed in 3 to 4 days. Use protection until the semen has been checked for absence of sperm.

MEDICATION

You may take Tylenol (acetaminophen) for pain. It is the safest of all the pain relievers, because it causes no bleeding. Aspirin, Ibuprofen and similar medications are to be avoided.

  • You should continue to take most medications that you took prior to surgery. If you are taking a blood thinner such as Coumadin, Plavix, Aspirin, Aggrenox, Pradaxa or anti-inflammatory drugs such as Ibuprofen, Advil, or Motrin, speak to your doctor before taking them again.
  • If your doctor prescribes pain medication, take it as needed. Occasionally, pain medication may cause stomach upset or changes in bowel movements. Be sure to consume enough liquids.
  • To avoid constipation and straining during bowel movements, your doctor may prescribe a stool softener or laxative such as Milk of Magnesia.

PROBLEMS YOU SHOULD REPORT TO US

Fever over 101 degrees Fahrenheit.
Moderate or severe swelling under the skin incision or involving the scrotum.

FOLLOW-UP

You need NO routine follow-up visits to have us examine you unless problems arise. You will need to have two semen analyses, however, to make certain that the vasectomy was successful, at 2 and 3 months. Then bring in a semen specimen in a small jar. The specimen does not have to be fresh. You may collect it the night before and bring it in the next day. If the specimen shows no sperm, then wait four weeks and bring in another specimen. With two negative specimens, you should be sterile permanently.

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Flowood

294 E. Layfair Dr.
Flowood, MS 39232
Phone: 601.936.4645
Fax: 601.936.4643

Monday - Thursday
8:00am - 4:30pm
Friday
8:00am - 12 noon

Kosciusko Clinic

332 Highway 12 West
Kosciusko, MS 39090
Phone: 601.936.4645

Thursday
8:00 am – 3:00pm

We participate with the following hospitals

St. Dominic Jackson Memorial Hospital
Merit Health River Oaks
Merit Health Woman's
Merit Health Rankin
Merit Health Central (CMMC)

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