Pre-op instructions

PRE-OPERATIVE INSTRUCTIONS
FOR YOUR SURGERY
Drug Sheet:
Please notify your doctor if you are taking ANY of the drugs listed below. You should discontinue these drugs and ALL
VITAMINS THREE TO FOUR WEEKS prior to your surgery and
before any laboratory tests are done. However, if your doctor
has ordered the medication, consult him/her before discontinuing.

This list is constantly changing. Please consult your local physician to
make sure that the medications you are taking do not affect your
platelets or blood coagulation (PT/PTT tests).
IMPORTANT: If you are taking any of the drugs listed below,
please indicate the date on which you last took this medication on the new patient consultation form, under medications, and the Vitamins
*Metformin has to be stopped only 3 days before surgery* Attention all patients:

Please start practicing Kegel exercises prior to your surgery
and resume them once the catheter is removed. Thank you.

Q: KEGEL EXERCISES/SPHINCTER MUSCLE EXERCISES:
Wil you provide me in writing the proper way to do Kegel exercises
post radical prostatectomy?
A: There are many disagreements about what is the “proper” way.
I like to have patients do Kegel exercises by imagining that they are
urinating and then contracting the muscles to “cut off” the stream. They should hold the contraction for only a second or two. Then, they should let the muscle rest for 5-10 seconds and repeat the contraction. I advise patients to do a set of 10 contractions four times a day – usually at breakfast, lunch, dinner, and bed time. This allows the muscles to rest between exercise periods so the muscles do not remain in a fatigued state. In addition, I like the patient to actually stop the urinary stream once or twice when urinating to determine whether he is contracting the right muscles. If the stream stops, he is contracting the right muscles. Taken together, this leads to about 50 contractions per day. This is like doing 50 push-ups a day and wil strengthen the muscles if done faithfully. More than 50 contractions may be too much and may leave the muscles fatigued – resulting in worse continence. PLEASE follow these instructions and not other instructions you may receive from other sources.
Bowel Prep for Radical Prostatectomy with Dr. Catalona:

In preparation for your surgery, Dr. Catalona has prescribed the
fol owing bowel preparation, which you wil do at home, or in the
 Eat light meals all day such as fish, chicken, soup, salad, and fruit. AVOID steak, pasta or deep fried foods.  After your evening meal, give yourself a Dulcolax suppository (or any over the counter suppository). The suppository wil stimulate a bowel movement in about one hour. After you have had the bowel movement, give yourself a Fleet enema (or any brand, as long as it’s an enema).
No food or drink or after 10:00 PM the evening before your
surgery, including water and gum. If you must take
medicine, please take it with only a few sips of water. Please
consult the RN regarding any medications you can or cannot
take.
While purchasing the suppository and enema, you may wish to
purchase a stool softener (Colace or docusate sodium 100mg
capsules), Milk of Magnesia, and Ferrous Sulfate iron tablets of 325mg. You wil also need these items after the surgery. Also, purchase adult pads (Depends or Poise) and bring with you, when you have the catheter removed. You may also need them when the catheter is in place due to leakage outside the catheter. Please bring them with you to the hospital.


*** NOTE: Please begin taking Cialis 5mg (1 tab daily) starting five days before surgery and continue taking until you run out. You wil be given a prescription for 30 tablets. You wil begin injection therapy during your hospital follow up visit (4-6 weeks post op). You are to stop the pil s before your office visit therefore it is ok if you run out of cialis several days/weeks before your appointment. Please contact our office for prescription before surgery***
Hospital Instructions:

 Nothing to eat or drink AFTER 10:00 p.m.  You wil be given an antibiotic the morning of your surgery.  You must have someone with you when you are discharged  Bring current medications and adult urinary pads.  Bring a container and solution for contact lenses.  Bring a large pair of pants (i.e. sweat pants, jogging suit, etc.) to wear home. They should fit loosely in the waist and
Special Instructions:
• To help prevent infection, always wash your hands. • Begin taking Cialis 5mg 5 days BEFORE your surgery. Please
call or email the nurse if you do not have a prescription for cialis or email her at sshresth@nmff.org • Wear the larger drainage bag at night. Never go to bed with the leg bag on. Urine could backflow into the bladder if the
• It is normal to have blood in the urine as long as the
catheter is in. It is also common for some urine and
blood to leak around the catheter at times. You should
wear a pad inside your briefs, if this occurs. • Urine must always drain downhil . Always keep the leg bag, drainage tube and bedside bag below the level of your bladder. • Avoid kinks in the drainage system. While in bed, don’t lie on • Empty your bags at least every 4 hours or more often as • Keep everything clean. After cleaning the drainage bag, hang the bag in the shower or bath tub to dry out between uses. • Drink sufficient liquids to keep your urine flowing freely and prevent the catheter from becoming clogged. • It is okay to shower with the catheter in. • Keep the catheter taped in place to prevent it from moving in • Make sure it is taped wel to guard against kinking of the catheter tubing that would obstruct the urine flow.
When to Call Dr. Catalona:
Notify your doctor if any of the symptoms listed below occur:
• Pain, redness or swel ing in your lower legs that makes it • If the catheter stops draining, it should be irrigated. You should have received these supplies and instructions before you left the hospital. If you are unable to do this yourself, go to our Emergency Room for assistance with this. If you are not local, go to your nearest Emergency Room. If the catheter needs to be changed it should be changed by a urologist.

Source: http://www.drcatalona.com/new_patient/forms/2013/Pre-Op_Instructions.pdf