Cr yoa bla tion of the Pr osta te C r y o a b l a t i o n o f t h e P r o s t a t e Four Weeks Before Surgery:
Stop any herbal medicines and excessive dosages of Vitamin E.
After surgery you will likely have a suprapubic catheter in the blad-
Start kegel exercises - contract your urinary sphincter 20-30 times
der, and possibly a urethral catheter as well. You may have a
per day and hold for 5-10 seconds. This will feel like you are try-
strong urge to pass urine. This is a normal sensation but be sure
ing to hold back urine or hold back a bowel movement. This will
and tell the nursing staff if this is excessive or painful. You will
strengthen your sphincter muscle and help in post-operative
have pain medication and medication for bladder spasms pre-
continence. Start Avodart or Proscar if recommended by your
scribed and be able to use it as necessary. After Surgery: Two Weeks Before Surgery:
Generally, you will be discharged from the hospital on the morning
Stop any Aspirin use and also do not take any over-the-counter
after surgery (post-op day #1) with the suprapubic catheter and
pain relievers. This includes Ibuprofen (Advil), Aleve, Motrin, etc.
possibly a urethral foley catheter. You will be given instructions
The only over the counter pain reliever that is alright to take is
regarding catheter care. You can resume a normal diet at that
Tylenol (Acetaminophen) and this can be taken up until the day
time, and will be placed on a stool softener to avoid constipation.
before surgery. You should also stop any other non-steroidal anti-
You will be maintained on antibiotics.
inflammatory drugs. If you are on any other blood thinners, suchas Coumadin (Warfarin) or Plavix, you will need to stop these as
well. Your doctor will discuss the timing of this with you.
• It is MOST IMPORTANT that NOTHING be placed in the rectum
for several months following surgery. Therefore you must avoid
Two Days Prior to Surgery:
enemas, suppositories, rectal thermometers, sigmoidoscopy,
Start a LIQUID diet (clear liquids preferred) and take no solid
colonoscopy, etc. If you have any questions in this regard,
One Day Prior to Surgery:
• It is very common not to have a bowel movement for a number
On the day before surgery, continue only clear liquids (no solid
of days following treatment. If necessary, you may use any over
foods) and take nothing after midnight. Sometime in the early
the counter laxative TAKEN BY MOUTH. If mild laxatives do not
afternoon take one bottle of Magnesium of Citrate which you can
work, you can use Magnesium of Citrate but this is rarely necessary.
purchase at a pharmacy without a prescription. This is a rapid act-
• The suprapubic bladder catheter can be left to "straight
ing laxative and will usually work within 4-6 hours. Continue to
drainage" (continuously open and draining into a urine collection
drink clear fluids until bedtime or midnight to avoid dehydration.
bag), or may be closed and opened intermittently as needed. Instructions and demonstrations will be provided prior to discharge. The Day of Surgery:
Remember not to eat or drink anything with one exception. If you
• When you are able to pass urine well, the catheter will be
take blood pressure or heart medications, you may take these with
a very small sip of water prior to 5:00 a.m. If you have questionsregarding certain medications, please inquire ahead of time.
• Please note that blood in the urine or blood coming out of the
Check in at the hospital is 2 hours prior to surgery. The hospital
urethra is common after this procedure. Activity, such as walk-
will send you separate information regarding check-in procedures.
ing, may make this worse at times. When there is blood in the
Your surgery will likely be done under general anesthesia and usu-
urine, it is advisable to drink plenty of fluids and it will usually
ally takes between 2 and 3 hours. After surgery there is usually a
clear. If the catheter stops draining you should call your
1-2 hour stay in the recovery room and then you will be transferred
to your room. The rooms are private and semi-private and we willrequest a private room for you but they are limited and this deter-mination can only be made on an availability basis the day of sur-gery. L a r r y L . B a n s , M . D . - C r y o a b l a t i o n o f t h e P r o s t a t e
• It is very common to have bloody discharge from the urethra
after treatment. Using a protective pad may be necessary.
• You may begin showering the day after surgery, but should
avoid tub baths, swimming pools, Jacuzzi's, etc. until yourcatheter is removed.
• It is very common to have swelling and ecchymosis (bruising /
black & blue) on the penis, scrotum and perineum after surgery. If necessary, an ice pack used intermittently (30 minutes on - 30minutes off) and a scrotal supporter may be helpful. When lyingdown, scrotal elevation with a rolled towel under the scrotummay be helpful.
• Bladder spasms are common after surgery. This may be painful
and urine may come out the penis or around the catheter. Medication will be provided for this. As long as your catheter isdraining well, this is NOT harmful.
• It is possible that there may be some numbness in the penis
after treatment. This is not harmful, but may take weeks tomonths to gradually improve. Larry L. Bans, M.D. Prostate Solutions of Arizona 2525 E Arizona Biltmore Circle, Suite C236 • Phoenix, AZ 85016 Ph: 602-426-9772 • Fx: 602-426-9775 • www.psa.md Activity After Surgery:
Walking is fine after surgery, but avoid strenuous activities for about 3 weeks. You should not drivehome from the hospital, but may resume driving when your reaction time is not impaired by pain,swelling, the catheter, etc. Remember not to drive if taking any narcotic pain medication. Discharge Medications:
Colace (stool softener) - This is over the counter (non-prescription) and you should take 100 mg,3-times a day for at least a month. A "generic" is fine.
Pain Medication - You will be given a prescription for a narcotic pain medication. It is fine to useif needed but remember: It may cause constipation, so use Tylenol if or when appropriate. NOTE: Most patients are off narcotic pain medication by post-op day 1 or 2.
Antibiotic - Usually Levaquin 500 mg daily for 5 days then Bactrim DS-1 twice a day until yourcatheter is removed. This may vary depending on allergies, etc., and your doctor will explain.
Bladder Spasm Medication - Bladder spasm medication can be used when necessary. You willhave a prescription for this and can fill it if needed. It should be stopped 1 or 2 days prior tocatheter removal. In some cases this medication may make your mouth dry.
You may resume your usual medications after surgery, with the exception of Aspirin or other bloodthinners. These can usually be resumed after your catheter is removed. Please inquire if thereare specific questions in this regard. Catheter Removal:
Your physician will remove the catheter when you are able to pass urine adequately on your own. Voiding trials will be explained. Please notify us promptly if any of the following occur:
• Catheter not draining• High fever (generally above 102° F)• Severe nausea or vomiting• Shortness of breath or chest pain• Leg pain or leg swelling• Diarrhea after urination or foul smelling urine
This information is a general guideline for most patients. As with anything in medicineyour case may vary or need to be individualized. We will be happy to answer any ques-tions and assist with your perioperative care.
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