General Postoperative Instructions:
1. You are being discharged today following urologic surgery.
2. You should refrain from any straining activities, including lifting anything more than 10 pounds ( gallon of milk) for four weeks time. Avoid straining to push any heavy objects, avoid straining to have a bowel movement. You may continue normal daily activities including walking and taking stairs.
3. You may resume your normal diet.
4. Tylenol and ibuprofen should be used for postoperative pain control. You may use up to 3000 mg/day of Tylenol. You may also use up to 2400 mg/day of ibuprofen, provided you do not have a history of gastric ulcers or bleeding. A low-dose narcotic pain medication will be prescribed which can be used if these medications are not successful in managing your pain, but will increase risk of constipation andr possibly opiate dependency.
5. Do not shower for 48 hours after surgery, at that time you may resume showers but no underwater bathing for 2 weeks. All stitches are underneath the level of the skin, and your incisions are covered with bandaids or skin glue. Allow soapy water to run over these incisions, do not scrub aggressively, pat yourself to dry. Do not bathe underwater or submerge in any bodies of water for 2 weeks postoperatively
6. The Tulane urology department will contact you regarding your follow-up appointment. If for any reason you are not contacted within 5 days of your surgery, please feel free to call the clinic at 504-988-5271 to schedule your follow up appointment.
7. Please also call the urology clinic at the above number if you have any concerning symptoms which include fever with temperature greater than 100.4, severe worsening pain, persistent nausea and vomiting, or foul or malodorous drainage from any of your incisions concerning for infection. Additionally, call immediately if you have a catheter and it stops draining for more than 2 hours.
8. Thank you for choosing Tulane Urology; we are grateful for the opportunity to serve you.
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Post-prostatectomy instructions:
1. You are being discharged today following a robotic prostatectomy (prostate removal) surgery. You will keep your catheter in place for approximately 1 week, and this will be removed in clinic at the time of your return visit. For no reason should anyone attempt to remove or manipulate your catheter. Please attempt to keep the catheter attached to a StatLock device (leg sticker) to secure it and prevent any traction or pulling on the catheter at all times. The nurses will teach you how to manage her catheter using a leg bag which can be worn under your clothing, and a larger bag which can be used to collect urine at night so you don't have to wake up to empty the bag.
2. You should refrain from any straining activities, including lifting anything more than 10 pounds ( gallon of milk) for four weeks time. Avoid straining to push any heavy objects, avoid straining to have a bowel movement. You may continue normal daily activities including walking and taking stairs.
3. You may resume your normal diet.
4. Tylenol and ibuprofen should be used for postoperative pain control. You may use up to 3000 mg/day of Tylenol. You may also use up to 2400 mg/day of ibuprofen, provided you do not have a history of gastric ulcers or bleeding. A low-dose narcotic pain medication will be prescribed which can be used if these medications are not successful in managing your pain, but will increase risk of constipation and possibly opiate dependency.
5. You may use lidocaine jelly, bacitracin or another antibacterial salve to apply to the catheter where it enters the penis to decrease catheter irritation. This can be done as often as necessary.
6. You may be provided with a prescription for antibiotics which are meant to be taken around the time of the catheter removal. Based on your next clinic appointment, you will take the antibiotics 1 day prior, the day of, and 1 day after catheter removal.
7. Do not shower for 48 hours after surgery, at that time you may resume showers but no underwater bathing for 2 weeks. All stitches are underneath the level of the skin, and your incisions are covered with bandaids or skin glue. Allow soapy water to run over these incisions, do not scrub aggressively, pat yourself to dry. Do not bathe underwater or submerge in any bodies of water for 2 weeks postoperatively
8. The Tulane urology department will contact you regarding your follow-up appointment. If for any reason you are not contacted within 5 days of your surgery, please feel free to call the clinic at 504-988-5271 to schedule your follow up appointment.
9. Please also call the urology clinic at the above number if you have any concerning symptoms which include fever with temperature greater than 100.4, severe worsening pain, persistent nausea and vomiting, or foul or malodorous drainage from any of your incisions concerning for infection. Additionally, call immediately if catheter stops draining for more than 2 hours.
10. If you have not had a bowel movement at least every 3 days following your surgery, please go to your local pharmacy and obtain some milk of magnesia or MiraLAX to stimulate a bowel movement. You may also be discharged with a stool softener medication which can be taken for 1 to 2 weeks after the surgery until daily soft bowel movements return.
11. Thank you for choosing Tulane Urology, we are grateful for the opportunity to participate in your healthcare.
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Post-cystectomy instructions:
1. You are being discharged today following a robotic cystectomy (bladder removal) with formation of ileal conduit for urinary diversion.
2. You should refrain from any straining activities, including lifting anything more than 10 pounds (gallon of milk) for four weeks time. Avoid straining to push any heavy objects, avoid straining to have a bowel movement. You may continue normal daily activities including walking and taking stairs.
3. You may resume your normal diet. If you have not had a bowel movement on the third day after your surgery, please go to your local pharmacy and obtain milk of magnesia or MiraLAX to stimulate a bowel movement. You will also be discharged with a stool softener medication which can be taken for 1 to 2 weeks after the surgery until daily soft bowel movements return.
4. Tylenol and ibuprofen should be used for postoperative pain control. You may use up to 3000 mg/day of Tylenol. You may also use up to 2400 mg/day of ibuprofen, provided you do not have a history of gastric ulcers or bleeding. A low-dose narcotic pain medication will be prescribed which can be used if these medications are not successful in managing your pain, but will increase risk of constipation and possibly opiate dependency.
5. Your ileal conduit urinary diversion will need to be managed with application and routine changes of your ostomy appliance. This should be emptied regularly when it’s 33% to 50% full. This averages to about every 2-4 hours. Your pouch should be changed on a schedule that fits your return, on average every 3-7 days depending on the brand. You should not wait until it is leaking to change it. Changing it in the morning before eating/drinking anything will improve your ability to get a good seal as there will be less urine draining. Supplies should be clean but do not need to be sterile. Spots of blood in the stoma are common and can we observed.
6. Avoid underwater bathing for 2 weeks after surgery. You can shower or bathe withor without your pouch in place. Too much soap may prevent good adherence of the appliance to your skin, rinse well. All stitches are underneath the level of the skin, and your incisions are covered with bandaids or skin glue.
7. If any antibiotics are prescribed at the time of discharge, be sure to follow instructions and complete the entire course of medication.
8. The Tulane urology department will contact you regarding your follow-up appointment. Pathology results often take 5-10 businesss days. If for any reason you are not contacted within 5 days of your surgery, please feel free to call the clinic at 504-988-5271 to schedule your follow up appointment. In general, we expect you to follow up in approximately 6 weeks after surgery for a "loopogram" procedure to make sure the conduit and kidneys are draining normally. We may ask to see you sooner to check on the surgical incisions.
9. Please also call us if you have any concerning symptoms which include fever with temperature greater than 100.4, severe worsening pain, intractable nausea and vomiting, or foul or malodorous drainage from any of your incisions concerning for infection, worsening fatigue, collapse, or loss of consciousness.
10. You will likely be discharged with a blood thinner medication to be taken for 1 month as a preventative measure. Take either 2.5mg apixaban (eliquis) once daily for 30 days, or give yourself daily 40mg llovenox subcutaneous injections once daily for 30 days postoperatively to help prevent a blood clot.
11. If you have not had a bowel movement at least every 3 days following your surgery, please go to your local pharmacy and obtain some milk of magnesia or MiraLAX to stimulate a bowel movement. You may also be discharged with a stool softener medication which can be taken for 1 to 2 weeks after the surgery until daily soft bowel movements return.
12. Thank you for choosing Tulane Urology, we are grateful for the opportunity to participate in your healthcare.
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Post-nephrectomy instructions:
1. You are being discharged today following a robotic partial or radical nephrectomy (kidney removal) surgery.
2. You should refrain from any straining activities, including lifting anything more than 10 pounds (gallon of milk) for four weeks time. Avoid straining to push any heavy objects, avoid straining to have a bowel movement. You may continue normal daily activities including walking and taking stairs.
3. You may resume your normal diet. If you have not had a bowel movement on the third day after your surgery, please go to your local pharmacy and obtain milk of magnesia or MiraLAX to stimulate a bowel movement. You will also be discharged with a stool softener medication which can be taken for 1 to 2 weeks after the surgery until daily soft bowel movements return.
4. Tylenol and ibuprofen should be used for postoperative pain control. You may use up to 3000 mg/day of Tylenol. You may also use up to 2400 mg/day of ibuprofen, but try to avoid prolonged use of these (NSAID) medications as they can worsen kidney function if overused. A low-dose narcotic pain medication will be prescribed which can be used if these medications are not successful in managing your pain, but will increase risk of constipation and possibly opiate dependency.
5. If prescribed any antibiotics at time of discharge, be sure to complete the entire treatment course.
6.. Do not shower for 48 hours after surgery, at that time you may resume showers but no underwater bathing for 2 weeks. All stitches are underneath the level of the skin, and your incisions are covered with bandaids or skin glue. Allow soapy water to run over these incisions, do not scrub aggressively, pat yourself to dry. Do not bathe underwater or submerge in any bodies of water for 2 weeks postoperatively.
7. The Tulane urology department will contact you regarding your follow-up appointment. Pathology results often take 5-10 businesss days. If for any reason you are not contacted within 5 days of your surgery, please feel free to call the clinic at 504-988-5271 to schedule your follow up appointment.
8. Please also call the urology clinic at the above number if you have any concerning symptoms which include fever with temperature greater than 100.4, severe worsening pain, persistent nausea and vomiting, or foul or malodorous drainage from any of your incisions concerning for infection. Additionally, call immediately if you notice new onset blood in the urine.
9. If you have not had a bowel movement at least every 3 days following your surgery, please go to your local pharmacy and obtain some milk of magnesia or MiraLAX to stimulate a bowel movement. You may also be discharged with a stool softener medication which can be taken for 1 to 2 weeks after the surgery until daily soft bowel movements return
10. Thank you for choosing Tulane Urology, we are grateful for the opportunity to participate in your healthcare.
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Post-prostate biopsy instructions:
1. You are being discharged today following a prostate biopsy (tissue sampling) procedure.
2. You should refrain from any straining activities, including lifting anything more than 10 pounds (gallon of milk) for 3-7 days time. Avoid straining to push any heavy objects, avoid straining to have a bowel movement. You may continue normal daily activities including walking and taking stairs.
3. You may resume your normal diet. If you have not had a bowel movement on the third day after your procedure, please go to your local pharmacy and obtain milk of magnesia or MiraLAX to stimulate a bowel movement. You may also be discharged with a stool softener medication which can be taken for 1 to 2 weeks after the surgery until daily soft bowel movements return.
4. Tylenol and ibuprofen should be used for postoperative pain control. You may use up to 3000 mg/day of Tylenol. You may also use up to 2400 mg/day of ibuprofen, however be cautious as this may increase risk of worsened bleeding. A low-dose narcotic pain medication will be prescribed which can be used if these medications are not successful in managing your pain, but will increase risk of constipation and possibly opiate dependency.
5. If being discharged with a catheter in place, an appointment will be scheduled for you to get this out in clinic as a nurse visit, or you will be provided instructions on home removal. When removing a catheter at home, always perform this first thing in the morning so if you are later unable to urinate we may be able to see you in clinic during work hours.
6. If prescribed any antibiotics at time of discharge, be sure to complete the entire treatment course.
7. Okay to resume normal showering and bathing at this time.
8. Pathology results usually take 5-10 business days. You will be scheduled for a follow up visit in 2 weeks to discuss results. If you are not contacted, call 504-988-5271 to schedule an appointment.
9. If your procedure was performed transperineally (Dr. Krane), you may experience bruising or swelling of your scrotum or perineum. Apply ice packs 15 minutes on, 15 minutes off for the first three days as needed.
10. Regardless of the biopsy technique, it is normal to have blood per urethra/urine and blood in stool for up to 1 week after the procedure. Blood in the ejaculate may last up to 1 month. Contact the urology office or present to an emergency room immediately if you notice fevers > 100.4F postoperatively, or are unable to urinate with sever lower abdominal pain. A temporary catheter may be necessary to allow for bladder drainage.
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Post-ureteroscopy instructions:
1. You are being discharged today following a ureteroscopic procedure (procedure for managing stones or lesions of the upper urinary tract).
2. You may be discharged with a catheter in place. The length of need to maintain this catheter is dependent on the procedure. Be sure to confirm the date of removal with your surgeon. You may remove this at home, have it removed by your local urologist, or come to our clinic to have it removed. Please attempt to keep the catheter attached to a StatLock device (leg sticker) to secure it and prevent any traction or pulling on the catheter at all times. The nurses will teach you how to manage her catheter using a leg bag which can be worn under your clothing, and a larger bag which can be used to collect urine at night so you don't have to wake up to empty the bag.
3. You are likely being discharged with a stent in place (foreign object inside your body meant to help keep your urinary tract open and draining). Stents are required for various periods of time, from 72 hours to up to 6 weeks. Be sure to confirm with your surgeon what the plan is for stent removal. Stents left in place for more than 3-4 months are at risk of calcification which can make their removal challenging and dangerous, and even lead to loss of a kidney. Stents also commonly cause flank/back pain, lower abdominal discomfort, blood in the urine, and other voiding symptoms like increased urgency and frequency. Stent pain can be managed with daily tamsulosin (Flomax), ibuprofen (up to 2400mg daily), or anticholinergic medications (oxybutynin, etc).
4. Your activity level is self-limited. If something causes you pain or discomfort avoid that activity until the stent is removed.
5. You may resume your normal diet. If you have not had a bowel movement on the third day after your surgery, please go to your local pharmacy and obtain milk of magnesia or MiraLAX to stimulate a bowel movement. You will also be discharged with a stool softener medication which can be taken for 1 to 2 weeks after the surgery until daily soft bowel movements return.
6. Tylenol and ibuprofen should be used for postoperative pain control. You may use up to 3000 mg/day of Tylenol. You may also use up to 2400 mg/day of ibuprofen, provided you do not have a history of gastric ulcers or bleeding. A low-dose narcotic pain medication may be prescribed which can be used if these medications are not successful in managing your pain, but will increase risk of constipation and possibly opiate dependency.
7. IF DISCHARGED WITH A CATHETER - You may use lidocaine jelly, bacitracin or another antibacterial salve to apply to the catheter where it enters the penis to decrease catheter irritation. This can be done as often as necessary.
8. IF DISCHARGED WITH A CATHETER - You may be provided with a prescription for antibiotics which are meant to be taken around the time of the catheter removal. You will either get daily antibiotics until the catheter is removed, or 3 days of antibiotics to begin the day prior to catheter removal.
9. You may resume showering and/or bathing now.
10. The Tulane urology department will contact you regarding your follow-up appointment. If for any reason you are not contacted within 5 days of your surgery, please feel free to call the clinic at 504-988-5271 to schedule your follow up appointment.
11. Please also call the urology clinic at the above number if you have any concerning symptoms which include fever with temperature greater than 100.4, severe worsening pain, persistent nausea and vomiting, or foul or malodorous drainage from any surgical incisions. Additionally, call immediately if a catheter stops draining for several hours.
12. If you have not had a bowel movement at least every 3 days following your surgery, please go to your local pharmacy and obtain some milk of magnesia or MiraLAX to stimulate a bowel movement. You may also be discharged with a stool softener medication which can be taken for 1 to 2 weeks after the surgery until daily soft bowel movements return.
13. Thank you for choosing Tulane Urology, we are grateful for the opportunity to participate in your healthcare.
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Post-TUR instructions:
1. You are being discharged today following a transurethral surgical procedure (resection of tissue in prostate or bladder).
2. You may be discharged with a catheter in place. The length of need to maintain this catheter is dependent on the procedure. Be sure to confirm the date of removal with your surgeon. You may remove this at home, have it removed by your local urologist, or come to our clinic to have it removed. Please attempt to keep the catheter attached to a StatLock device (leg sticker) to secure it and prevent any traction or pulling on the catheter at all times. The nurses will teach you how to manage her catheter using a leg bag which can be worn under your clothing, and a larger bag which can be used to collect urine at night so you don't have to wake up to empty the bag.
3. You should refrain from any straining activities, including lifting anything more than 10 pounds ( gallon of milk) for about 1-2 weeks. Avoid straining to push any heavy objects, avoid straining to have a bowel movement. You may continue normal daily activities including walking and taking stairs.
4. You may resume your normal diet. If you have not had a bowel movement on the third day after your surgery, please go to your local pharmacy and obtain milk of magnesia or MiraLAX to stimulate a bowel movement. You will also be discharged with a stool softener medication which can be taken for 1 to 2 weeks after the surgery until daily soft bowel movements return.
5. Tylenol and ibuprofen should be used for postoperative pain control. You may use up to 3000 mg/day of Tylenol. You may also use up to 2400 mg/day of ibuprofen, provided you do not have a history of gastric ulcers or bleeding. A low-dose narcotic pain medication may be prescribed which can be used if these medications are not successful in managing your pain, but will increase risk of constipation and possibly opiate dependency.
6. You may use lidocaine jelly, bacitracin or another antibacterial salve to apply to the catheter where it enters the penis to decrease catheter irritation. This can be done as often as necessary.
7. You may be provided with a prescription for antibiotics which are meant to be taken around the time of the catheter removal. You will either get daily antibiotics until the catheter is removed, or 3 days of antibiotics to begin the day prior to catheter removal.
8. You may resume showering and/or bathing now.
9. The Tulane urology department will contact you regarding your follow-up appointment. If for any reason you are not contacted within 5 days of your surgery, please feel free to call the clinic at 504-988-5271 to schedule your follow up appointment.
10. Please also call the urology clinic at the above number if you have any concerning symptoms which include fever with temperature greater than 100.4, severe worsening pain, persistent nausea and vomiting, or foul or malodorous drainage from any surgical incisions. Additionally, call immediately if catheter stops draining for several hours.
11. Thank you for choosing Tulane Urology, we are grateful for the opportunity to participate in your healthcare.
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Post-IPP Instructions:
1. You are being discharged today following a penile implant surgery (placement, revision, or removal of device for erectile function).
2. You should refrain from any straining activities, including lifting anything more than 10 pounds ( gallon of milk) for four weeks time. Avoid straining to push any heavy objects, avoid straining to have a bowel movement. You may continue normal daily activities including walking and taking stairs.
3. Do not attempt to inflate or use your penile prosthesis until approved by your surgeon which will occur approximately 6-8 weeks after surgery during your clinic return appointment. Do not attempt to have penetrative intercourse or any sexual activity involving your penis.
4. Remove the scrotal wrap dressing 48 hours after surgery. You should pull gentle, downward traction on the implant pump in the scrotum at least twice a day as soon as it is tolerable. This should not be painful but is meant to help the device heal and settle into a more dependent (lower) position in the scrotum.
5. You may resume your normal diet. If you are diabetic, it is vitally important to control your blood sugars in the weeks following surgery to prevent infection of your implant.
6. Tylenol and ibuprofen should be used for postoperative pain control. You may use up to 3000 mg/day of Tylenol. You may also use up to 2400 mg/day of ibuprofen, provided you do not have a history of gastric ulcers or bleeding. A low-dose narcotic pain medication may be prescribed which can be used if these medications are not successful in managing your pain, but will increase risk of constipation and possibly opiate dependency.
7. Keep your scrotum compressed and elevated for 1-2 weeks postoperatively to help prevent bleeding. This includes wearing compressive underwear or placing a small towel or garment under your scrotum to keep it elevated while lying down.
8. You will be given a prescription for antibiotics which are meant to be taken for 1-2 weeks after surgery. This is very important to help prevent an infection.
9. Do not shower for 48 hours after surgery, at that time you may resume showers but no underwater bathing for 2 weeks. All stitches are underneath the level of the skin, and your incisions are covered with bandaids or skin glue. Allow soapy water to run over these incisions, do not scrub aggressively, pat yourself to dry. Do not bathe underwater or submerge in any bodies of water for 2 weeks postoperatively
10. The Tulane urology department will contact you regarding your follow-up appointment. If for any reason you are not contacted within 5 days of your surgery, please feel free to call the clinic at 504-988-5271 to schedule your follow up appointment.
11. Please also call the urology clinic at the above number if you have any concerning symptoms which include fever with temperature greater than 100.4, severe worsening pain, persistent nausea and vomiting, or foul or malodorous drainage from any of your incisions concerning for infection. Additionally, call immediately if you feel you are unable to urinate.
12. If you have not had a bowel movement at least every 3 days following your surgery, please go to your local pharmacy and obtain some milk of magnesia or MiraLAX to stimulate a bowel movement. You may also be discharged with a stool softener medication which can be taken for 1 to 2 weeks after the surgery until daily soft bowel movements return.
13. Thank you for choosing Tulane Urology, we are grateful for the opportunity to participate in your healthcare.
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Post-AUS instructions:
1. You are being discharged today following placement of an artificial urinary sphincter device (placement, revision, or removal of device for urinary incontinence).
2. You should refrain from any straining activities, including lifting anything more than 10 pounds ( gallon of milk) for four weeks time. Avoid straining to push any heavy objects, avoid straining to have a bowel movement. You may continue normal daily activities including walking and taking stairs.
3. Remove the scrotal wrap dressing 48 hours after surgery. You should expect to continue to leak urine after surgery until the device is activated. This will happen approximately 6-8 weeks after surgery. Under NO circumstances should anyone other than a urologist attempt to place a catheter into your bladder while this device is in your body, as this can damage the device. Make certain to consult with a urologist if you are having concerns regarding your urination.
4. You may resume your normal diet. If you are diabetic, it is vitally important to control your blood sugars in the weeks following surgery to prevent infection of your implant.
5. Tylenol and ibuprofen should be used for postoperative pain control. You may use up to 3000 mg/day of Tylenol. You may also use up to 2400 mg/day of ibuprofen, provided you do not have a history of gastric ulcers or bleeding. A low-dose narcotic pain medication may be prescribed which can be used if these medications are not successful in managing your pain, but will increase risk of constipation and possibly opiate dependency.
6. Keep your scrotum compressed and elevated for 1-2 weeks postoperatively to help prevent bleeding. This includes wearing compressive underwear or placing a small towel or garment under your scrotum to keep it elevated while lying down.
7. You will be given a prescription for antibiotics which are meant to be taken for 1-2 weeks after surgery. This is very important to help prevent an infection.
8. Do not shower for 48 hours after surgery, at that time you may resume showers but no underwater bathing for 2 weeks. All stitches are underneath the level of the skin, and your incisions are covered with bandaids or skin glue. Allow soapy water to run over these incisions, do not scrub aggressively, pat yourself to dry. Do not bathe underwater or submerge in any bodies of water for 2 weeks postoperatively
9. The Tulane urology department will contact you regarding your follow-up appointment. If for any reason you are not contacted within 5 days of your surgery, please feel free to call the clinic at 504-988-5271 to schedule your follow up appointment.
10. Please also call the urology clinic at the above number if you have any concerning symptoms which include fever with temperature greater than 100.4, severe worsening pain, persistent nausea and vomiting, or foul or malodorous drainage from any of your incisions concerning for infection. Additionally, call immediately if you feel you are unable to urinate.
11. If you have not had a bowel movement at least every 3 days following your surgery, please go to your local pharmacy and obtain some milk of magnesia or MiraLAX to stimulate a bowel movement. You may also be discharged with a stool softener medication which can be taken for 1 to 2 weeks after the surgery until daily soft bowel movements return.
12. Thank you for choosing Tulane Urology, we are grateful for the opportunity to participate in your healthcare.