PRE-OPERATIVE INSTRUCTIONS

Blood Thinners

Plavix (clopidogrel)
Cease 7-10 days prior to surgery. You MAY be instructed to take aspirin in its place.

Warfarin
Speak to your doctor. You will need Clexane ‘bridging’ therapy (last dose 24 hours before surgery)

Pradaxa (dabigatran)
Cease 3 days prior to surgery

Astrix, Cartia, Solprin (aspirin)
Cease 3-7 days prior unless otherwise instructed by your surgeon

Pre-Op Assessment / Pre-admission clinic/ Pathology Tests

  • You must attend this visit if asked to do so by your surgeon or the hospital
  • You must have all blood/urine tests done

Films

Please bring your CT/ultrasound or other appropriate films to your operation. In some cases your surgery will be postponed if you do not.

When do I stop eating and drinking prior to the procedure?

Generally you should be fasted for 6 hours prior to an anaesthetic for elective surgery. The hospital will inform you of when to start fasting depending on your position on the operating list. If you are admitted to the hospital the day prior for bowel prep then the nursing staff will inform you of when to fast based upon my instructions.

Do I take my regular medications?

Take all your regular medications with a sip of water. It is particularly important not to miss blood pressure medications and medications for control of your heart rhythm.

Aspirin and Plavix (clopidogrel)

Generally aspirin or clopidogrel need to be ceased 7-10 days prior to your operation. This is to allow your blood to recover the ability to clot effectively. Please discuss this with me so that you understand what is required prior to the procedure as it may vary depending on your medical problems and the type of procedure.

Warfarin

Warfarin needs to be stopped 5 days before surgery. We start injections of Clexane 4 days before surgery with the last one the night before. You will need your INR checked on the day of surgery. An INR of 1.3 or less is acceptable. Clexane and warfarin will be restarted as soon as possible after surgery. Please discuss this with me if you have questions as advice may vary according to the individual circumstances of each patient.

Vitamin E, fish oil, garlic, gingko biloba

Please avoid taking large doses of Vitamin E, fish oil, garlic or gingko biloba for 10 days prior to your procedure and for two weeks after your procedure. Please do disclose any other herbal supplements or complementary medicines you may be taking.

Diabetics

Notify my staff as well as the hospital if you are diabetic. We will try to prioritise diabetic patients on the operating list.

We follow the Australian diabetic society peri-operative guidelines on fasting:

https://diabetessociety.com.au/documents/PerioperativeDiabetesManagementGuidelinesFINALCleanJuly2012.pdf

Inform staff at the hospital when you are admitted to ensure that your blood sugars are monitored.

Do I bring my CT scan or ultrasound?

It is essential that you bring your CT scan or ultrasound with you. This is especially important if you are having surgery for stones or kidney cancer surgery. If you have forgotten your CT or ultrasound please let the nurses know.

Do I need tests prior to my surgery?

For all urological procedures a urine sample is tested to ensure that there is no infection. Performing elective urological surgery on patients with a urinary tract infection is dangerous. We can perform a quick urine test in the hospital or surgery may have to be postponed if necessary. If you have not been given a request form to have your urine checked one week prior to surgery please contact my staff.

Our goal

Our goal is to ensure that your procedure goes safely and smoothly and that you feel well informed and understand the procedure you are having done. Please contact my staff or myself if you have any questions before or after surgery.

POST-OPERATIVE INFORMATION

Cystoscopy

Expect

  • Burning/Urgency/Frequency (24-72 hrs)
  • Bleeding (minor)

What to do

  • Drink plenty of fluid
  • Take Ural sachets (up to 4 times a day)

Avoid

  • Driving or operating heavy machinery for day after

Inform us if:

  • You are unable to void (pass urine)
  • Have heavy bleeding/clots
  • Have fevers/feel unwell

Bladder/prostate resection/urethral stricture dilatation

(BNI,TURP,TURBT)

Expect

  • Burning (for 24 hrs-72 hrs)
  • Urgency/frequency (for up to 6 weeks)
  • Bleeding/clots (minor)
  • 1-2 nights in hospital
  • Catheter in place for 24-36hrs

What to do

  • drink plenty of fluid
  • take Ural sachets (up to 4 times a day)

Avoid

  • driving (two weeks)
  • Lifting/constipation/straining (6 weeks)

Inform us if you are:

  • Unable to void (pass urine)
  • Have heavy bleeding/clots
  • Have fevers/feel unwell catheter pain/spasms

PATIENT INFORMATION

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