Patient Name: ___________________________ Hospital: Abbott Northwestern Hospital
Date of Surgery: __________________________ Surgeon: Harold J. Hoppmann, M.D.
Important: Do not eat or drink anything, including water after midnight on the day before surgery!
You must stop all blood thinners 10 days before your procedure. Aspirin, Ecotrin, Persantine and anti-inflammatory drugs taken for arthritis are all blood thinning medications. Vitamin E is also a substance that will thin the blood. If you are taking Coumadin, discuss this with Dr. Hoppmann. If you have any questions regarding your medications, please do not hesitate to call our office.
If you have a heart valve, heart defect or mitral valve prolapse, or an orthopedic joint or implant, please discuss this with Dr. Hoppmann so that preventative antibiotics can be ordered.
Make sure that you take a list of all of your medications to the hospital with you. This is important information that Dr. Hoppmann and the hospital staff involved in your care will need to know.
Preparation for your procedure:
Please use a Fleet's enema 24 hours prior to your procedure and again 2 hours before coming to the hospital. Your local drug store will carry these kits. Follow only a liquid diet the day before surgery. REMEMBER: absolutely nothing to eat or drink after midnight the night before your surgery.
Please make an appointment to see your primary care physician for a pre-operative history and physical within one week of your procedure. This is a requirement that must be fulfilled. If you do not have your H&P, the hospital will cancel your procedure.
Wear comfortable clothing on the day of your procedure. Jewelry and other valuables including watches should be left at home. You will spend the night in the hospital so you may want to bring your own robe and slippers with you.
Arrange to have someone drive you home after surgery. Under no circumstances will you be allowed to drive yourself home.
Notify you primary physician if you develop a cold or other acute illness near your surgery date.
Please call us if you have any questions.
Contact: ____________________________ Urologic Physicians, P.A. 952-920-7660
Prostate Cryo Post Operative Instructions
Activity:
- You will have swelling and bruising of the penis and scrotum (rarely, it may be up to the size of a grapefruit).
- Ice packs to the scrotum and behind the scrotum, 2 hours at a time with a œ hour break. Do not try to freeze the area. The ice packs will help to keep the swelling down. Use the ice packs for 5-7 days. Some people may require a longer time period. Wearing an athletic supporter also helps.
- Lying flat on your back will also help decrease swelling. You may find that during the day when you are sitting up or walking around that the swelling will increase. Lying on you back will decrease it. You may get up to do minimal daily routines, but staying off your feet the rest of the time for 5-7 days will greatly help decrease the swelling. Some people may require a longer period of time.
- You may shower the 2nd day after surgery.
Diet:
Resume your normal diet, unless you are having nausea and vomiting, or feel that you are bloated. If you have any constipation, you can try a mild laxative like Dulcolax. Do not give yourself an enema or rectal medication. The rectal wall is thin after cryoablation.
Medications:
- Take the pain medications you were prescribed as needed. Remember; it takes a while to get into your systems so if you are having chronic pain, take your medication every 4-6 hours. Otherwise you are letting the level of medication go down when you need it. Take any antibiotics as prescribed by Dr. Hoppmann for the full course prescribed.
- You may resume your regular medications, except the blood thinners (as addressed in your pre-op instructions). Please discuss with Dr. Hoppmann when you may resume the blood thinning medications.
Other instructions/information:
- Suprapubic catheter: Do not attempt to urinate normally until 7-10 days after your procedure. Avoid straining! At 7-10 days, you can try turning the valve off for the suprapubic tube and try voiding on you own. After urinating, or if you are unable to urinate, open the valve, drain and measure the amount in a measuring cup and record the amount.
- Suprapubic tube dressing: Take two 4x4 gauze dressings and place one above and one below the tube. Secure them with tape. Change the dressing daily.
- Foley catheter: If you have a Foley catheter, it is usually attached to a leg bag or an overnight bag. You may or may not have a suprapubic tube with this catheter. If you do, the suprapubic tube will always be turned "off" and not attached to the drainage bag.
- You will have 6 puncture wounds with the suture behind your scrotum. This makes it painful and uncomfortable to sit down. Use a hemorrhoid donut to sit on. The stitches are usually uncomfortable for 1-2 weeks.
When to call Dr. Hoppmann:
- If you have any pain not alleviated by medication, fever or chills.
- If you have any questions or problems.
- If your catheter or suprapubic tube is not draining urine.
Post operative cryo information
You will be discharged from the hospital on the day after your cryoablation procedure. What follows are important facts that we want you to be aware of relating to your post operative care. In general, there are no restrictions in activity following cryoablation and you can return to your normal activities as soon as you feel comfortable.
Suprapubic Catheter
If you have a suprapubic catheter do not attempt to urinate normally until 7-10 days. At 7-10 days, you can try turning the valve off for the suprapubic tube and try voiding on your own. After urinating, or if you are unable to urinate, open the suprapubic tube, drain and measure the amount in a measuring cup and record the amount.
Change the suprapubic dressing daily. Use two 4x4 gauze dressings, placing one above and one below the tube. Secure with tape.
Foley Catheter
You may have a Foley catheter in your urethra draining your bladder when you leave the hospital. While the Foley catheter is in, you will be taking an antibiotic to prevent urinary tract infection. We will keep the Foley catheter draining your bladder for three weeks; at which time the catheter will be removed and you will be able to urinate normally. Occasionally, there is still swelling in the area of the prostate at 3 weeks, which makes normal urination difficult. If this is the case, the Foley catheter will need to be reinserted for an additional week.
You will be given two different urine collection bags. One is a large bag for overnight use and the other is a leg bag for day use that you can wear under clothes. It is possible that at some point in the 3 weeks your Foley catheter could become blocked with a small amount of tissue that has sloughed from the urethra. If this occurs, you will notice that the drainage bag has stopped filling and you will become uncomfortable as your bladder fills with urine. Before you leave the hospital you will be given the proper equipment and instructions to clear the Foley catheter if this should happen. Please do not hesitate to call us if your catheter is not functioning properly and you help.
Medications you will be discharged with:
You will be given prescriptions for certain medications that we want you to take after your procedure.
- Antibiotics to prevent infection while your catheter is in. This will usually be Bactrim, one pill 2 times per day.
- Anti-spasmodic to prevent bladder contractions. This will usually be Ditropan, one pill three times per day.
- Anti-inflammatory to prevent pain. Celebrex 200 mg, one pill once per day.
Normal after cryoablation:
You may experience a number of symptoms after your procedure that occur in some patients and should not be cause for alarm. These include:
- Blood in the urine. When you are discharged from the hospital your urine will have some blood in it and may appear red, but without any clots in it. This occurs to some degree in all patients after cryoablation and is not cause for alarm. Your urine should clear in approximately 24 hours after the procedure.
- Scrotal and penile swelling. This occurs about 2-3 days after the cryoablation and is caused by tissue swelling that temporarily blocks the lymph drainage. This is painless and resolves in less than one week. Lying down for short periods of time during the day will improve the swelling.
- Small amounts of bloody discharge from the end of your penis. This can occur for up to 6 weeks after the procedure and is not cause for alarm. It is due to some discharge from the urethra in the area of the prostate.
- Some numbness in the head of the penis. Occasionally, when a large amount of freezing is required, the nerve that supplies sensation to one or both sides of the head of the penis may be affected. After a number of months the sensation returns.
Reasons for concern after cryoablation:
There are certain symptoms that you may experience which might indicate a problem after cryoablation. If you should have any of these symptoms described below after the procedure, do not hesitate to contact us. Some symptoms of concern would include:
- Fever, chills, worsening pelvic pain, or pain during urination. These symptoms may indicate an infection and must be dealt with promptly.
- Decreasing urinary stream. This may indicate sloughing of some dead tissue in the area of the prostatic urethra. This may clear on its own, or if the problem becomes severe, may require removal of dead tissue through a cystoscope.
- Diarrhea after urination or foul smelling urine. These symptoms may indicate an urethrorectal fistula and should be investigated.
Main Phone: 952.920.7660
Billing/Business Office: 952.920.2046
| Main address 6363 France Ave. South Suite 500 Edina, MN 55435 Satellite offices |
||
| 303 E Nicollet Blvd Suite 310 Burnsville, MN 55337 |
2545 Chicago Ave S Suite 502 Minneapolis, MN 55404 |
1515 St Francis Ave Suite 250 Shakopee, MN 55379 |