Preoperative Instructions | Thomas E. Ahlering, M.D.        

COUNTDOWN TO SURGERY

If you are currently awaiting a robotic prostatectomy, it is essential for your own safety and for the success of your surgery that you carefully read and obey these instructions from UCI Urology.

Pre-Operative Instructions:

6-8 WEEKS PRIOR TO SURGERY

• Schedule pre-operative testing.  This testing should be completed no sooner than six weeks prior to the date of surgery to ensure the results are current.  This testing will help to ensure that we have not overlooked any serious medical complications with surgery.  Pre-operative testing generally consists of a chest X-ray, routine blood testing, and an ECG (electrocardio gram, an electrical map of your heart that can reveal and diagnose electrophysiological problems with your heart).

• Initiate a regular routine of male kegel exercises.  Kegel exercise strengthens the pelvic floor muscle group which are involved in stemming the flow of urine.  By building them up now, you will speed up your return to continence after surgery.  Also, strengthing the pelvic floor muscles improves orgasmic function, and thus will help you preserve and regain potency.  In the interest of continence and potency, it is essential you begin a consistent regiment as soon as possible and continue to maintain it faithfully after surgery.
  

7 DAYS PRIOR TO SURGERY

• STOP taking any aspirin products, they increase your chance of excess bleeding during surgery.
• STOP taking any Motrin (ibuprofen) or related non-steroidal anti-inflammatory drugs.
• STOP taking most herbal supplements. 
  
• STOP taking supplements believed to be detrimental to your pre-surgery health including: St. John's Wort, the now illegal ephedra or Ma Huang, kava kava, licorice, pennyroyal, germander, chaparral, borage, coltsfoot, comfrey, life root, sassafras, aristolochia fangchi.
• STOP taking supplements that act as blood thinners and increase the chance of excessive bleeding during surgery including: ginko biloba, garlic, gensing, dong quai, willow, red clover.

• STOP taking Vitamin E before surgery because it too can increase the risk of excess bleeding during surgery.

• If you have been prescribed Coumadin or Warfarin, call the doctor who prescribed them, and ask if it is okay to STOP taking them in light of your impending surgery.  While it is generally beneficial to stop taking these 7 days prior surgery, in certain cases it is not advisable.  If your doctor does NOT allow you to discontinue taking these, please inform your urologist.

TWO DAYS PRIOR TO SURGERY

• Absolutely NO Alcohol or alcoholic beverages 48 hours prior to surgery and 48 hours after surgery.  These can have disasterous consequences on the surgery as well as the anesthesia.

THE DAY BEFORE SURGERY

• Absolutely do not take any of the medications or supplements already stopped (above) including Aspirin or Motrin.
• If you are the first case (7:15AM), do a fleets enema between 8-9pm the night prior to surgery. DO NOT EAT anything after 10PM.
• If you are the second case (11:00AM), DO NOT EAT anything after 12pm & do your fleets enema the morning of the procedure at 6am.

THE DAY OF SURGERY

• You may and probably should take any of these if they are currently prescribed to you:
  
• Heart Medication
• Blood Pressure Medication
• Anti-Seizure Medication
• Insulin (please only take HALF of your normal dose though)
• DO NOT take Water Pills, Diabetic Pills... in addition to anything you have previously stopped taking in preparation for surgery (remember this includes aspirin, motrin, coumadin, warfarrin)
• If you have accidentally taken any medications, supplements, or eaten food that you should not have please call your urologist immediately.

• Bring all medications currently prescribed to you in their labeled containers with you to the hospital.


• Bring your CPAP machine with you if you suffer from sleep apnea

• Leave non-essential valuables (such as watches, jewelry, cell phones) at home to reduce the chance of misplacing or losing them in the hospital.

• If you wear glasses, contact lenses, false teeth or related personal items remember to bring a case to store them in during surgery.