I. General Instructions Before Surgery

Medications

• Do not take any aspirin, Motrin (Ibuprofen), Aleve (Naprosyn), or similar medications for one week before or after your surgery. These medications can cause increased bleeding both during and after your surgery.
• If you have a headache or mild discomfort, you may take Tylenol.
• You may be given antibiotics to take each day for three days before your surgery.

The Night Before

• Do not eat or drink anything after midnight the evening before your surgery.
• Be at Loyola University Medical Center at least two hours before your scheduled surgery time.
• Visitor/Patient parking [ map ] is located in the parking garage connected to Loyola University Medical Center. The parking fee is $3.00

II. Instructions After Surgery

Catheter Care

• During your surgery, a catheter will be inserted to drain the urine from your bladder. The nursing staff will teach you how to care for your urinary catheter and drainage bags before you are discharged.
• Do not sit directly on the catheter, while it is in your bladder. (The pressure from your body weight could damage your urethral repair). A semi-reclining position is best. If you must sit, it is better to sit on a well-padded chair or a pillow.

Pain / Swelling

• To decrease the pain and swelling, place an ice pack on the surgical area (between your legs) for 24 hours. Leave the ice pack in place for twenty or thirty minutes every two hours (a bag of frozen peas works well and can be refrozen between uses).
• When you are sitting or lying down, place a rolled-up hand towel under the scrotum. Elevating the scrotum also helps decrease the pain and swelling.
• If you’ve had a piece of buccal mucosa taken from your mouth, you will need to apply an ice bag to your face for 24 hours. Also use Peridex Swish and Spit after each meal and at bedtime for three days.

Diet

• If you have NOT had a buccal graft taken from your mouth, you may eat a regular diet immediately following surgery.
• If you have had buccal graft taken from your mouth, the evening after your surgery, you may have a Clear Liquid Diet. This includes: Clear broth, weak Tea, Ginger-Ale, Jello, and water. The day after your surgery, you should have a Soft Diet which consists of: Mashed Potatoes, Cream of Rice, Creamed Soups, Ice Cream, and puddings. You can progress to a Regular Diet the second day after surgery.

Hygiene

• The dressings and jock strap may be removed after 48 hours. If they get soaked or very dirty, you may take them off early. No further dressings are needed.
• It is OKAY to bathe or shower after 48 hours.

III. Medications

To control your surgical pain, bladder spasms, and prevent infection you will receive the following medications and prescriptions:

Pain

• In order to decrease your pain after, a local anesthetic will be placed directly into your surgical wound. Due to the effect of this medication, patients often report little or no incisional pain when they wake up after the surgery.
• While you are in the recovery room, you will also receive an intravenous dose of long-acting non-narcotic pain medication such as Toradol. This will further decrease your pain on the day of surgery.
• Most people will still need additional doses of non-narcotic and narcotic pain medications such as Vicodin, and you will be given a prescription for this.
• In order to have the Vicodin on hand when you need it, you should have this prescription filled as soon as possible after you are discharged.

Bladder Spasms

Bladder spasms may feel like abdominal "cramping". You may also feel an urgent need to empty your bladder, even though you have a catheter. At times, bladder spasms will also force urine to squirt out around the catheter. Your catheter is not "leaking".

• You will be given a prescription for medication such as Ditropan XL 10 mg to control bladder spasms. The potential side effects of this medication include: dry mouth, sleepiness, and blurred vision. Generally, these are mild.
• Take one pill every day ONLY if you have bladder spasms. Have this prescription filled only if needed.

Stool Softeners

Pain medications may make you constipated. You may take a stool softener such as Colace each day until your bowel movements return to normal. This can be purchased without a prescription. Some stool softeners also contain a laxative. You do not need the laxative. If you have questions about what to purchase, check with your pharmacist.

Antibiotics

You will need to take an antibiotic such as Macrobid, Cipro, Levaquin, or Bactrim for as long as your catheter is in after surgery. This prescription should also be filled as soon as you get home. When your catheter is removed, you will receive 1-2 weeks of another antibiotic

IV. Follow-Up

VCUG

• You will need to have an X-ray called a VCUG/RUG to make sure you are healed and can have your catheter removed. This is usually done one to four weeks after your surgery.
• The VCUG will be set up by the resident team prior to discharge or by Jeanette Sofia in my academic office at Loyola. If you need to confirm the time or date for this test, please call Jeanette at (708) 216-5100.
• The follow-up VCUG X-ray will be done in the urology clinic at the Loyola Outpatient Center [ map ].

Office Visits

• For the first year after your surgery, you will need to be seen every 3-4 months to review your voiding habits, check for Post-void residual urine, and have a Uroflow study. This will be at the in the urology clinic at the Loyola Outpatient Center [ map ]. Please call 708 216 5100 to schedule your follow-up appointments.
• PLEASE COME TO ALL YOUR APPOINTMENTS WITH A FULL BLADDER, so we can obtain the needed urinary studies.
• You need seek medical attention as soon as possible if you experience either of the following problems:
  • Difficulty emptying your bladder
  • A change in your urinary stream.

V. Contact Numbers

• Ms. Jeanette Sofia is Dr. Alsikafi’s administrative assistant and can be reached at (708) 216-5100. If you call after hours, you will be immediately connected to Loyola Call Connection (the hospital operator). The operator will help you reach the urology resident on call or myself.
• Dr. Alsikafi’s clinic at the Loyola Outpatient Center (708) 216-6901.
• Nights / weekends for emergencies: Call the paging operator at (708) 216-5100 or (708) 216-8000. You will need to wait on the line for a few minutes to give the on-call doctor time to get to a phone.