Dr James Thompson is an experienced robotic, laparoscopic, endoscopic and open urological surgeon. He has sub-specialty training in (and passion for) the treatment of prostate, bladder and kidney cancer using the latest robotic surgery techniques and for high-impact cancer research that has the ability to immediately improve quality of life and cancer cure rates for the community.
Preparing for Prostate Surgery
A pre-operative guide for prostate surgery
PRE-OP INVESTIGATIONS
Once your surgery date has been decided you will be sent for routine blood and urine tests and an ECG will also be performed at the same time.
These blood and urine tests should be done two weeks before surgery.
If you have a cardiac history (heart condition), you may be sent to a cardiologist for a stress test; if you have had a recent stress test please provide these results to us.
HOSPITAL ADMISSION FORMS
These forms need to be filled out and returned to the hospital as soon as possible after seeing the urologist.
MEDICATIONS
At your pre op nursing consult you will be given a comprehensive list of medications that need to be ceased prior to surgery. All blood thinners (e.g. aspirin, plavix, xarelto, eliquis, pradaxa, warfarin, clexane, asasantin, anti inflammatories or any others) will need to be stopped prior to surgery; these include natural supplements such as Omega 3, fish oil and krill oil. Your surgeon or nurse will advise you when you should stop these and when you may recommence these medications; this decision depends what n your individual medical history and varies from 3-10 days depending on the medication and reason you take it.
If you are on anticoagulants such as Warfarin, Eliquis, Pradaxa or Xarelto, you may need to commence Clexane injection therapy prior to your surgery and continue for up to 4 weeks postop. Your urologist will be in contact with the specialist who prescribes the blood thinners to tailor a plan to your individual situation.
Please bring all of your medications in their original packaging with you to hospital, so the nurses may dispense them to you.
Your Urologist may have prescribed Viagra to be taken prior to your surgery. This may be taken 2 weeks pre-op, twice per week, ½ a 100mg tablet (i.e. 50mg dose) 2 hours before dinner or sexual activity. Once your catheter is removed, you may restart Viagra at 25mg daily with a higher ‘pulse’ dose of 50-100mg twice per week (note: do not take the lower 25mg dose on the days when you take the higher 50-100mg dose).
WHAT TO WEAR TO HOSPITAL
Please bring comfortable pyjamas to hospital and a supply of undies. The undies that we recommend are the firm trunks with the legs in them. They come up high on your tummy for comfort they are also firm, giving excellent scrotal support.
It is not uncommon to have some scrotal swelling and loose undies or loose boxer shorts are unsuitable. Bring firm underwear (e.g. tight briefs or tight boxer shorts that lift and gently compress the scrotum) to hospital with you.
You will need Tena for Men (or alternate brands) level 2 pads when the catheter is removed. If they are required in hospital they are provided by the hospital.
TED stockings, which will be given to you on admission; these anti-embolus stockings are worn for 4 weeks after surgery to prevent a DVT (blood clot), especially important if you have lymph node removal.
if you have extensive lymph node removal, to prevent a blood clot (DVT) you will be discharged with a 4 week supply of once-daily Clexane injections (usually 40mg, but 20-60mg depending on your weight and kidney function). You need to self-inject just under the skin into either the abdomen (in the region above the level of the belly button and below the ribs) or the outside of the upper arms (less preferable as less fat here and difficult to self-inject).
You should NOT inject into the abdomen below the belly button or the thighs, because fluid from this area does not reliably drain into the blood stream after pelvic lymph node removal, so if injected here it may not be effective in preventing clots.
DAY OF ADMISSION
The hospital will contact you on the business-day prior to surgery regarding your admission time and fasting time.
You will arrive at the hospital at your designated time, undergo an admission process with admin staff and a nurse then be dressed for surgery.
Your anesthetist will call you for a phone Pre-op assessment, then will assess you in person on the day of the operation, in the pre-op anaesthetic bay.