Microsoft word - website version penile implant 3_2011.doc
A Guide To Implantation of a Penile Prosthesis You have elected to have an implantation of penile prosthesis. The primary purpose of a penile implant is to help you achieve an erection for sexual intercourse. This booklet is aimed at helping you understand your surgery, what will happen in the hospital, and what you can expect when you go home. You should talk to your surgeon or a member of your healthcare team any time you have questions or concerns.
1021 Talbotton Road ● Columbus, GA 31904
(706) 324-7700 ● www.harperurology.com
Implantation of a Penile Prosthesis Things to Consider:
Tell your physician what medications or substances give you allergies, such as, latex, anesthesia, morphine, codeine, penicillin, and seafood. Generally, patients taking “blood thinners,” such as Coumadin (Warfarin) and aspirin, should discontinue their blood thinner 1 week before any medical procedure. Patients taking Plavix (Clopidogrel), however, will need to stop 10 days prior to procedure. (Refer to full list of blood thinning medications supplied) Two Months Prior to Your Surgery
When men with erectile dysfunction (ED) do not get natural erections, fibrosis can occur in the erectile tissue of the penis, which can result in loss of penile girth and length. You are being prescribed a vacuum constriction device (VCD) with specific instruction on use in an attempt to restore some or all of the loss of girth or length you may have experienced. Please read all instructions before using your VCD. If you already have a VCD, please follow manufacturer’s instructions and directions specified below. The ideal goal is to use your VCD for 10-15 minutes daily for 2 months prior to your penile implant surgery. Apply your VCD according to instructions and leave the device on your penis for the full 10-15 minutes prescribed. DO NOT apply constrictive band. Once you have achieved maximum erection on the first day of use, take a marker and mark the length of your penis on the VCD cylinder. After removal, measure from base of the cylinder to your mark and record. Repeat this marking and measuring maneuver every 2 weeks to record your progress. DO NOT use your VCD for 2 days prior to your implant surgery. Discontinue VCD usage if you have any complications and contact Triage Nurse at Urology Center of Columbus, LLC. Summary:
• Read manufacturers and Physician’s instructions • Apply VCD 10-15 minutes daily for 2 months prior to your implant surgery • Leave VCD on your penis for full 10-15 minutes • DO NOT apply constrictive band • Mark length of penis on VCD cylinder on first day of usage and every 2 weeks thereafter • Measure length from base of cylinder to marks and record your progress • DO NOT use your VCD for 2 days prior to your implant surgery • DISCONTINUE usage if you have any complications and contact the Triage nurse at
1021 Talbotton Road ● Columbus, GA 31904
(706) 324-7700 ● www.harperurology.com
One Week Before Surgery
Discontinue aspirin and do not take over-the-counter pain relievers or non-steroidal anti- inflammatory drugs. This includes Advil (ibuprofen), Aleve, Motrin, etc. The only over-the- counter pain reliever that is alright to take is Tylenol (acetaminophen), and this can be taken until the day before surgery. You should also stop blood thinners, such as, Coumadin. Your doctor will advise you when it is appropriate to restart. (Refer to list of blood thinning medications supplied) Pre-Registration Appointment
You will have a pre-registration appointment at the hospital. Please make sure that you make this appointment and bring the paperwork that the surgery scheduler gives you. One Day Prior To Surgery
On the night before surgery, do not eat or drink after midnight. Also, you may want to arrange in advance who will drive you home. The Day of Surgery
Please arrive at the hospital or The Surgery Center at the time instructed by our surgical schedule unless the hospital or The Surgery Center informs you of another time. Remember not to eat or drink anything. If you have questions regarding certain medications, please ask the anesthesiologist at registration. Your surgery will be done under spinal anesthesia or general anesthesia. This will be determined the day of surgery by the anesthesiologist. After surgery there will be an overnight stay for observation, and then you will be discharged home. If you are having an implant revision or replacement, you will most likely be discharged the day of your surgery. If you have any questions prior to surgery, please contact our surgery scheduler at (706) 324-7700.
1021 Talbotton Road ● Columbus, GA 31904
(706) 324-7700 ● www.harperurology.com
After Surgery
The following are common after this type of surgery:
• Pain, swelling, and/or bruising of the scrotum and penis • Mild drainage at surgical site
After surgery you should drink plenty of fluids and have a healthy diet. Swelling of the genital area will be lessened if ice is applied for the first 48-72 hours following the surgery. After that, mild heat should be applied to promote healing. Whenever you are up and about, the scrotal support should be worn. Otherwise, swelling and pain will increase. During the first week following surgery, you should spend most of the time off your feet, with the scrotum elevated and with ice or heat applied according to the previous mentioned time frame. After 1 week, you may increase your activities as tolerated. If swelling and pain worsen, you are probably overexerting yourself. Sexual activity must be avoided for at least 4 weeks. Post-Operative Follow Up
Post-operative follow up is usually 1 week after surgery. At that time, the implant will be fully deflated (it is left partially inflated after the surgery). Please call the office to make this appointment if an appointment was not given to you. Discharge Medication Antibiotic – Take this medication to prevent infection as instructed. Pain Medication – Take this medication to control post-op pain as needed. You should stop taking narcotic pain medication within 1-2 weeks, and then use an anti-inflammatory, such as, ibuprofen. Please notify us at 706-324-7700 if any of the following occur
1. Heavy bleeding 2. High fever (generally above 102o F) 3. Severe nausea or vomiting 4. Leg pain or leg swelling 5. Shortness of breath or chest pain 6. Severe pain, swelling, redness, or heat at the surgical site
This information is simply a guideline for most patients. As with anything in medicine, your case may vary or need to be individualized. We will be happy to answer any questions and assist with your perioperative care.
1021 Talbotton Road ● Columbus, GA 31904
(706) 324-7700 ● www.harperurology.com
Blood Thinning Medications If you are taking any of the following medications, please review the instructions below for use of these medications prior to your procedure. You may use Tylenol or other brands that contain acetaminophen prior to the procedure if needed. Medication Name
Length of Time Medication Stopped Prior to Procedure
14 days but must consult ordering physician
7 days but must consult ordering physician
The following are elective for urgent cases: Aspirin
1021 Talbotton Road ● Columbus, GA 31904
(706) 324-7700 ● www.harperurology.com
Engaging Resistant Adolescents in Drug Abuse Treatment Center for Family and Adolescent Research In the first phase of a two-part treatment development study, families with a treatment-resistant, drug-abusing adolescent (n=42) were offered 12 sessions of Community Reinforcement and Family Training (CRAFT). This parent-focused intervention was designed to help parents facilitate their adoles
The following are the instructions for CT Head, Chest, Neck, Arms & Legs: 1. NPO – Nothing to eat or drink 4 hours prior to scan. 2. Take medications with small sips of water. 3. For sinus/head scans: remove all metal from the head area including dentures/partials with metal, earrings, necklaces and pins. 4. IV contrast may be used depending on the reason for the procedure. 5. During