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
Suomen sivusto, jossa voit ostaa halvalla ja laadukas Viagra http://osta-apteekki.com/ toimitus kaikkialle maailmaan.
Yritti äskettäin viagra, se toimii erittäin tehokkaasti)) Ostaa Internetin kautta täällä viagra Myös ostaa levitra oikeudenkäynti, vaikutus on silmiinpistävää.
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
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.
• 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
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
If you have any questions prior to surgery, please contact our surgery
1021 Talbotton Road ● Columbus, GA 31904 (706) 324-7700 ● www.harperurology.com
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.
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,
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
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