Dr. Geoff Coughlin

THE FIRST WEEK

Pain: During the first 3 days following your operation take regular panadol (2 tablets 4 times a day). It is helpful to take this whether you are feeling pain or not as it can help prevent the pain from starting and escalating. You will also be discharged from the hospital with a stronger painkiller to take if required. Do not take any medication you are allergic to. Initial discomfort is common and is often described as “I feel like I have done a hundred sit-ups’ If pain is more severe please notify us Some gas pains can occur until the bowel function begins to return

The Incisions: You will have 6 small incisions and 1 incision for specimen extraction. They will often have surgical glue on them. The glue will wear off in 3-4 weeks A small amount of drainage from the incision is normal. It is not uncommon to bruise around the incision site. It can even develop 1-5 days after surgery.

The Foley Catheter: You may experience some discomfort where the catheter inserts. It can be helpful to put a small amount of Vaseline on the tip of the penis and catheter several times a day. You may experience a small amount of urine leakage around the catheter. You may want to put an absorbent pad (such as Depends) in your underwear to soak up any leakage. After activity or a bowel movement, you may have bloody drainage around the catheter or in your urine. This is not a cause for concern. Your urine may be blood stained and the degree can vary throughout the day. It will often be worse after activity. Keep a good fluid intake to help clear the urine. If the amount of blood in the urine is heavy and there are blood clots coming through the catheter please notify us. Should your catheter stop draining urine and you leak large amounts of urine about the catheter then it may be blocked. This happens rarely but if it does you will need to notify us.

Swelling of the Scrotum, Testicles or Penis: Some patients may experience swelling and or bruising in this area after the surgery To help reduce swelling roll up a small towel and place it under the scrotum to elevate it when lying down or sitting You may experience some pain in the perineal area, which is between your scrotum and anus. This is usually relieved by simple analgesics and will resolve over a couple of weeks following the operation

Diet and Bowel Movements: Following the surgery it can take several days for your bowels to begin functioning properly. During this time you can feel distended and may experience gas pains. Belching can occur. It may be a few days before you begin to pass gas and it can take 4-5 days before your bowels begin to work. Do not try and force a bowel movement. Aim to drink 2-3 litres of water per day. Initially you may not have an appetite. Eat small amounts of food for the first few days – more like half of what you would typically eat. Initially eat light meals such as soups, toast and pasta. Once you begin passing gas, you may return to your regular diet You will receive a prescription for stool softener when you leave the hospital. It is important no to strain or bear down at the toilet after your surgery. After activity or a bowel movement, you may have bloody drainage around the catheter or in your urine. This is not a cause for concern.

Physical Activity: Regular walking after your surgery is important for your recovery. Don’t exert yourself more than this for the first 6 weeks. No cycling, running, jogging, weights, sit-ups, swimming, beach etc. Don’t lift more than 5 kgs for 4 weeks after surgery (including luggage and children).

Showers and Baths: You do not need to cover your incisions Avoid tub baths, hot tubs, swimming pools and the ocean for four weeks after surgery. top

THE SECOND WEEK

You will return to the hospital 7days after surgery. You will book in at admissions then go to the ward. On the ward your catheter will be removed and your voiding will be monitored for a period of time.

If your job is primarily sedentary (sitting at a desk) you can usually return to work in 1-2weeks. If your job is physically demanding, you will typically require 4-6 weeks off work.

CARING FOR YOUR CATHETER

What is a Foley Catheter? The Foley Catheter is a flexible tube that passes through the urinary opening into your bladder. Its purpose is to drain urine. There is a small balloon inflated with water at the end of the catheter in your bladder, which keeps it in place.

What is a Leg Bag? The leg bag is a smaller drainage bag that can be attached to your leg for convenience.

Caring for your Catheter Supplies Needed: Soap and warm water Washcloth and dry towel Leg Strap

Caring for Your Catheter: Gather the supplies. Wash your hands with soap and warm water. Gently wash the following areas with soap and water: around the catheter, the catheter tube itself the foreskin, penis and scrotum. Wash twice daily - morning and evening.

Caring for your Drainage Bag and Emptying the Bag: The catheter remains connected to a drainage bag, which collects the urine. You have the option of using the larger Foley bag that can be hung from the bed, etc. or the small leg bag that is strapped to the leg.

With either bag you must: Make sure the bag remains lower than your bladder to ensure drainage. Keep the tubing kink free. Empty the drainage bag when it is just over half full. It is important to remember whether you are wearing the large or small bag as the small one will need to be emptied more frequently. After you empty the bag, close the clamp so it will collect urine again.

Call your doctor or nurse if: The urine is heavily blood stained and contains blood clots The urine is not draining – your bladder may feel full and large amounts of urine may leak around the catheter (small amounts of leakage about the catheter is normal). Your catheter falls out.