Our Comprehensive
Care Model

Pre-and Post-Operative Instructions

 

Pre and Post-Operative Instructions

Our goal is superior care and the highest satisfaction for all of our patients. Part of our comprehensive care model is providing pre- and post-operative instruction and follow-up care.

Pre-operative Instruction

There is no requirement to shave or use a vacuum device. Blood thinners are usually stopped according to the prescribing physician’s recommendations. The morning of the procedure, patients should arrive at the Summit Ambulatory Surgery Center at least one hour prior to the scheduled surgery.

Post-operative Instructions

Day of procedure:  Relax, stay in bed, use ice, keep the catheter in.

Postoperative day 1:  In the morning, remove the catheter with instructions given by the nursing team. Dressings can be removed, the incision can be open to the air. Take antibiotics and very sparingly, the pain medication.

Postoperative day 1-3:  BED REST, lay flat when at all possible. This is critical to prevent hematoma formation and swelling.

Day 5:  Back at work if no heavy lifting is required.

Day 14:  Can resume taking walks for exercise, normal ambulation.

Day 21:  Back to the gym, exercise, golf, weight lifting.

Day 28:  Activation of the device! Can inflate and deflate the implant, if successful, can resume sexual activity at this point.

 

Best Way to Recover During the First 48 to 72 Hours

The procedure is of short duration and there are some critical steps to take in the first few days that really set the tone for a positive recovery.

The wrap and catheter can both be removed the morning of the first postoperative day.

Bed Rest and Scrotal Elevation

The absolute key to everything is to be essentially in BED REST position for the first 2-3 days.  Being flat, or supine, is critical because it reduces or eliminates swelling and hematoma formation.

Man restingDr. Kramer typically does not leave in a drain that has to be removed. However, the expectations are that there will be little to no swelling. Staying flat reduces the ability of the scrotum to swell. In general, the scrotum “just hangs,” which enables fluids and blood to pool and collect there. Staying flat will, in general, reduce this effect. You can certainly go to the bathroom, or go to the kitchen. Otherwise, stay lying down, or on a couch with your feet up. Surround yourself with your phone, laptop, TV remote, and books and magazines. At day three, you can then start to be more upright.

Getting up and walking after surgery is OVERRATED for this particular surgery. Your heart and lungs will be fine even though you just had surgery, but it will be critical for you to be flat. So don’t feel that you need to walk the hall, do laps down the street, or take a drive and walk around the mall. Remember, the key to everything is reducing and eliminating hematoma (internal collecting of blood).

Ice, Medications, and Showering

Post-op careApplication of an ice pack over the scrotum and penis is helpful for at least the first 24-hours following a 20 minutes on and 20 minutes off routine.

The antibiotics given should be taken twice per day.  Pain medications given do NOT have to be taken, and avoiding them could be beneficial in your recovery.  You may choose to take Advil/Motrin/Aleve, which are good for inflammation AND pain.

You can shower on post-operative day one. Water can just run over the incision, it doesn’t put you at any extra risk.

You can drive postoperative day one as well, as long as you are not taking narcotic pain medication within eight hours of driving.

Foley Catheter
Foley catheter

If you have a foley catheter following surgery, it should be kept in overnight and removed post-operative day one.  If you are staying in a hotel or have gone home you can easily remove it yourself.  The nurses will give you instructions and a demonstration on how to remove it prior to leaving the surgery center.  Keeping it in overnight allows you to recover a bit, get the anesthetic medications out of your system, and your bladder working again. To remove it, you will need to deflate the balloon port of the catheter with a syringe that you’ve been given. Then, withdraw 10cc from the balloon and the catheter will come out.

Inflating and Deflating Instructions

Inflation:

Grip the device and control it with one hand, to stabilize it, while the other tries to inflate the bulb. Draw it down to the bottom or lowest point that the pump can go, it’ll help you control it and get a good grip on that bulb, better than if it floats higher in the scrotum. Then, to inflate– it requires one pretty firm and quick squeeze or pop to get it going and out of the dormant state that it’s in now. Try squeezing slightly hard for the first pump, or quickly and completely to get it going. Subsequent squeezes are easier, but that first pop is hard to get sometimes. You can pump it as hard and as many times as it’ll allow for getting it rigid. This will be reviewed with you.

Deflation:

You’ll need to really pinch that deflate button above the pump bulb, but remember it could turn or twist in any direction. It can be hard to tell which orientation the pump is in and where exactly that deflate button is until you are examined. Feel around to see if you can locate it with your fingers. It is a raised bump that is always above the pump. It’s easier to feel that bump, like a little pellet sticking out if you pull down on the pump because that button is always above it.  Squeeze that button all the way in and hold it for five seconds. It takes equal and opposite force on both sides of that pump while pinching the deflate button to get it all the way in. You’ll feel a little hum or buzz when you find the button – that is the fluid cycling back from the cylinder to the reservoir.

Follow-Up For Out Of Town Patients

Personalized, first-class care and follow-up is an essential part of Dr. Andrew Kramer’s comprehensive concierge services.

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Appointments & Information

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Monday–Friday, 8:30 a.m. to 4:30 p.m.

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