GENERAL

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• Exercise/diet: exercising regularly and eating a healthy diet will help your postop recovery and promote overall good health.

• Bowel preop: clearing the colon/rectum before surgery.

• Constipation: defined as not having regular bowel movements (example: one large bowel movement per day is expected); very common after surgery.

• Smoking: any form of inhaled drug (like cigarettes, marijuana, vaping, including but not limited to nicotine free smoking) may lead to an increased risk of complications; failure to comply with avoiding smoking may lead to cancellation and rescheduling of your procedure.

• Assistance: it is helpful to have someone with you during your recovery.

• Showering: Shower the night before and the morning of surgery with an antibacterial soap such as Hibiclens®, Dial® or Lever 2000®. Take special care to cleanse your penis and genitals. Wash your hair the night before surgery. Do not apply deodorant, powder or lotion.

• Location: surgery will be at CPMC Davies hospital with an average 5 day hospital stay; weekly postop care will be at 45 Castro St Ste 121 (across street from main hospital) with your surgeons.

 

SUPPLIES

 

• Dressings: the list below has the most commonly used dressings for postop care​​

  • Gauze: 4x4 in gauzes work well; they are the right size for placing behind the scrotum and between the scrotum and penis. Expect 1-2 x per day changes for about 4 weeks.

  • Rolls: Kerlix rolls work well for wrapping the leg and arm. When unrolled and fluffed, it acts as a soft “bean bag” to support the phallus in your underwear.

• Underwear: in general, slightly loose boxer briefs work well to hold the gauze in place

  • We don’t want the scrotum compressed or smashed in underwear. We want it gently supported with gauze and/or washcloths inside the underwear.

  • Alternatively, mesh disposable underwear may be used and the facility will provide this before you leave.

• Ointments: in general, aquaphor is helpful for wounds that develop

• Hibiclens: it is important to reduce the amount of bacteria on your skin prior to surgery.

  • Shower with Hibiclens 4% (aka chlorhexidine gluconate) starting 1-3 days prior to surgery. Avoid the head and face.

  • If allergic, use Dial or lever soap.

• Bowel Prep: one bottle of magnesium citrate (8-10 ounces); start at 10am the day before surgery.​

• Constipation prevention: begin regular use once you leave the hospital

  • Miralax powder tends to work best out of all the over-the-counter constipation meds. Use as directed to start; on occasion you will be asked to use it at an off- label dosage of 2-3 x per day to help with constipation.

• Medications:

  • Nausea meds: not required; may be ordered if requested or desired.

  • Pain meds: most patients report good pain control with tylenol with or without ibuprofen with tramadol for breakthrough pain.

 

Please note that this is not a complete list and is generalized for the average patient. We recognize that each patient will have individualized needs and therefore will require specific items not present on this list.

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RISKS

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Risks of surgery in general include bleeding, infection, anesthesia complication, pain, transfusion, blood-borne disease, sepsis (severe infection), medication reactions, positioning injuries including numbness or weakness of an extremity, heart attack, stroke, blood clots in legs or lungs, pneumonia, rhabdomyolysis, nausea, ileus, atelectasis, death.

 

Risks of our surgery in particular includes need for further treatment(s), need for life-long surveillance, incontinence, hematuria (blood in the urine), bladder spasms, post void leakage, damage to surrounding organs (blood vessels, nerves, muscles) necessitating immediate or delayed repair, abscess, fistula and/or stricture formation, injury to the urethra, prolonged need for drain or urinary catheter, unsatisfactory aesthetics or function, partial or total flap loss, and other risks that are not listed but can uncommonly occur.