It is important that Dr Swindle’s instructions are followed prior to your surgery as there are a number of things which need to be done in preparation for your open radical prostatectomy. Surgery is sometimes cancelled if instructions are not followed.

Diet

You are required to commence a bowel preparation 24 hours before your admission. Begin a clear liquid diet (no solid foods) 24 hours before the operation and take nothing by mouth after midnight the night before. Use two Microlax Enemas 1 hour before bedtime the night before the operation to help cleanse the lower intestine (Microlax Enemas can be purchased over the counter at your local pharmacy).

It is important to keep your fluid intake high in the 24 hours before surgery. It is very important that you do not eat 8 hours prior to your surgery, as during an anaesthetic there is a risk of vomiting and the stomach contents can enter your lungs. You will, however, be encouraged to drink water up until six hours before the operation.

Medication advice

Many medications can thin the blood and cause excessive bleeding during surgical procedures. It is very important that you cease any blood thinning medications 7-10 days prior to the procedure. Common medications that thin the blood are Aspirin, Warfarin, Plavix (Clopidogrel) and anti-inflammatory pain medications.

For a complete list of medications that may thin the blood or interfere with a surgical procedure, please refer to our information on surgery preparation and medications. Do not stop any of these medications without discussion with Dr Swindle as he will advise you of the exact timing to cease any medication.

Please ensure Dr Swindle is aware of all drugs, pills and medications that you take, whether on prescription or not, even if they are not on the list of medications to avoid.

Admission to hospital

It is recommended you bring loose-fitting and comfortable clothing such as pyjamas for after surgery. If you wear contact lenses, glasses or dentures, bring a case so these can be stored during surgery. You will be given a surgical gown to wear and anti-thrombus compression stockings will be fitted after you have showered. Though these can come off to shower during your hospital stay, they must remain on at other times to reduce the risk of blood clots forming in the legs. The stockings are removed when you are ready to be discharged from hospital.

You need to be ready one hour prior to theatre. You will also be fitted with SCD’s or sequential compression devices. These compress your legs using specially designed air bags and help prevent blood clots, know as deep vein thrombosis (DVT), forming in your legs.

Generally unless there are significant problems, you will see the anaesthetist on the morning of surgery. Once you are due to go to theatre, the nurses will complete a checklist and escort you to the theatre. You will enter the theatre anaesthetic room where you will be once again check-listed by the theatre staff and anaesthetist. A drip will be placed in your arm to allow them intravenous access during the operation.

Pre-operative preparation

We ask all patients to meet with Peter Dornan, a physiotherapist interested in prostate cancer and urinary continence, prior to the operation to discuss pelvic floor exercises as they are recommended to build strength, commencing up to 8 weeks prior to surgery. Information about these exercises may be found in post operative information below.

We ask all patients to meet with Dr Michael Gillman, a doctor who specialises in penile rehabilitation post robotic prostatectomy. Patients erections may be diminished immediately post surgery and there is increasing evidence that early medical interventions can aid in both early recovery and eventual recovery of erectile function.

Dr Swindle will advise you regarding getting as fit as possible for your surgery and may discuss losing weight prior to surgery. There is evidence to suggest that patients who are fit and not overweight have less postoperative complications from surgical procedures.

You will see Dr Swindle the week or so prior to the operation to ensure that all necessary investigations are up to date and that all important pre operative consultations and appropriate investigations have taken place.

The following things will be double checked: Blood and urine test results (FBE, ELFT’s, MSU), x-ray results (CXR, CT scan and possibly bone scan and MRI of the prostate), flexible cystoscopy results and that a physiotherapy and penile rehabilitation consultation have taken place.