Urology, urological conditions and treaments explained by a group of expert urologists in Surrey and Sussex.

Patient Information about Urological Operations
(click on headlines to move to details)

- Total Cystectomy And Formation Of Ileal Conduit
- (Clam) Ileocystoplasty
- Removal Of Urinary Catheter
- Information For Male Patients With After-Dribble
- Advice To Parents Of Children Undergoing A Circumcision
- Advice To Parents Of Children Having An Orchidopexy
- Rigid Cystoscopy
- Rigid Cystoscopy And Bladder Biopsy
- Rigid Cystoscopy And Urethral Dilatation
- Rigid Cystoscopy And Hydrodistension
- Trans-Urethral Resection Of Bladder Tumour (TURBT)
- Nephrectomy
- Pyeloplasty
- Circumcision (Adult)
- Frenuloplasty
- Removal Of Penile Lesion
- Nesbit’s Procedure
- Dorsal Split Of The Foreskin
- Transurethral Resection Of The Prostate (TURP)
- Urethrotomy
- Bladder Neck Incision
- Biopsy Of The Prostate
- Litholapaxy (Endoscopic Removal Of Bladder Stones)
- Rigid Ureteroscopy
- Patients With An Indwelling Stent
- Removal Of An Epididymal (Testicular) Cyst/Lump
- Orchidopexy
- Orchidectomy
- Radical Orchidectomy
- Sterilisation By Vasectomy
- Reversal Of Vasectomy

TOTAL CYSTECTOMY AND FORMATION OF ILEAL CONDUIT
Discharge information for patients

This information should be read in conjunction with the information you have received from your stoma care nurse. The time periods below indicate the time from your operation date.

The average length of hospital stay is 7-10 days. If you still have wound stitches on discharge the District Nurse will remove them. Your stents will be removed by the Stoma Nurse if still in place on discharge.

Contact your GP if there is an increase in any drainage from the wound site; increased pain, redness or swelling in that area. Or if you feel any fever, temperature or chills - these may be signs of infection.

It is quite normal to feel tired and lethargic following an operation. It may take up to 3 months for you to feel fully recovered. Rest as much as possible and gradually build up to your previous activity level. For the first 6 weeks however, to help prevent straining of your abdominal muscles, refrain from such activities as heavy lifting (anything over 2lb in weight), mowing the lawn, digging, lifting small children etc..

We recommend that you do not drive for at least 6 weeks until you feel comfortable doing an emergency stop. We also recommend you inform your car insurers.

Try and eat a normal well balanced diet, including fresh fruit and vegetables, to help prevent constipation and straining.

Drink at least 1½ litres/3 pints of fluid a day e.g. water. Drinking cranberry juice every day may help break down the mucous if production is excessive.

The stoma care nurse and District Nurse will visit to ensure you are managing at home.

Your GP will advise you when to return to work. If you require a sick certificate whilst in hospital, please see the ward clerk before discharge. Further certificates may be obtained from your GP if required.

You will receive an Outpatient appointment through the post for about 4-8 weeks post-discharge; here you will be reviewed by your medical team.

Meanwhile should you require any other information please do not hesitate to contact:

the stoma care nurse at East Surrey Hospital on 01737-768511.
out of hours : nurse in charge, Buckland Ward 01737- 231654.

EM April2000

(CLAM) ILEOCYSTOPLASTY
Discharge information for patients

The time periods below indicate the time from your operation date.

The average length of hospital stay is 7-10 days. If you still have wound stitches on discharge the District Nurse will remove them. Your medical team will decide when the catheter in your lower abdomen will be removed. You may have a test using a dye in your bladder before this happens.

If there is an increase in any drainage from the woundsite, increased pain, redness or swelling in that area, or if you feel any fever, temperature or chills, please contact your GP; these may be signs of infection.

We recommend that you do not drive for at least 6 weeks until you feel comfortable doing an emergency stop. We also recommend you inform your car insurers.

Try and eat a normal well balanced diet, including fresh fruit and vegetables, to help prevent constipation and straining.

Drink at least 1½ litres/3 pints of fluid a day e.g. water. Drinking cranberry juice every day may help break down the mucous if production is excessive.

You will receive an Outpatient appointment through the post for about 4-8 weeks post-discharge; here you will be reviewed by your medical team.

Meanwhile should you require any other information please do not hesitate to contact:

Buckland Ward, East Surrey Hospital 01737- 231654.

EM April2000

REMOVAL OF URINARY CATHETER
Discharge information for patients

For the first 24 hours following the removal of your urethral catheter (tube) you may experience:

passing urine more frequently than usual
a burning sensation on passing urine
a small amount of blood in your urine

If these symptoms persist, or you notice that

your urine is cloudy
your urine has an offensive smell
you have a fever
you have a fever,

please contact your GP so that a urinary infection may be ruled out. If you were discharged from hospital with antibiotics, it is important that you complete the course as instructed.

Please also note it is important:

that you drink plenty of fluids (at least 2 litres/4 pints per day) for about 3 days following the removal of your catheter.
Keep your bowels moving regularly and prevent constipation.

Please seek advice from your GP or your Named nurse/Nurse in charge on Buckland Ward (01737- 231654) if:

your urine stream diminishes to a dribble
you are unable to pass urine
ou feel as though your bladder is full after you have urinated.

EM April2000

INFORMATION FOR MALE PATIENTS WITH AFTER-DRIBBLE

Males may experience After-Dribble. This means the loss of a few drops of urine after the main stream has finished, even after shaking the penis.

This usually occurs at the most inconvenient moment, as the penis is being replaced in to the underwear. It may result in both the underwear and trousers getting wet and stained.

The following may assist you in stopping this from happening.

After passing urine, wait for a few seconds to allow the bladder to empty.

Then place the fingertips of the left hand three finger-breadths behind the scrotum (testicle sack) and apply gentle pressure.

Keeping the pressure on the midline, gently but firmly draw the fingers forwards towards the base of the penis under the scrotum.

Shake or squeeze the penis in the usual way.

Repeat the technique twice more before replacing your underclothes and leaving the toilet.

This technique may be practised at home. It may also be done discreetly in public lavatories using your hand inside the trouser pocket. This should only take a few seconds to do and hopefully relieve you of a potentially embarrassing problem.

EM April2000

ADVICE TO PARENTS OF CHILDREN UNDERGOING A CIRCUMCISION

This procedure removes the foreskin from the end of the penis. It is a quick operation which is usually done on a day case basis. This means that your child will be admitted and discharged on the same day as your operation. They will have a general anaesthetic or sedation so will be sleepy and possibly feel sick after the operation. You should arrange with Outwood Ward regarding their admission and discharge procedures.

On discharge home after the operation, and for a few days, your child may experience pain/discomfort at the wound site. You may find giving them the prescribed/recommended children’s dose of a painkiller may help. Your child may find that wearing loose underpants and trousers may aid their comfort.About 24 hours after surgery you may bath or shower your child, allowing the water to soak off the wound dressing. Avoid the use of bubble baths and scented soaps. Dry your child genital area carefully afterwards.

There may be oozing from the wound site for a few days and you may need to reapply dressings obtained from the ward before discharge. Your child may pull these off, but if dressings are used, remember to thoroughly wash your hands immediately before handling the wound site / the clean dressings, and afterwards.

Help your child keep his penis free from urine as much as possible i.e. dab end with clean tissue paper after each time he urinates. If the ooze from the wound changes to a yellow/green colour with or without an offensive smell, and/or the wound site becomes very red and sore and this does not resolve within 2 days, your child may have a wound infection. You will need to contact your child’s GP or Outwood ward immediately for advice.If your child is sent home with antibiotics ensure he takes the whole course given as instructed.

The stitches are usually dissolvable over 2-3 weeks so will not require removing; check before discharge that this is the case.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654
Outwood (Children’s) Ward, East Surrey Hospital Telephone: 01737- 768511

EM April2000

ADVICE TO PARENTS OF CHILDREN HAVING AN ORCHIDOPEXY

Men usually have two testicles (testis) held in the scrotal sac beneath the penis. Sometimes, one (or rarely both) of the testis do not descend into this sac prior to being one year old. An orchidopexy is an operation which is performed in order to move a testicle into it’s normal position within the scrotal sac, and fix it there. It is a quick operation where (usually) two small cuts are made, in the scrotal sac and the groin, through which the surgery takes place. The operation is usually done on a day case basis but you need to discuss this with Outwood children’s ward.

On discharge home after the operation, and for a few days, your child may experience pain/discomfort at the wound site(s). You may find giving them the prescribed/recommended doses of a painkiller may help. Wearing loose underpants and trousers may also aid comfort because there may be a small amount of scrotal swelling or bruising following the operation. (Resting as much as possible for a few days, particularly with your child’s legs elevated, will aid healing and help reduce any potential swelling of your scrotal area).

If your child is sent home with antibiotics please ensure they take the whole course given as instructed. About 24 hours after surgery your child may bath or shower, allowing the water to soak off the wound dressing. Avoid the use of bubble baths and scented soaps and ensure your child is dried carefully.

There may be oozing from the wound site(s) for a few days and your child may need to have dressings reapplied (these may be obtained from the ward before discharge). Your child may pull these off, but if dressings are used, remember to thoroughly wash your hands before handling the wound site / the clean dressings.

However, if:

the ooze from the wound changes to a yellow/green colour with or without an offensive smell; and/or
the wound site becomes very red and sore; and/or
scrotal swelling or pain is severe;

or you are generally concerned, please contact your child’s GP or Outwood Ward immediately for advice.The stitches are usually dissolvable over 2-3 weeks so will not require removing; check before discharge that this is the case.

Buckland (Urology) Ward, East Surrey Hospital Telephone: 01737- 231654
Outwood (Children’s) Ward, East Surrey Hospital Telephone: 01737- 768511

EM April2000

RIGID CYSTOSCOPY
Discharge information for patients

This is an examination of the bladder and ‘urine pipe’ (urethra) using a fine telescope called a cystoscope. It may be performed under local anaesthetic when it is called a flexible cystoscopy, or a general anaesthetic (when you are asleep) when it is called a rigid cystoscopy.

In addition to the cystoscopy you may have one of a number of possible procedures carried out in your bladder or urethra depending on your urological condition. Any planned treatment will have been discussed with you before your operation by your medical team and your written consent obtained.

After a cystoscopy most patients have an uneventful recovery and are discharged home the same day. When you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours after the anaesthetic. You should arrange for someone to collect you from hospital.

You should drink plenty of fluids following your operation (approximately 2 litres/4 pints per 24 hours). For about 72 hours you may pass urine frequently, experience a mild burning sensation on passing urine, and/or see a little blood in the urine. Continue drinking plenty of water and rest as much as possible.

If these uncomfortable symptoms persist and you notice that your urine is cloudy and/or has an offensive smell, please contact your GP so that a urinary infection may be ruled out. If you were discharged from hospital with antibiotics, it is important that you complete the course as instructed.

If you are at all concerned about your recovery at home and require further information please contact your Named nurse or nurse in charge on Buckland Ward 01737-231654.

EM Mar2000

RIGID CYSTOSCOPY and BLADDER BIOPSY
Discharge information for patients

A cystoscopy is an examination of the bladder and ‘urine pipe’ (urethra) using a fine telescope called a cystoscope. It may be performed under local anaesthetic when it is called a flexible cystoscopy, or a general anaesthetic (when you are asleep) when it is called a rigid cystoscopy.

Biopsy

This is the removal of a small piece of body tissue (in this case from the bladder area) for examination under a microscope in the laboratory. The piece of tissue removed is very small and only leaves a tiny internal wound which heals rapidly.

You will usually have an appointment to return to the urology outpatients department after this operation in order for results to be discussed.

After a cystoscopy and biopsy most patients have an uneventful recovery and are discharged home the same day. When you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours after the anaesthetic. You should arrange for someone to collect you from hospital.

If you are at all concerned about your recovery at home and require further information please contact your Named nurse or nurse in charge on Buckland Ward 01737-231654

EM Mar2000

RIGID CYSTOSCOPY and URETHRAL DILATATION
Discharge information for patients

Urethral Dilatation

This is a procedure to gently stretch a narrowing in the urethra or bladder neck. This procedure does not involve cutting the tissue or stitches.

After a cystoscopy and urethral dilatation most patients have an uneventful recovery and are discharged home the same day. When you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours after the anaesthetic. You should arrange for someone to collect you from hospital.

If you are at all concerned about your recovery at home and require further information please contact your Named nurse or nurse in charge on Buckland Ward 01737-231654

EM Mar2000

RIGID CYSTOSCOPY and HYDRODISTENSION
Discharge information for patients

Hydrodistension / Bladder Dilatation

This procedure does not involve cutting the tissue or stitches. The bladder is gently stretched by filling it with a large quantity of fluid, via the cystoscopy instruments, and held there for a short amount of time. This fluid is removed in the theatre before the patient awakes. It will hopefully result in long term improvement of urinary problems, though occasionally the procedure may have to be repeated at a later date.

After a cystoscopy and hydrodistension most patients have an uneventful recovery and are discharged home the same day. When you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours after the anaesthetic. You should arrange for someone to collect you from hospital. Rest as much as possible.

You should drink plenty of fluids (approximately 2 litres/4 pints per 24 hours). This will help reduce symptoms such as passing urine frequently, a mild burning sensation on passing urine, and a little blood in the urine which may occur for about 72 hours after your operation.

If you are at all concerned about your recovery at home and require further information please contact your Named nurse or nurse in charge on Buckland Ward 01737-231654

EM Mar2000

TRANS-URETHRAL RESECTION OF BLADDER TUMOUR (TURBT) Discharge information for patients

This is an operation to remove an area of suspicious tissue on the lining of the bladder. It is done under a general anaesthetic (when you are asleep). Any planned treatment will have been discussed with you before your operation by your medical team and your written consent obtained.

Firstly, the doctor will perform a rigid cystoscopy. This is an examination of the bladder and ‘urine pipe’ (urethra) using a fine telescope called a cystoscope. Then the area of suspicious tissue is scraped off, usually using a ‘hot wire’. Sometimes there may be many small areas of tissue which need removing. Some of the bladder tissue which has been removed may be sent for examination under a microscope in the laboratory (biopsy). You will usually have an appointment to return to the urology outpatients department a few weeks after this operation in order for results to be discussed. After a TURBT most patients have an uneventful recovery but usually stay in hospital overnight. This is because it may be necessary to insert a catheter into your bladder during your operation to drain the urine and blood. This will be removed before you are discharged home. However it is important to remember that you should not drive a car, drink alcohol or handle machinery for at least 24 hours after a general anaesthetic or sedation. You should therefore arrange for someone to collect you from hospital.

The internal wound(s) will heal rapidly but you may experience some lower abdominal discomfort for a couple of weeks. For about 72 hours after the operation you may pass urine frequently, experience a mild burning sensation on passing urine, and have some blood in the urine, which is normal. Drinking about 2 litres (4 pints) of fluid, preferably water, per 24 hours will aid your comfort, as will resting as much as possible.

If a bladder cancer is confirmed from your biopsy result, it is important that someone examines inside your bladder at least once a year for the next five years. Usually follow up will be more frequent than this and be automatically arranged for you. However, if you move area or do not hear from the hospital for nearly a year, please ring your urology Consultant’s secretary to arrange a bladder check. If you are at all concerned about your recovery at home and require further information please contact your Named nurse or nurse in charge on Buckland Ward 01737-231654.

EM April2000

NEPHRECTOMY
Discharge information for patients

Each human usually has two kidneys located at the back of the abdomen, one on each side of the body. They filter unwanted substances from the blood and produce urine, which is passed out of the body via the bladder. A nephrectomy is an operation performed to remove a kidney. This may be necessary because the kidney is not functioning effectively. Occasionally the operation is necessary because a cancer in the kidney is suspected, though if this is the case it will be discussed with you prior to your operation.

A nephrectomy is performed under a general (you are asleep) anaesthetic and takes about 2 hours. The kidney is removed through an cut / incision, usually made across the affected side of your abdomen at the lower part of your ribs. You will find this quite uncomfortable for a few days when you breath, cough or move, but this will be eased with painkillers. It is important that you do breath deeply and start moving soon after your operation to reduce your risk of complications such as a chest infection or blood clots in the circulation.

During the operation you will have a urine tube - catheter - passed into your bladder. This will remain for a few days so that the urine from your remaining kidney may be monitored. You may also have a small wound drain which will also be removed soon after the operation. You may not be allowed to eat and drink normally for a few days after the operation as you may feel sick. Once this passes you will be able to resume eating and drinking.

The average length of hospital stay is 7-10 days after which you will be discharged into the care of your GP. A district nurse may be arranged to visit you to ensure you are recovering well at home and to remove your wound stitches (at around 10 days after the operation) if still in place. The edges of the wound should remain together and the site free of soreness, redness, inflammation and pus. If any of these symptoms occur once you have gone home please inform your district nurse or GP.

To help prevent straining and potential discomfort at your wound site, it is suggested that you refrain from strenuous physical activities such as heavy lifting, digging the garden etc. for about 6 weeks. You may resume sexual activity after about 4 weeks/ when you feel able. We recommend that you do not drive for at about 4 weeks after discharge (until you feel comfortable doing an emergency stop) and that you inform your car insurers about your operation.

It is quite common to feel quite tired during your recovery, but you should feel fully recovered after about 3 months. You will be reviewed by your medical team about 4-8 weeks after your operation.

It is important to remember that once you have got over the operation you may lead as normal a life with one kidney as with two. Meanwhile should you require any other information please do not hesitate to contact your Named nurse/ nurse in charge, Buckland Ward 01737- 231654

EM April2000

PYELOPLASTY
Discharge information for patients

A pyeloplasty is an operation that is performed when the urine is not draining from the kidney properly because of a narrowing at the junction where the kidney and ureter meet. This is called a pelviureteric junction (PUJ) obstruction. The operation is performed under a general (you are asleep) anaesthetic and takes 1-2 hours. A cut / incision is usually made across the affected side of your abdomen at the lower part of your ribs. The narrowed PUJ area is reconstructed around a small temporary tube, called a stent. This will be removed 7-10 days after surgery simply by cutting a stitch and pulling the tube out.

During the operation a urine tube - catheter - may be passed into your bladder to monitor your urine output. This will be removed after a few days. You may also have a small wound drain which will also be removed soon after the operation. You may not be allowed to eat and drink normally for a few days after the operation as you may feel sick. Once this passes you will be able to resume eating and drinking.

You may find the wound site quite uncomfortable for a few days when you breath, cough or move, but this will be eased with painkillers. It is important that you do breath deeply and start moving soon after your operation to reduce your risk of complications such as a chest infection or blood clots in the circulation.

To help prevent straining and potential discomfort at your woundsite, it is suggested that you refrain from strenuous physical activities such as heavy lifting, digging the garden etc. for about 6 weeks. You may resume sexual activity after about 4 weeks/ when you feel able. We recommend that you do not drive for at least 4 weeks until you feel comfortable doing an emergency stop. We also recommend that you inform your car insurers.

You will receive an Outpatient appointment through the post for about 4-8 weeks after discharge where you will be reviewed by your medical team.

It is quite common to feel quite tired during your recovery which subsides as the weeks go by. You should feel fully recovered after about 3 months.

Meanwhile should you require any other information please do not hesitate to contact your Named nurse/ nurse in charge, Buckland Ward 01737- 231654.

EM April2000

CIRCUMCISION (Adult)
Discharge information for patients

This procedure removes the foreskin from the end of the penis. It is a quick operation which is usually done on a day case basis. This means that you will be admitted and discharged on the same day as your operation. When you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours post-op. You should therefore arrange for someone to collect you from hospital.

About 24 hours after surgery you may bath or shower, allowing the water to soak off the wound dressing. Avoid the use of bubble baths and scented soaps. Dry yourself carefully afterwards.

You may have oozing from the wound site for a few days. Keep penis free from urine as much as possible i.e. dab end with clean tissue paper after each time you pass urine. If the ooze from the wound changes to a yellow/green colour with or without an offensive smell, and/or the wound site becomes very red and sore and this does not resolve within 2 days, you may have a wound infection. You will need to contact your GP or Buckland Ward for advice. If you are sent home with antibiotics take the whole course given as instructed.

The stitches are usually dissolvable over 2-3 weeks so will not require removing; check before discharge that this is the case. For a few days after the operation you may experience pain/discomfort at the wound site which may be relieved by taking prescribed/recommended painkillers. Wearing supportive underpants and loose trousers may aid comfort. It is important to try and avoid having erections until your penile wound has healed. Avoid sex until the wound is healed and you are pain free.

You may return to work when you feel comfortable and know that you can cope with the activities that your job entails.

All men, particularly between the ages of 18-35 and regardless of whether they have had surgery, should perform Testicular Self-Examination (TSE). This checks for any lumps or bumps on the testis and should be done on a monthly basis. Please ask for a leaflet if you are unsure of how to do it.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654

EMApril2000

FRENULOPLASTY
Discharge information for patients

This is a procedure which lengthens the frenulum, the small tag of skin stretched between the shaft of the penis and the foreskin (like the skin tag visible under your tongue when you lift it up). The procedure does not alter the length of your penis.

It is a simple operation which is usually done on a day case basis. This means that you will be admitted and discharged on the same day as your operation. When you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours post-op. You should therefore arrange for someone to collect you from hospital.

About 24 hours after surgery you may bath or shower, allowing the water to soak off the wound dressing. Avoid the use of bubble baths and scented soaps. Dry yourself carefully afterwards.

You may return to work when you feel comfortable and know that you can cope with the activities that your job entails.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654

EMApril2000

REMOVAL OF PENILE LESION
Discharge information for patients

This procedure removes an area of tissue from the penis. Sometime this tissue is sent to the laboratory for analysis (a biopsy).

It is a quick operation which is usually done on a day case basis. This means that you will be admitted and discharged on the same day as your operation. When you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours post-op. You should therefore arrange for someone to collect you from hospital.

About 24 hours after surgery you may bath or shower, allowing the water to soak off the wound dressing. Avoid the use of bubble baths and scented soaps. Dry yourself carefully afterwards.

You may return to work when you feel comfortable and know that you can cope with the activities that your job entails.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654

EMApril2000

NESBIT’S PROCEDURE
Discharge information for patients

This procedure is carried out to try and rectify a bend in the penis. The procedure will involve cutting the penis on one or both sides (with a circumcision-type incision/scar). After the operation your penis may be slightly shorter. If this is of concern to you please discuss this with the doctor before you operation.

This operation is usually done on a day case basis. This means that you will be admitted and discharged on the same day as your operation. When you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours post-op. You should therefore arrange for someone to collect you from hospital.

About 24 hours after surgery you may bath or shower, allowing the water to soak off the wound dressing. Avoid the use of bubble baths and scented soaps. Dry yourself carefully afterwards.

You may return to work when you feel comfortable and know that you can cope with the activities that your job entails.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654

EM April2000

DORSAL SPLIT OF THE FORESKIN
Discharge information for patients

Some men have a tight foreskin, for whatever reason, which may split and bleed e.g. when having sex, which causes them discomfort. A dorsal split is a procedure where the foreskin on the end of the penis is surgically cut to widen, and therefore loosen, the foreskin.

About 24 hours after surgery you may bath or shower, allowing the water to soak off the wound dressing. Avoid the use of bubble baths and scented soaps. Dry yourself carefully afterwards.

You may return to work when you feel comfortable and know that you can cope with the activities that your job entails.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654

EM April2000

TRANSURETHRAL RESECTION of the PROSTATE (TURP)
Discharge information for patients

The prostate is a gland, shaped something like a small orange, situated inside the male body just in front of the rectum and just beneath the bladder. The urine flows out of the bladder and through the ‘urinepipe’, the urethra, which passes through the ‘core’ of the prostate.As men get older the prostate may enlarge gradually. This enlargement may press on the urethra and affect the urine flow out of the bladder. For some men, this may not cause symptoms. Others experience many problems such as going to the toilet frequently, not emptying the bladder fully, getting up to urinate at night, or some incontinence.

The effects will differ with individuals. Some men will suddenly find they are unable to pass urine as normal and will need a ‘plastic’ tube, called a catheter, to be inserted into the bladder to drain the urine as an emergency. Other men notice a gradual decline in urine flow. Eventually some men will need an operation to remove part of the prostate and relieve this urine flow. The operation A TURP is performed under an anaesthetic using instruments which are passed up your penis. Pieces of the prostate are ‘chipped’ or ‘scraped’ off and removed through the penis, so you will not have a cut on your abdomen from this procedure.

The operation may take 30 minutes to an hour, but you may be off the ward for longer as you are observed in a recovery area after theatre. You will then return to the ward for an average length of hospital stay of 3-5 days. During the operation the surgeon will have placed a catheter in your penis to drain the urine from your bladder. This will be removed after 2-3 days when your drained urine is reduced / free of blood and clots. You will then be discharged into the care of your GP who will receive a report from the Hospital on your operation. Although you have no visible scar, you have had a major operation. There are certain things you need to be aware of during your recovery.

Physical activity It is common to feel quite tired during your recovery which usually subsides over the first month. It is important that you get up and about when at home after surgery, though physical activity should be restricted for the first 2 weeks. It is safe for you to take short walks (no more than 1 mile in length) but strenuous activities such as heavy lifting, digging the garden and mowing the lawn should be avoided. After the first 2 weeks you may gradually increase your physical activity to pre-operative levels depending on your usual level of fitness.

We recommend that you do not drive for at least one week after you return home, until you feel comfortable doing an emergency stop. We also recommend you inform your car insurers. A return to work may be planned for about 4 weeks after leaving hospital. Your full recovery may take 3 months. Very occasionally some men will need a further operation to resolve urinary symptoms. Also, some men may require a redo-TURP within 5-15 years simply because the prostate can re-grow.

Urinary Symptoms You may experience a small amount of bleeding into your urine at any time for the first few weeks at home even after several days of clear urine. This is usually harmless but it may be aggravated by strenuous physical activity as detailed above. Should it occur you should rest completely and drink plenty of fluid, particularly water, (at least 1½ litres/3 pints per day), and it should resolve within 48 hours. If the bleeding is heavy and persists for more than 24 hours, or you are unable to pass urine at all, please contact either your GP or Buckland Ward for advice.

The benefits of the TURP operation may not be fully seen for many weeks, sometimes months. Frequent visits to the toilet, getting up at night, small clots of blood in the urine, slight discomfort on passing urine are all to be expected during you recovery; gradually everything will settle down. Only very occasionally do men experience a long-term problem with the incontinence. About ten days after the operation you can start doing regular pelvic floor exercises which strengthen the internal muscles which help urine control. Please obtain a leaflet from the ward about these.

Sexual activity Although a few men may experience problems achieving an erection in the long term, removal of part or all of the prostate seldom affects the man’s sexual desires nor his ability to have full and satisfying intercourse. Having erections after your operation will do no harm, but it is advisable not to have intercourse for two weeks after leaving hospital as it may cause further bleeding. The fluid which men ejaculate contains sperm from the testicles, but is mostly fluid produced by the prostate. However, many men after a TURP may experience ‘retrograde ejaculation’ where they have the sensation of ejaculation but no fluid comes out of the penis. This is because the fluid moves back into the bladder and is then passed out of the body with the urine when the man next goes to the toilet. It is a harmless side-effect of the operation which means fathering children may be difficult, though absolute sterility is not guaranteed. Other points to note:

Keep your bowels moving regularly to prevent straining.

If you are given a course of antibiotics on leaving hospital you should take them as instructed. If you notice an offensive smell or cloudiness to your urine, or you feel any temperature or fever, you may have a urinary infection and it is important that you contact your GP for treatment.

You will receive an Outpatient appointment through the post for about 4-8 weeks after discharge where you will be reviewed by your medical team. Please see the ward clerk before discharge if you require a sick certificate.

If you are at all concerned about your recovery at home and require further information please contact your Named nurse or Nurse in Charge on Buckland Ward : 01737-231654

EM April2000

URETHROTOMY
Discharge information for patients

In humans urine is passed out of the body from the bladder via the urethra, or ‘urine pipe’. Sometimes the urethra may be scarred in one part of the tube. This scar tissue may result in a narrowing called a ‘stricture’. This scar tissue may occur for several reasons such as previous surgery, untreated infection, or trauma/damage to the penis. In some people this stricture can impede the urine flow meaning more frequent passing of urine and more likelihood of repeated urinary tract infections. A urethrotomy is a procedure which may be performed to remove this narrowing / stricture. It is usually done under a general anaesthetic (when you are asleep). A fine instrument is passed up through the urethra (for example up the penis in males) to the narrowed area. The stricture is then gently slit open, thus widening the urethra at this point. A catheter (urine tube) is then inserted into the urethra for a few days to drain the bladder of urine whilst the cut area may start healing.

Occasionally this procedure needs to be repeated at a future date.

After a urethrotomy most patients have an uneventful recovery but usually have to stay in hospital for 2-3 days because of the catheter. If however you are discharged home within 24 hours of your operation, it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours following the general anaesthetic / sedation. You should arrange for someone to collect you from hospital.

You should drink plenty of fluids following your operation (approximately 2 litres/4 pints per 24 hours). After your catheter has been removed, and for about 72 hours, you may pass urine frequently, experience a mild burning sensation on passing urine, and/or see a little blood in the urine. Continue drinking plenty of water and rest as much as possible.

If you are at all concerned about your recovery at home and require further information please contact your Named nurse or nurse in charge on Buckland Ward 01737-231654.

EM April2000

BLADDER NECK INCISION
Discharge information for patients

A fine telescope called a cystoscope will be used to examine your bladder and ‘water pipe’ (urethra) whilst you are asleep with a general anaesthetic. This procedure is called a cystoscopy. In addition to this, you will also have a bladder neck incision, where a nick/small cut is made in the muscle which controls the flow of your urine. You will return from theatre with a fine ‘plastic’ tube, called a catheter, in your urethra which remains there for about 2 days. The average length of hospital stay is 2-3 days. The following information is to aid your post-operative recovery. Keep your bowels moving regularly to prevent straining.

It is important that you get up and about after your surgery, though strenuous physical activity such as heavy lifting, mowing the lawn and digging the garden for example should be avoided for about 3 weeks following surgery. Rest as much as possible.

We recommend that you do not drive for at least a week until you feel comfortable doing an emergency stop. We also recommend you inform your car insurers.

You should drink approximately 2 litres / 4 pints per 24 hours after your operation, especially water. This may ease any discomfort you experience such as a mild burning sensation on passing urine or a little blood in the urine. This may occur intermittently for a couple of weeks.

If these symptoms intensify or persist and you notice that your urine is cloudy and/or has an offensive smell, please contact your GP so that a urinary infection may be ruled out. If you were discharged from hospital with antibiotics, it is important that you complete the course as instructed.

If any bleeding into your urine is heavy and persists for more than 24 hours even when you have rested and consumed fluids, please contact your GP or your Named nurse/Nurse in charge on Buckland Ward 01737-231654.

You will receive an Outpatient appointment through the post for about 4-8 weeks post-discharge; here you will be reviewed by your medical team.

Please see the ward clerk before discharge if you require a sick certificate.

Buckland Ward East Surrey Hospital 01737 231654

EM April2000

BIOPSY of the PROSTATE
Discharge information for patients

This procedure is usually done on a day case basis and may be performed either under local (you are awake) or general (you are asleep) anaesthetic. You are positioned onto your left side with your knees bent up towards your chest. An finger-sized probe is carefully passed through your back passage into your rectum. Ultrasound is often then used to locate the prostate. You may feel a needle prick as up to six small pieces of prostate tissue are removed - this tissue is the biopsy and is sent to the laboratory for analysis. It may take 10 days to 3 weeks to obtain a result, which you will receive from your medical team at an outpatients appointment a few weeks after this procedure.

After the procedure

For 24 hours after a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery. You should therefore arrange for someone to collect you from hospital.

You may experience some discomfort around the rectal area for a day or two. Taking prescribed / recommended painkillers may help.

You may notice blood in your urine, semen or bowel motions for several weeks. This may be red or ‘rusty brown’ in colour. You need not worry about this unless the bleeding becomes heavy or clotted.You may also notice a slight burning sensation when passing urine for a day or two. Drinking plenty of fluids -about 4 pints / 2 litres per 24 hours- for a few days will help ease this. You will have received some antibiotics during the procedure, but if you suspect that you have a urinary infection (going frequently, burning, cloudy offensive-smelling urine) please consult your GP as more may be required.

It is important that you contact your GP or the hospital’s Accident & Emergency department (take along this leaflet) if you experience any of the following symptoms:

a temperature, fever with shivering chills;
severe pain in the rectal / groin area;
continuous or heavy /clotted bleeding.

If you are at all concerned about your recovery at home and require further information please contact your Named nurse or nurse in charge on Buckland Ward 01737-231654.

EM April2000

LITHOLAPAXY
(ENDOSCOPIC REMOVAL OF BLADDER STONES)
Discharge information for patients

This is procedure is used to remove bladder stones. It is performed endoscopically under a general (you are asleep) anaesthetic. A thin telescopic instrument is passed up through the ‘urine pipe’ (urethra) into the bladder. The bladder stone may then be crushed or disintegrated and washed away. Any planned treatment will have been discussed with you before your operation by your medical team and your written consent obtained.Most patients have an uneventful recovery after this procedure and go home on the same day. If a urinepipe - catheter - has been inserted, this may mean a stay in hospital for a day or two. If you do go home on your operation day when you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours post-op. You should therefore arrange for someone to collect you from hospital.

For a few days following your operation it is very important to drink plenty of fluids (approximately 4 pints / 2 litres per 24 hours) in order to wash out any remaining stone fragments. Occasionally, for about 72 hours after your operation you may pass urine frequently, experience a mild burning sensation on passing urine, and/or see a little blood in the urine. If this occurs, keep drinking and rest as much as possible.

If these symptoms persist and you notice that your urine is cloudy and/or has an offensive smell, please contact your GP so that a urinary infection may be ruled out. If you were discharged from hospital with antibiotics, it is important that you complete the course as instructed.

If you are at all concerned about your recovery at home and require further information please contact your Named nurse or nurse in charge on Buckland Ward 01737-231654.

EM April2000

RIGID URETEROSCOPY
Discharge information for patients

Humans usually have two kidneys at the back of the abdomen at the lower part of the ribs, one on each side of the body. The kidneys filter the blood and make urine. Each kidney is connected to the bladder by a tube called the ureter, through which urine drains. A rigid ureteroscopy is an examination of the ureter using a fine telescope called a ureteroscope. A ‘right’ or ‘left’ ureteroscopy indicates which ureter requires examination.A rigid ureteroscopy is usually performed under a general anaesthetic (when you are asleep) so that one of a number of possible procedures may be carried out in one of your ureters depending on your urological condition. For example, to remove stones with a ‘basket’ or by ‘crushing’, take a tissue sample (biopsy), or to dilate a narrowing (stricture) in the ureter. Any planned treatment will have been discussed with you before your operation by your medical team and your written consent obtained.

After a ureteroscopy most patients have an uneventful recovery and are discharged home the same day. When you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours post-op. You should therefore arrange for someone to collect you from hospital. Occasionally however it may be necessary to insert an internal stent (thin tube) into the ureter at the time of the operation which means you may stay in hospital a little longer. This stent usually remains in place for a few days to aid the healing process, and you may be discharged with this stent. Arrangements will be made for it’s removal under a local (you are awake) anaesthetic. This removal is very important and you must ensure you have a date to attend hospital in the near future before you are discharged.

For about 72 hours after your operation, especially if you have a stent, you may pass urine frequently, experience a mild burning sensation on passing urine, and/or see a little blood in the urine. Drinking plenty of fluids (approximately 2 litres /4 pints per 24 hours) and resting as much as possible may help to reduce these symptoms. It is particularly important to drink this amount if you have had stones removed with this procedure.

If symptoms persist and you notice that your urine is cloudy and/or has an offensive smell, please contact your GP so that a urinary infection may be ruled out. If you were discharged from hospital with antibiotics, it is important that you complete the course as instructed.

If you are at all concerned about your recovery at home and require further information please contact your Named nurse or nurse in charge on Buckland Ward 01737-231654.

EM April2000

INDEWLLING STENT
Discharge information for patients

It was necessary to insert an internal stent (thin tube) into the ureter at the time of your operation. This stent may remain in place for a few days, or for a few weeks, to aid the healing process. If you are discharged with this stent, arrangements will be made for it’s removal under a local (you are awake) anaesthetic. This removal is very important and you must ensure you have a date to attend hospital in the near future before you are discharged.After your discharge from hospital

For about 72 hours after your operation you may pass urine frequently, experience a mild burning sensation on passing urine, and/or see a little blood in the urine. Drinking plenty of fluids, preferably water, (approximately 2 litres /4 pints per 24 hours) and resting as much as possible may help to reduce these symptoms. It is particularly important to drink this amount if you have had stones removed with this procedure.

If you are at all concerned about your recovery at home and require further information please contact your Named nurse or nurse in charge on Buckland Ward 01737-231654.

EM April2000

EXCISION OF HYDROCELE
Discharge information for patients

A hydrocele is a collection of fluid which develops around the testicle within the scrotal (testicular) sac. The condition is harmless, but some men find it very uncomfortable. Sometimes the fluid is removed by aspiration (drawn off with a needle) but the condition may recur and a small operation may be required to cure the problem. This is where a small cut is made, usually in the scrotum. The fluid is removed and the fluid sac lining is either stitched in place or removed.

You will be admitted and discharged on the same day as your operation. When you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours post-op. You should therefore arrange for someone to collect you from hospital.

On discharge home after the operation, and for a few days, you may experience pain/discomfort at the wound site. You may find taking the prescribed/recommended doses of a painkiller may help. You may find that wearing supportive underpants and loose trousers may aid comfort. You may have a small amount of swelling following the operation, even slight bruising of your scrotum. Resting as much as possible for a few days, particularly with your legs elevated, will aid healing and prevent excessive swelling of your scrotal area.

About 24 hours after surgery you may bath or shower, allowing the water to soak off the wound dressing if one is present. Avoid the use of bubble baths and scented soaps. Dry yourself carefully afterwards. If you are sent home with antibiotics take the whole course given as instructed.

You may have oozing from the wound site for a few days. However, if:

the ooze from the wound changes to a yellow/green colour with or without an offensive smell; and/or
the wound site becomes very red and sore; and/or
scrotal swelling or pain is severe;
with no improvement over 48 hours, or you are concerned, please contact either your GP surgery or Buckland Ward for advice.

The stitches are usually dissolvable over 2-3 weeks so will not require removing; check before discharge that this is the case. You may return to work when you feel comfortable and know that you can cope with the activities that your job entails. Avoid sex until the wound is healed and you are pain free.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654

EM4/2000

REMOVAL OF AN EPIDIDYMAL (TESTICULAR) CYST/LUMP
Discharge information for patients

An epididymal lump may be a cyst (small fluid-filled sac) or a small amount of tissue found on the epididymis of a testicle. This is a quick operation where a small cut is made in the scrotal sac through which the cyst/lump is removed. A piece of tissue (if a lump) may be sent off to the laboratory for analysis.

About 24 hours after surgery you may bath or shower, allowing the water to soak off the wound dressing. Avoid the use of bubble baths and scented soaps. Dry yourself carefully afterwards.

You may have oozing from the wound site for a few days. However, if:

the ooze from the wound changes to a yellow/green colour with or without an offensive smell; and/or
the wound site becomes very red and sore; and/or
scrotal swelling or pain is severe;
with no improvement over 48 hours, or you are concerned, please contact either your GP surgery or Buckland Ward for advice.

The stitches are usually dissolvable over 2-3 weeks so will not require removing; check before discharge that this is the case.

You may return to work when you feel comfortable and know that you can cope with the activities that your job entails. Avoid sex until the wound is healed and you are pain free.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654

EM 4/2000

ORCHIDOPEXY
Discharge information for patients

Men usually have two testicles (testis) held in the scrotal sac beneath the penis. Sometimes, one (or rarely both) of the testis do not descend into this sac prior to being one year old. An orchidopexy is an operation which is performed in order to move a testicle into it’s normal position within the scrotal sac, and fix it there. It is a quick operation where (usually) two small cuts are made, in the scrotal sac and the groin, through which the surgery takes place.You will be admitted and discharged on the same day as your operation. When you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours post-op. You should therefore arrange for someone to collect you from hospital.

On discharge home after the operation, and for a few days, you may experience pain/discomfort at the wound site(s), for which prescribed /recommended painkillers may help. You may find that wearing supportive underpants and loose trousers may aid comfort. You may have a small amount of swelling following the operation, even slight bruising of your scrotum. Resting as much as possible for a few days, particularly with your legs elevated, will aid healing and help reduce any potential swelling of your scrotal area. If you are sent home with antibiotics take the whole course given as instructed.

About 24 hours after surgery you may bath or shower, allowing the water to soak off the wound dressing. Avoid the use of bubble baths and scented soaps. Dry yourself carefully afterwards. The stitches are usually dissolvable over 2-3 weeks so will not require removing; check before discharge that this is the case.

You may have oozing from the wound site(s) for a few days. However, if:

the ooze from the wound changes to a yellow/green colour with or without an offensive smell; and/or
the wound site becomes very red and sore; and/or
scrotal swelling or pain is severe;
with no improvement over 48 hours, or you are concerned, please contact either your GP surgery or Buckland Ward for advice.

You may return to work when you feel comfortable and know that you can cope with the activities that your job entails. Avoid sex until the wound is healed and you are pain free.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654 EM4/2000

ORCHIDECTOMY
Discharge information for patients

Men have two testicles (testis) which sit in the scrotal sac by the penis. Sometimes it is necessary to remove one or both of these testes. A small cut is usually made in the groin area of the affected side, and the testicle removed. Some men have a false testicle implanted at this time. Please discuss this with your medical team prior to your operation day.

You will be admitted and discharged on the same day as your operation. When you have had a general anaesthetic or sedation it is important that you do not drive a car, drink alcohol or handle machinery for 24 hours post-op; you should arrange for someone to collect you from hospital.

On discharge home after the operation, and for a few days, you may experience pain/discomfort at the wound site which may be eased by prescribed/ recommended painkillers. You may find that wearing supportive underpants and loose trousers may aid comfort. You may have a small amount of swelling following the operation, even slight bruising of your scrotum. Resting as much as possible for a few days, particularly with your legs elevated, will aid healing and help reduce any potential swelling of your scrotal area. If you are sent home with antibiotics take the whole course given as instructed.

About 24 hours after surgery you may bath or shower, allowing the water to soak off the wound dressing. Avoid the use of bubble baths and scented soaps. Dry yourself carefully afterwards.

You may have oozing from the wound site for a few days. However, if:

the ooze from the wound changes to a yellow/green colour with or without an offensive smell; and/or
the wound site becomes very red and sore; and/or
scrotal swelling or pain is severe;
with no improvement over 48 hours, or you are concerned, please contact either your GP surgery or Buckland Ward for advice.

The stitches may be dissolvable over 2-3 weeks or may require removal after 10 days; check before discharge which applies to you.

You may return to work when you feel comfortable and know that you can cope with the activities that your job entails. Avoid sex until the wound is healed and you are pain free.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654 EM4/2000

RADICAL ORCHIDECTOMY
Discharge information for patients

Men have two testicles (testis) which sit in the scrotal sac by the penis. Sometimes it is necessary to remove one of these testicles, usually because a testicular tumour (cancer) is suspected. A cut is usually made in the groin area of the affected side and the testicle and surrounding tissue removed. This tissue is sent to the laboratory for analysis (biopsy), with a result available between 10 days - 3 weeks later. Some men have a false testicle implanted during this operation. Please discuss this with your medical team prior to your operation day.

The operation usually takes about 30 minutes and is performed under a general anaesthetic. You may stay overnight in hospital. It is important that you do not drive a car, drink alcohol or handle machinery for 24 hours after an anaesthetic. You should therefore arrange for someone to collect you from hospital.

On discharge home after the operation, and for a few days, you may experience pain/discomfort at the wound site which may be eased with prescribed/recommended painkillers. You may find that wearing supportive underpants and loose trousers may aid comfort. You may have a small amount of swelling following the operation, even slight bruising of your scrotum. Resting as much as possible for a few days, particularly with your legs elevated, will aid healing and help reduce any potential swelling of your scrotal area. If you are sent home with antibiotics take the whole course given as instructed.

About 24 hours after surgery you may bath or shower, allowing the water to soak off the wound dressing. Avoid the use of bubble baths and scented soaps. Dry yourself carefully afterwards. The stitches may be dissolvable over 2-3 weeks or may require removal after 10 days; check before discharge which applies to you.

You may have oozing from the wound site for a few days. However, if:

the ooze from the wound changes to a yellow/green colour with or without an offensive smell; and/or
the wound site becomes very red and sore; and/or
scrotal swelling or pain is severe;
with no improvement over 48 hours, or you are concerned, please contact either your GP surgery or Buckland Ward for advice.

You may return to work when you feel comfortable and know that you can cope with the activities that your job entails. Avoid sex until the wound is healed and you are pain free.

After the operation you will be asked to attend the clinic for the results of the biopsy of the removed testicle. If a tumour is confirmed, your medical team will discuss with you any further treatment and follow up.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654

EM 4/2000

STERILISATION BY VASECTOMY
Discharge information for patients

A vasectomy is an operation that is performed to sterilise the male. It should be considered as irreversible. It should therefore only be undertaken after careful thought and consideration by a couple who have decided not to have (more) children. It is sometimes necessary to have the written consent of both man and female partner before this procedure can take place. The operation is more than 99% effective. However, a sperm count at about 3 months after the operation will confirm whether sterility has been achieved. You are advised to use a method of contraception until this sterility has been confirmed. The operation: This involves making two small incisions in the scrotum. The tube coming from each testicle (of which there are two) which carry the sperm will be isolated and cut. The ends of these tubes remaining in the scrotum will be tied off. The cuts in the scrotum will then be sealed using one or two self-dissolving stitches.

Discomfort at the wound site may be eased by prescribed/ recommended painkillers. Wearing supportive underpants and loose trousers may aid your comfort. You may have a small amount of swelling following the operation, even slight bruising of your scrotum, so rest as much as possible for a few days. If you are sent home with antibiotics take the whole course given as instructed.

About 24 hours after surgery you may bath or shower. Dry yourself carefully afterwards. You may have oozing from the wound site for a few days. However, if:

the ooze from the wound changes to a yellow/green colour with or without an offensive smell; and/or
the wound site becomes very red and sore; and/or
scrotal swelling or pain is severe;
with no improvement over 48 hours, or you are concerned, please contact either your GP surgery or Buckland Ward for advice.

You may return to work when you can cope with the activities that your job entails. Avoid sex until the wound is healed and you are pain free.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654 EM4/2000

REVERSAL OF VASECTOMY
Discharge information for patients

A vasectomy is an operation that is performed to sterilise the male and usually considered irreversible. Reversal of this procedure therefore is very difficult. The chances of success decrease as the man gets older and the length of time between the original vasectomy and the attempted reversal gets longer. Overall, the operation is successful in restoring sperm to the semen in about 50% of men. However, not all of these 50% will be able to achieve a pregnancy in their female partner. A sperm count at about 3 months after the operation will determine whether the operation has been successful or not.

The operation: This involves making two small incisions in the scrotum. The tube coming from each testicle (of which there are two) which usually carry the sperm are then located and carefully rejoined. The cuts in the scrotum will then be sealed using one or two stitches which dissolve over 2-3 weeks.

About 24 hours after surgery you may bath or shower. Dry yourself carefully afterwards.You may have oozing from the wound site(s) for a few days. However, if:

the ooze from the wound changes to a yellow/green colour with or without an offensive smell; and/or
the wound site becomes very red and sore; and/or
scrotal swelling or pain is severe;
with no improvement over 48 hours, or you are concerned, please contact either your GP surgery or Buckland Ward for advice.

You may return to work when you can cope with the activities that your job entails. Avoid sex until the wound(s) is healed and you are pain free.

Buckland Ward, East Surrey Hospital Telephone: 01737- 231654 EM4/2000

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