Planning for your Discharge 3
Preoperative Instructions 5
Pre op Checklist 9
8. Transurethral Resection of Prostate Pathway 13
10. Hospital Stay 18
11. Discharge Checklist 22
12. Guidelines for Home 25
13. When to call the Doctor 26
The prostate gland is located just below the bladder. It
as it leaves the body. If the prostate becomes enlarged,
which can happen as a normal part of aging or because
of prostate disease, it may squeeze the urethra making
the normal flow of urine out of the bladder difficult.
by removing the inner portion of the prostate that is
pressing on the urethra. The surgeon will insert an
instrument up the penis through the urethra and cut
away the prostate tissue until the passage is well open.
The tissue that is cut away will drain out through the
catheter. No incision is made.
This area takes about 8-12 weeks to heal completely.
Remember that your surgery is planned. It is
that you have made the necessary
arrangements for your discharge home prior to coming
in for your surgery.
Arrange for family or a friend to stay with you for the
manage on your own. Alternate arrangements such as
staying with family or friends should be considered.
You will need some help for several weeks with such
tasks as cooking, laundry, housework, shopping,
shovelling, mowing the lawn and transportation (you will
not be able to drive yourself until your surgeon advises
Your discharge plans will be documented prior to your
surgery at your Pre admission Clinic visit.
Please bring the following:
soap, deodorant, Kleenex, comb, brush, electric
Non-slip supportive shoes or slippers
If you wear glasses, hearing aid or dentures, be sure
to bring a case to put them in, as well as any
cleaning solutions. These should be labeled with
Notify your surgeon if you receive antibiotics before
and/or heart valve replacement, joint replacement, etc.
Notify your surgeon if you are taking blood thinners,
be stopped before your surgery. Inquire when to restart
these after your surgery
Notify your surgeon if you have sleep apnea. If you
with you the day of surgery. Plan to be in the recovery
room for 4 hours after your surgery.
No smoking is advised within 48 hours of your surgery.
surgery and decrease wound healing. There is no
smoking in the hospital.
No alcoholic beverages for at least 24 hours before your
you will be receiving.
If you develop a sore throat, fever, cold or flu within a
may be delayed until you are feeling better. Please notify
the Surgical Preadmission Clinic at (613) 969-7400
ext.2827, if you have ever been told you have VRE or
If you would like an appointment(s) booked for your
ordered), please call 969-7400 ext. 2494. If no
appointment is arranged prior, you will be seen on a first
come, first serve basis.
If your surgeon has ordered blood work and the lab
it falls off, bring it to the hospital with you. Your
surgery will be delayed otherwise.
The hospital will notify you of your arrival time 2
business day prior to your surgery at the Trenton and
Picton sites. The hospital number will not appear on
your phone. It will show up as a private
number/unknown number or a blocked number.
A $5.00 telephone charge for phone use is to be paid in
room. Local calls – dial 9, Long distance calls – dial 0 to
go through the hospital operator.
Leave money and jewelry at home. The hospital is not
QHC Reduced Scent Policy (patients, visitors and
staff). Please refrain from wearing any scented products
(perfumes, colognes, scented soaps, lotions, etc.)
If you are not able to speak English or do not
Discharge time is 10 a.m. Please ensure that your ride
home is arranged before your surgery.
stop in these driveways to drop off or pick up
someone. Unattended vehicles will be considered
parked and subject to ticket and/or towing. Patient
pick-up instructions will be given by hospital staff.
Visiting Hours are from 2-4 p.m. and 6-8 p.m. (2 visitors
per patient per 2 hour visitation block).
Visitors should be restricted to immediate family and
must be quiet and under constant adult supervision
Visitors should not visit if feeling unwell or have any
Patient care is our priority. If visitors are asked to
leave for any reason, please abide by staff request. There
is a waiting area provided on the patient care unit.
This checklist has been designed to assist you in
preparing for your surgery. Please use it as your guide
and check off items as they apply.
3-4 weeks before Surgery
□ Review Transurethral Resection of Prostate booklet
□ Make arrangements for help at home on discharge
(page 6 in this booklet)
My Discharge Plans
□ Arrange ride for the day of surgery and on discharge
2-3 weeks before Surgery
□ All pre admission testing completed (blood work,
□ Medication(s) to discontinue (if applicable)
48 hours Before Surgery
□ Hospital has notified you of your arrival time
□ Pack personal items (page 6)
□ Take a mild laxative for bowels (if needed)
□ Try not to smoke (if applicable)
Day before Surgery
Eat well-balanced meals. Avoid fatty foods. Drink
□ Bath or shower evening before surgery and/or
morning of surgery
□ Remove all jewelry (may leave wedding band on)
surgery may be delayed or cancelled otherwise
Day of Surgery
□ $5.00 for phone charge (if desired)
□ Breathing machine (CPAP) if used
□ Your Transurethral Resection of Prostate
Day of Surgery
Take all of your usual
including any inhalers with small amounts of water
only UNLESS TOLD OTHERWISE BY YOUR
DOCTOR. Do not take any diabetic medication(s)
unless instructed by your Surgeon and/or Anaesthetist.
Check with your doctor for special instructions if you
are on an
□ Bring all medications to the hospital (prescription
their original containers
□ Arrange for family or a friend to bring your personal
Your Transurethral Resection of Prostate Care Pathway is
a guide for you to follow during your hospital stay. It is a
day-to-day plan of what to expect during your hospital stay
and what you should do to assist in your recovery. Each
day is mapped out as to what you will be doing (under
“Goals for Today”) in this booklet.
Please review all of the information and be familiar with
able to work with your Health Team to make a successful
Arrive at Patient Registration – (Admitting/Emergency
You will then be directed to Day Surgery where your
Your nurse will:
Review leg exercises
Once you are prepared for surgery, a family member or
While you are in the Operating room and Recovery
across from the Operating room doors).
Your Surgeon will provide your family with an update
after your surgery or a phone number may be left for the
surgeon to call.
The length of surgery is approximately 1-2 hours.
You will have an opportunity to speak with the
types of anaesthesia are general anaesthesia (which puts
you to sleep) or spinal/epidural anaesthesia (numbs
from the waist down). Your Anaesthetist will discuss
the risks and advantages of each type of anaesthesia and
answer any questions and/or concerns that you may
After surgery, you will remain in the recovery room for
You will then be taken to your hospital room. Patients
often return from surgery with a variety of tubes:
Intravenous is given for fluids and medication
The Continuous Bladder Irrigation (CBI) will flow
from 1-2 bags through the catheter into the bladder
to flush the tissue out of the bladder to prevent clot
formation. This fluid and urine will drain into a
catheter bag. The rate of the irrigation will be
adjusted to keep the urine clear. Sometimes, blood
clots may pass through the catheter. If this
happens, the nurse or doctor will wash the clot
using a syringe of sterile salt water
recovery. Our goal is to keep you as comfortable as
Measuring your Pain
To help your doctors and nurses evaluate your pain, you
0 meaning no pain and 10 indicating the worst possible
pain. Using this scale will help your doctors and nurses
make sure that your pain is adequately controlled.
are experiencing any nausea or vomiting.
You will be allowed to increase your diet as your
to diet as tolerated. Specific diets may be ordered
according to your health and cultural needs.
Deep breathing and coughing is very important to help
prevent congestion and pneumonia. Inhale deeply
through your nose then slowly exhale through your
mouth. Repeat 3 times and then cough twice. Do this
10 times per hour when awake. A breathing device
called an incentive spirometer may also be taught and
Leg and foot exercises (i.e. moving your feet up and
promote good blood flow and decrease chance of blood
clots. You will be helped to turn in bed every 2 hours
for comfort and to prevent complications.
GOALS FOR THE DAY OF SURGERY
□ Bedrest the day of surgery, nursing staff will assist
you with positioning every 2 hours if needed
□ Deep breathing and coughing (10 times per hour
□ Ankle pumping (10 times per hour while awake)
Once urine begins to clear, you will start by sitting on
Avoid prolonged periods of sitting to avoid stress or
returns, you will be able to get up on your own. Ask for
help as needed.
The drainage bag must be kept lower than the level of
your bladder, which may cause an infection.
While the catheter is in, you may have the urge to pass
like a muscle cramp that comes and goes. This is
common after surgery and can be relieved with
Your diet will be increased if you are drinking well and
The intravenous (IV) will be changed to a saline lock
GOALS FOR TODAY
□ Patient teaching: Importance of increasing fluid
□ Patient teaching: Pain management, bladder spasms
□ Continue with deep breathing and coughing
□ Continue with leg exercises (10 times per hour)
Your diet will be increased to a regular diet as tolerated.
Adequate fluids are necessary to keep your urine clear,
prevent clot formation and to prevent constipation.
Drink at least 8 glasses of fluids per day.
High fibre foods such as grains, fruits and vegetables
necessary to receive a laxative to assist with regular
bowel movements since medication and reduced activity
may change your bowel habits
The catheter is removed when the urine is pink to clear
After catheter removal, it is very important that you
and check the colour.
You may experience difficulty controlling your urine at
at first. Empty your bladder when you feel the urge.
There may be burning or frequency. Dribbling may
occur, so wearing a protective pad may be required.
POST OP DAY 2
It may be necessary to have the catheter reinserted if
you are having difficulty voiding. If discharged home
with a catheter, it may be attached to a leg bag.
Instructions will be given on the care of the catheter.
Your surgeon will make arrangements for catheter
removal when the swelling from the surgery lessens.
GOALS FOR TODAY
□ Patient teaching: importance of increasing fluids,
reinforced prior to discharge
□ Instructions given on care of the catheter at home
□ Prescription(s) provided (if applicable)
□ Discharge Instructions provided by your surgeon and
□ All questions/concerns answered
□ All belongings packed and returned
□ All medications you brought with you to hospital
□ Follow-up appointment with surgeon
Date ______________ Time ____________
Place _____________ Phone ___________
We hope that your hospital stay has been a pleasant one.
For the first few weeks, drink plenty of fluids to keep
your urine flowing freely. One glass per hour is
recommended, until early evening to prevent getting up
Good nutrition promotes healing and helps to prevent
green vegetables, whole grain breads and cereal. The
vitamin C in juice or citrus fruits helps iron to be better
Alcohol is not recommended after surgery for at least a
Avoid coffee and spicy foods as they may cause
Avoid constipation to prevent straining which can cause
bran, prunes) and if necessary, take a mild laxative
(magnolax, milk of magnesia). No enemas or
Avoid long car trips for 2-3 weeks after surgery. Short
No stooping, bending, hoeing, shovelling or cutting
No sports (including golf and swimming) for 4-6 weeks
Sex should be avoided until after you have seen your
normally not be affected; however, you may experience a
change in the sex act. Sometimes after surgery, the
semen is discharged not forward but back into the
bladder and this is passed with the next passage of urine,
which may be cloudy. This is normal. This does not
change sexual performance
Blood in your urine may occur for 4-6 weeks after
appear in the urine 7-14 days after surgery. This bleeding
is temporary and is a normal part of the healing process
caused by the the scab inside the prostate breaking away.
When this occurs, it is important to increase your fluids
to help flush your system and decrease your activity. If
bright red bleeding continues after increased fluids and
rest, call your surgeon
Check with your surgeon before taking any aspirin or
No strenuous exercise or lifting heavy objects (more
No long walks, no fast stair climbing for the first 2-3
increase the distance daily as tolerated
Returned to work as directed by your surgeon
You may experience some temporary loss of control of
urination or dribbling. These symptoms are temporary
and will resolve. Strengthening exercises may help to
buttocks and pull upwards
Pause and relax
Repeat 10 times. Do these exercises every hour while
times a day only.
Fever and chills
bladder (may be retention)
continues with rest and increased fluids
Developed By: Surgical Services, 2003
Approved By: Department of Urology, Quinte Health Care
Revised: February, 2009