Preparing for Surgery

Preparing for Urologic Surgery

Before scheduling you for surgery, you may need some staging tests. Such tests are usually only ordered for patients with high risk disease characteristics such as a high serum PSA ≥ 20 or high Gleason score ≥ 8. These tests, including a bone scan, CT scan or prostate MRI, can help determine whether cancer has spread out of the prostate to the bone or to the lymph nodes. In addition, you will need to see your primary care doctor for a history and physical examination before surgery.


You will need to pre-register at the hospital a day or two before surgery. You can expect to complete paperwork for the hospital and blood tests. You will also need to get a chest x-ray and an electrocardiogram (EKG) to evaluate your heart. These tests are necessary prior to anesthesia and do not need to be repeated if your primary care doctor orders them at the time of your history and physical.


Because prostate surgery requires general anesthesia, you will usually speak with the anesthesiologist the night before surgery to discuss the details and logistics of your treatment. This is a good time to share your current medications and any questions or concerns you may have.

Stopping Medications

If you are currently taking aspirin, Coumadin, Plavix, Xarelto, Aggrenox, Pradaxa, Eliquis or other medications that can interfere with blood clotting, consult your Primary Care Doctor or Cardiologist about when to stop taking them. These medications usually need to be stopped at least one week before surgery.

Non-steroidal anti-inflammatories such as ibuprofen or naproxen should be stopped 1 week before surgery. If over the counter pain medications are needed, acetaminophen (Tylenol) is acceptable. Other than the previously stated medications, you should continue your other regular medications, unless specifically told not to do so..

The Day before Surgery

To avoid a bowel prep, patients must not eat solid food or dairy products and may only drink clear liquids the entire day before surgery.

Clear Liquids

  • Water
  • Gatorade
  • Black tea
  • Black coffee
  • Ginger ale
  • Clear soups
  • Clear bouillon
  • Jell-O
  • Popsicles
  • Strained fruit juices without pulp (apple, white grape, or lemonade)

Do not eat or drink anything (even water) after midnight on the day before your surgery. You should take a regular shower the evening before your surgery.

The Morning of Surgery

Do not eat or drink anything the morning of surgery. Unless specifically told not to do so, take your regular medications with a sip of water before coming to the hospital. The only exception is that you should not take Insulin or other diabetic medications, unless instructed by your doctor. You should confirm this with your anesthesiologist the night before surgery.

Your Hospital Stay

The hospital stay following radical prostatectomy is usually 1 night. There are several important things you can do to help speed up your recovery including walking early and often after surgery, controlling your pain and learning to manage your catheter so you can be comfortable before discharge.

Most patients will go to the surgical floor (after leaving the recovery room, where your family can visit you. There may be specific rules regarding the length and timing of visits. Your nurse will inform you and your family of these rules, if they apply.

When you wake up, your small skin incisions will be covered with skin glue, which usually falls off after 1-2 weeks. You will also have a Foley catheter in your bladder. In general, the catheter stays in place for 1 week following surgery, and we will instruct you how to care for this catheter. In addition to the catheter, a small tube known as a Jackson-Pratt (JP) drain is left in the pelvis at the end of the surgery, which exits through a small incision in the lower abdomen. This tube drains the remaining fluid in the pelvis. The JP drain is almost always removed the day after surgery, before the patient leaves the hospital to go home.