What to Expect during Your Preoperative Consultation
During your initial consultation with your surgeon, he or she will review your medical history as well as any outside reports, records and X-ray films (e.g., CT scan, MRI, sonogram). A brief physical examination will also be performed at the time of your visit. If your surgeon determines that you are a candidate for this procedure, you will then meet with a patient service surgery coordinator to arrange for the date of your procedure.
Note: It is very important that you bring all of your X-ray films and reports to the initial consultation with your surgeon.
What to Expect prior to Surgery
Since insurance companies will not permit patients to be admitted to the hospital the day before surgery to have tests completed, you must make an appointment to have preoperative testing done at your family doctor or primary care physician's office within one month prior to the date of surgery.
For The Johns Hopkins Hospital: These results need to be faxed by your doctor's office to the Preoperative Evaluation Center at 443-287-9358 two weeks prior to your surgery. Please call the Documentation Center at 410-955-9453 two weeks before your surgery date to confirm that this information was received.
Once your surgical date is secured, you will receive a form along with a letter of explanation to take to your primary care physician or family doctor in order to have the following preoperative testing done prior to your surgery.
- Physical exam
- Electrocardiogram (EKG)
- Complete blood count (CBC)
- Blood coagulation profile (PT/PTT)
- Comprehensive metabolic panel (blood chemistry profile)
Preparation for Surgery
Medications to avoid prior to surgery
Aspirin, Motrin, ibuprofen, Advil, Alka-Seltzer, vitamin E, Ticlid, Coumadin, Lovenox, Celebrex, Voltaren, Vioxx, Plavix and some other arthritis medications can cause bleeding and should be avoided one week prior to the date of surgery. (Please contact your surgeon’s office if you are unsure about which medications to stop prior to surgery. Do not stop any medication without contacting the prescribing doctor to get their approval.)
It is very important that your last urine culture was negative prior to having this procedure. Please call the physician’s office at least one week before this procedure to confirm your urine culture results. If you suspect that you may have a urinary tract infection, please call the physician’s office immediately so that proper antibiotics can be prescribed before your surgery.
What to Expect after Discharge from the Hospital
- Pain control: You can expect to have some pain that may require pain medication for a few days after discharge. Afterward, Tylenol should be sufficient to control your pain.
- Showering: You may shower at home.
- Activity: Taking walks is advised. Prolonged sitting or lying in bed should be avoided. Climbing stairs is possible. Driving should be avoided for at least one day after the procedure. Absolutely no heavy lifting (greater than 20 pounds) or exercising (jogging, swimming, treadmill, biking) until instructed by your doctor. Most patients return to full activity on an average of one week after surgery. You can expect to return to work in approximately one week.
- Diet: No dietary restrictions. Increase fluid intake until your stent is removed.
- Follow-up appointment: You will need to call soon after your discharge to schedule a follow up visit for one to four weeks after your procedure. To schedule an appointment at the Johns Hopkins Outpatient Center, call 410-955-6101.
- Ureteral stent removal: The length of time the stent remains in place is variable. Your doctor will probably request that it be removed within a three-day to a several week period. It can be removed in the doctor's office. It is common to feel a slight amount of flank fullness and urgency to void as a result of the stent. These symptoms often improve over time as the body adjusts to the indwelling stent. It is critical that patients return to have their stent removed as instructed by their physician, as a prolonged indwelling ureteral stent can result in encrustation by stone debris, infection, obstruction and loss of kidney function.
Professor of Oncology
Executive Vice Chairman, Department of Urology
Director of Adult Urology
Director, Minimally Invasive and Robotic Surgery
Director, The Stephens Center for Stone Disease
To make an appointment for consultation, please call 410-955-6100.