Before Your Surgery

In addition to eating well, staying physically active, and getting plenty of rest, there are important steps you need to take in the period leading up to your robotic prostate surgery to ensure that you are prepared for an optimal outcome.  

What follows are key guidelines and instructions for one month before the surgery and leading up to the actual day of the procedure. Also included is information about blood and sperm banking. The most important thing to remember is that you are in excellent hands. You have chosen an outstanding hospital and one of the foremost robotic prostate surgeons to perform the procedure.  

Medications

Some medications interfere with the clotting and coagulation of the blood (e.g., blood thinners) and can also increase the risk of bleeding before and after surgery. With the approval of your prescribing physician(s), please stop taking the following medications 30 days before your surgery

  • Aspirin
  • Non-steroidal anti-inflammatory drugs (e.g., Motrin, Advil, Celebrex, Arthotec)
  • Vitamin E, fish oil, fax seed oil, and all supplements
  • Plavix

In addition, it is recommended to stop taking Coumadin seven days prior to surgery, with the permission of your prescribing physician.

Medical Clearance

You will need medical clearance from your primary care physician prior to having the procedure. If you don’t have a primary care doctor, we can recommend one for you.

Pre-Admission Testing

Pre-admission testing may be done here at The Mount Sinai Hospital or through your internist or cardiologist. If you are having this done with your personal physician, we will need to have the test results back within seven days of surgery.

These tests generally consist of blood tests, urine analysis, radiologic exams, and electrocardiogram. Please see your pre-admission testing direction sheet, which will be emailed to you after scheduling your procedure, for a list of the tests needed. These tests are essential since the surgery is performed under general anesthesia.

Activity

Moderate exercise and activity prior to surgery is recommended to promote healing. If you are exercising regularly, maintain a moderate level of exercise prior to surgery. If your lifestyle is more sedentary begin light walking one to two miles daily. Be aware that after surgery you will be in “Prostate Bootcamp” and be asked to walk up to three miles daily; so, start moving now. (In addition to walking three miles daily, “Prostate Bootcamp” consists of drinking eight to 12 glasses of water daily for one month after surgery.)  

Preparations for the Day Before Surgery

Bowel Preparation

A limited bowel preparation helps clean the intestine and reduce the risk of infection. The day before the procedure, please make sure to do the following bowel prep:

  • Drink one bottle (10 ounces) of magnesium citrate in the morning (magnesium citrate can be purchased at most pharmacies)
  • Take one Fleet enema in the evening

Diet

Make sure that you drink plenty of fluid throughout the day because the bowel prep will make you lose fluid. Stay on clear liquid all day. Stop eating or drinking at midnight.

Blood Banking

While donating your own blood is not necessary (since the blood loss during surgery is minimal because the anatomy can be clearly viewed and small blood vessels precisely controlled thanks to high image magnification and precise robot-controlled maneuvers), we can make arrangement for you, if you still wish to do this. You will need to donate no more than two units three to four weeks before the operation.

Banking Sperm

After prostatectomy, men continue to have normal desire and orgasm, but they do not ejaculate anymore. The major portion of the seminal fluid is produced in the seminal vesicle and prostate, which have been removed. Therefore, men who have had a prostatectomy are not able to father children. If you are considering the possibility of fathering children in the future, banking sperm is an option. The cost is covered by most insurance companies.