Prior to your consult appointment, please do the following:
Complete all requested lab work complete at least 1 week prior to appointment
Bring a list of your medications. An itemized list of previous medical diagnoses and surgical procedures (if applicable) is also helpful. If this is a follow up appointment, please inform of us of any significant interval change in your health since you were last seen by Dr Dhanjani
Complete your voiding diary and/or questionnaires (if applicable).
If appointments are cancelled without at least 1 business day’s notice, except in exceptional circumstances, a $100 no show fee may be applied to your account. This is policy to ensure that we maximize our ability to accommodate all patients as no show appointments contribute to our wait lists. If you have concerns about your ability to pay, please speak to our office about what options may be available - we do not intend to cause undue financial hardship, and you will not be denied care on the basis of your ability to pay.
Uroflow and Bladder Scan
A uroflow test is a simple, non-invasive test that provides valuable information about well you are urinating, including the speed and strength of your urinary flow. During the test you will urinate into a special toilet that will analyze your stream and provide a real time graphical analysis. You should urinate in whatever position is easiest for you (sitting or standing). Immediately after you have finished voiding, we will perform a bedside ultrasound of your bladder by placing a probe on your lower abdomen. This will tell us how well you are emptying your bladder. Dr Dhanjani will use this information to help guide your treatment.
Length of procedure = 5 minutes
Preparation
Come to your appointment with a with comfortably full bladder and ready to urinate.
You can eat prior to this procedure and take all of your home medications as usual
Post Procedure
You should have no symptoms after this procedure
Cystoscopy
A cystoscopy uses a small camera to examine the urethra and bladder. This procedure takes place in the hospital (either Bluewater Health or Chatham-Kent Alliance). When you arrive at the hospital you must first register and then you will be asked to change into a hospital gown. When you enter the procedure room, you will be asked to lie down on your back. Depending on the procedure, your legs may be placed in stirrups. An antiseptic solution is then used to clean the genitals and a freezing gel will be applied to reduce your discomfort. A small camera will be inserted into the urethra and passed into the bladder. The bladder will be filled with fluid as your Dr Dhanjani exams the urethra, bladder neck, and prostate (if applicable).
Length of procedure = variable, usually 5-10 minutes
Preparation
No preparation is necessary for this procedure
You can eat prior to this procedure and take all of your home medications as usual
Try not to urinate immediately beforehand as sometimes a urine sample is collected during the procedure
Post Procedure
You may experience mild burning with urination and/or some blood in the urine. This may last 1-2 days on average
Drinking water and clear fluids will help to alleviate these symptoms.
Abstain from caffeine and alcohol for 24 hours after your scope
You may return to normal activities as tolerated immediately after this procedure
Prostate Biopsy
A prostate biopsy is used to diagnose prostate cancer. For the procedure, you will lie on your back with both legs in stirrups. A freezing agent will be used to numb skin. A spring loaded biopsy device will then be used to pass a small needle into the prostate to take several samples from throughout the gland.
Preparation
Have a light supper the night before your biopsy
Please complete a rectal fleet enema at 6:00pm the evening before your biopsy. This can be purchased over the counter at your pharmacy.
Regarding your Blood Thinners:
Dr Dhanjani will give you specific instructions about when to stop taking your blood thinners before the biopsy. If you are unsure, please contact our office to confirm instructions.
In general, if you are taking low dose aspirin 81mg due to a history of stroke, TIA, coronary stents, or heart attack, you can remain on this medication at time of biopsy.
On the Day of the Procedure
Report to Patient Registration at Bluewater Health, 89 Norman St. Sarnia ON at the time specified by the office
You will be given a one-time oral dose of prophylactic antibiotics in the hospital immediately before the procedure
The procedure, on average, will take about 20-25 minutes, but expect to be at the hospital for approximately 2 hours in total
You MUST have someone who can drive you home after the biopsy and monitor you for the next 24 hours.
After the Procedure
Expect blood in your urine and stool. This is usually mild and can last several days up to several weeks after your biopsy.
Expect blood in your semen for at least several weeks.
You will follow up with Dr. Dhanjani several weeks later to go over results.
IMPORTANT
If you develop any of these symptoms after your biopsy please go to the nearest Emergency Department
High fever or chills
Excessive bleeding from the rectum
Blood clots in the urine and/or inability to urinate
Persistent burning with urination
Feeling generally unwell
Vasectomy
A vasectomy is a permanent form of birth control. This is minor surgery in which the vas deferens on each side of the scrotum (the “sac”) is divided and blocked. The vas is a long tube that runs from each testicle to the urethra (urinary passage). It conducts sperm at the time of ejaculation. When the vas is divided and blocked, the ejaculation fluid (semen) is free of sperm and the egg produced by the woman cannot be fertilized to start a pregnancy. The procedure is completed in the hospital and you will be awake for the procedure.
Length of Procedure = 10-15 min
Preparation
Your Urologist may discuss stopping your blood thinners and anti-inflammatory medications prior to the procedure - please discuss this with your doctor
You will require someone to drive you home after the procedure
Post Procedure
It is normal to experience soreness and mild bruising in the scrotal area for the next one to two weeks following the procedure and do not require any medical attention
To help to reduce scrotal pain
Ice the scrotum for 10-15 minutes 3-4 times per day for the first 24 hours
Wear supportive underwear
Avoid heavy exercise for 1 week after the procedure
You may take Tylenol for pain management, AVOID blood thinners and anti-inflammatories (Aspirin, Ibuprofen, Naproxen etc.) to decrease the risk of bleeding
Avoid sexual activity for 5 days after the procedure
Use alternate forms of contraception (condoms etc.) until a follow up with the Urologist at 4 months post procedure has confirmed the vasectomy was successful with a repeat semen sample
You will be required to submit TWO semen samples to the lab at least 1-2 weeks prior to your follow up visit so that the results are available in time.
If you notice signs of infection (fever, blood or pus oozing from the puncture site), excessive swelling or pain please seek medical attention
Preparing For Your Surgery
Education
Review the Patient Education Handouts section of the website for any relevant brochure
Healthy Living
Abstain from smoking for 4 weeks prior to surgery. If that is not possible, at least try to cut down as much as you can. Consider speaking to your family doctor about smoking cessation aids (i.e. nicotine replacement).
Abstain from alcohol for 4 weeks prior to surgery
Exercises
Try to exercise at least 30 minutes a day to maintain your muscle mass
Diet
You can eat a regular diet up to the night before your surgery
No specific mechanical bowel preparation is required prior to your surgery
Medications
At your pre-admission appointment you received instructions about which of your home medications you should take and which ones you should temporarily hold immediately prior to your surgery.
If you are on blood thinners, you will have received specific instructions about how many day(s) you should hold these before the operation.
If you are unsure about any of these instructions, please contact our office ASAP for clarification so that your operation is not delayed!
Hospital Stay
Our goal is to get you up and walking as soon as possible after your surgery. This will help prevent blood clots, infections, bowel issues, and other potential complications.
After Discharge
No heavy lifting over 20lb for 6 weeks after your surgery. Light activity such as walking is encouraged and will help your recovery
Contact our office after you are discharged to arrange a follow up appointment if you were not given one already.
SPECIAL NOTE ABOUT STONE SURGERY & STENTS
If you have a stent in, it is very important that you contact our office to arrange a follow up. If you never attend your follow up appointment and your stent is not removed in a timely fashion, you risk serious complications!
Bladder Cancer: Transurethral resection of bladder tumour (TURBT)
BCG Treatment
Bladder Cancer: Preparing for removal of bladder (Radical Cystectomy)
Education
Review this handout Muscle Invasive Bladder Cancer
Visit https://bladdercancercanada.org/en/ for more information about your surgery and your recovery afterwards
Healthy Living
Abstain from smoking for 4 weeks prior to surgery. If that is not possible, at least try to cut down as much as you can. Consider speaking to your family doctor about smoking cessation aids (i.e. nicotine replacement).
Abstain from alcohol for 4 weeks prior to surgery
Try to exercise at least 30 minutes a day to maintain your muscle mass
Diet
Eat a carbohydrate-rich diet which also includes fruits and vegetables. It is important that you are well nourished going into your operation.
If you have low appetite, try supplementation with nutritional drinks (i.e. Boost, Ensure)
You can eat a regular diet up to the night before your surgery
We also recommend you consume 24oz of Gatorade the evening before your surgery (avoid red flavour; use low sugar Gatorade if you have diabetes)
No specific mechanical bowel preparation is required prior to your surgery
Medications
At your pre-admission appointment you received instructions about which of your home medications you should take and which ones you should temporarily hold immediately prior to your surgery.
If you are on blood thinners, you will have received specific instructions about how many day(s) you should hold these before the operation.
If you are unsure about any of these instructions, please contact our office ASAP for clarification so that your operation is not delayed!
Hospital Stay
You will be in the ICU for monitoring immediately after your surgery
Expect to stay in hospital on average 7-10 days
You may have an epidural for pain control
Our goal is to get you up and walking as soon as possible after your surgery. This will help prevent blood clots, infections, bowel issues, and other potential complications.
You and your family will receive teaching about caring for your new stoma while in hospital
After Discharge
CCAC Home Care will be arranged to help with care of your new stoma. They will also help care for any surgical drains that you may go home with.
You will go home on 4 weeks of heparin injections to reduce your risk of blood clots. CCAC nurses will either administer these shots for you or if you prefer they will teach your or a family member how to give them
No heavy lifting over 20lb for 6 weeks after your surgery. Light activity such as walking is encouraged and will help your recovery
You will be seen within several weeks of your surgery for assessment of your surgical site and removal of drains. The exact timing of this will be individualized to your case.
Prostate Cancer: Preparing for your prostate removal (Radical Prostatectomy)
Education
Review this Prostatectomy Handout
Visit the Patient Education Handouts section of this website as well as https://www.prostatecancer.ca/ for more information about your surgery and your recovery afterwards
Healthy Living
Abstain from smoking for 4 weeks prior to surgery. If that is not possible, at least try to cut down as much as you can. Consider speaking to your family doctor about smoking cessation aids (i.e. nicotine replacement).
Abstain from alcohol for 4 weeks prior to surgery
Exercises
Try to exercise at least 30 minutes a day to maintain your muscle mass
Visit a pelvic floor physiotherapist prior to your surgery for counselling about pelvic floor muscle strengthening (i.e. Kegel’s). The following are resources to help you find a physiotherapist with specialized training in this area.
Review this handout on Pelvic Floor Exercises you can try at home to prepare for the surgery
Diet
Review this handout out diet for patients with prostate cancer (insert link to handout that is on website)
You can eat a regular diet up to the night before your surgery
No specific mechanical bowel preparation is required prior to your surgery
Medications
At your pre-admission appointment you received instructions about which of your home medications you should take and which ones you should temporarily hold immediately prior to your surgery.
If you are on blood thinners, you will have received specific instructions about how many day(s) you should hold these before the operation.
If you are unsure about any of these instructions, please contact our office ASAP for clarification so that your operation is not delayed!
Hospital Stay
Average length of stay in hospital is 2-3 days
Our goal is to get you up and walking as soon as possible after your surgery. This will help prevent blood clots, infections, bowel issues, and other potential complications.
You will have a catheter and a small pelvic drain after the surgery. You will receive teaching about how to care for both of these while in hospital.
After Discharge
The catheter will remain in for about 10-14 days after surgery. CCAC Home Care will be arranged to help care for this.
In some cases, you may go home with a drain as well. CCAC will also help with this.
No heavy lifting over 20lb for 6 weeks after your surgery. Light activity such as walking is encouraged and will help your recovery
You will be seen within 2 weeks of your surgery for assessment of your surgical site and removal of the catheter. The exact timing of this will be individualized to your case.
Benign Prostatic Hyperplasia Surgery
Scrotal Surgery
Ureteroscopy & Percutaneous Nephrolithotomy
Childhood Circumcision
Adult Circumcision
A circumcision is the removal of the foreskin to expose the covered glans or head of the penis. The procedure is performed on an out-patient basis in an operating room under general anaesthetic.
After Surgery Care
First 24 hours after the procedure
Keep compressive dressing on
Use cold compresses (a frozen bag of peas wrapped with a towel) to reduce swelling and manage pain
Use anti-inflammatories (advil or motrin) as instructed to manage swelling
Wear supportive underwear i.e. briefs or boxer briefs
Keep your penis upright against your body by tucking under waistband of underwear (this helps to reduce swelling and provides added compression)
Two days after the procedure
Remove the dressing in a warm bath
Pat dry after taking showers
Keep the wound clean
Usually you can return to light activities (work, housework) within the first week
Refrain from having intercourse until you follow up with Dr. Dhanjani 6-8 weeks after the procedure