Before your operation for penile cancer
Before surgery for penile cancer you have tests to check your fitness. You will also meet members of your treatment team. You usually go into hospital on the morning of your operation.
Pre assessment clinic
Your pre assessment appointment prepares you for your operation. This usually happens in the 2 weeks before your surgery.
At your appointment the pre assessment team may:
- ask you questions about your health and any medicines you are taking
- tell you when to stop eating and drinking before your operation
- tell you if you need to stop taking any medicines before the operation
- check your weight, blood pressure, pulse and temperature
- ask what help and support you have at home
The pre assessment team will tell you how to prepare for your operation. What you need to do depends on what operation you are having.
They may also give you a leaflet about breathing and leg exercises to do after your operation. This is to help prevent chest infections and blood clots.
It helps to write down any questions you have and take them with you. The more you know about what is going to happen, the less frightening it will seem. You can ask more questions when you go into hospital so don’t worry if you forget to ask some.
Enhanced Recovery After Surgery (ERAS) Programme
The pre assessment team might tell you about the Enhanced Recovery After Surgery (ERAS) Programme. This is for people having a big operation and is to help you recover quicker. It starts before you have your operation and continues for a short time after you have gone home.
For example, they might give you carbohydrate drinks to have before your operation. How many drinks you have depends on what brand of drink the hospital uses. And when you have them depends on what time of day your operation is.
After your operation your nurses will encourage you to do breathing exercises. They will help you with getting out of bed and walking as soon as you can. And start you eating and drinking as soon as possible. This depends on the type of operation you’ve had. But your doctor will tell you when you are ready to do this.
Tests to check you are fit for surgery
You have tests before your operation to check:
- your fitness for an anaesthetic, if you need one
- that you’ll make a good recovery from surgery
You might have some or all of the following tests:
- blood tests to check your general health and how well your kidneys are working
- a swab test to rule out some infections
- an
ECG 
to check that your heart is healthy - breathing tests (called lung function tests)
- an
echocardiogram - a chest x-ray to check that your lungs are healthy
- a cardio pulmonary exercise test (which checks your heart and lung function when you're resting and exercising)
Who you might meet before your operation
You meet members of your treatment team and you can sign the consent form to agree to the operation.
Ask lots of questions. It helps to write down all your questions beforehand to take with you. The more you know about what is going to happen, the less frightening it will seem.
Surgeon
A member of the surgical team will tell you about:
- the operation you are going to have
- the benefits of having surgery
- the possible risks
- what to expect afterwards
Anaesthetist
The anaesthetist gives you the anaesthetic and looks after you during the operation. They make sure you’re fit enough for the surgery.
Clinical nurse specialist
The clinical nurse specialist checks what help and support you have to see what you will need when you go home. They are your point of contact and care for you throughout your treatment.
Nurse
The nurse checks your:
- general health
- weight
- blood pressure
- pulse
- temperature
Physiotherapist
The physiotherapist assesses how well you can move around. They let the doctors know if there is anything that could affect your recovery.
The physios also teach you leg and breathing exercises to do after your operation to help with recovery. Learning how to do the exercises beforehand makes it easier afterwards.
Learning breathing and leg exercises
Breathing exercises help to stop you from getting a chest infection. If you smoke, it helps if you can stop at least a few weeks before your operation.
Leg exercises help to stop blood clots forming in your legs. You might also have medicines to stop the blood from clotting. You have them as small injections under the skin. You start the injections before or after your operation. Your doctor or nurse will let you know when they start.
You might also wear compression stockings.
Your nurse and physiotherapist will get you up out of bed quite quickly after your surgery. This is to help prevent chest infections and blood clots forming.
This 3-minute video shows you how to do the breathing and leg exercises.
Breathing and circulation exercises after surgery
These exercises help prevent you developing a chest infection or blood clots in your legs after surgery. These problems are more likely when you are not moving around as you would normally.
You can do these breathing exercises while sitting up in a chair or in a bed or whilst lying down.
Relax your shoulders and upper chest.
Take a slow, deep, comfortable breath in and hold for a couple of seconds, then slowly breathe out.
Repeat this 3 times.
You can start these breathing exercises as soon as you come round from your anaesthetic.
You should try to do them every hour when awake until you are fully mobile.
If you need to cough, support your wound with your arms, a pillow or a rolled up towel.
If you are struggling to clear any phlegm, try a hu. This is where you breathe out in a short, sharp manner as if you were trying to steam up a mirror.
You should move about as soon as possible after your operation. But while you are not as mobile, try to keep your legs moving to encourage better circulation.
You can do these exercises in a bed or in a chair.
One foot at a time point your toes away from you then pull your toes towards your chin.
Try to do 10 of these on both feet at least 2-3 times an hour.
The next exercise is circling your ankles. One at time circle your ankles, clockwise and then anticlockwise. Repeat this 10 times with each ankle 2-3 times an hour.
The evening before or the morning of your operation
You usually go into hospital on the morning of your surgery. You might go in the evening before.
Your nurse might give you a carbohydrate-rich drink to have the evening before the operation. You might also have it the following morning. The drink gives you energy and can speed up your recovery.
You might have fluids through a drip (intravenous infusion) into your arm before your surgery if you have recently been finding it difficult to drink.
A few hours before
Your nurse will check your blood pressure, pulse and breathing rate.
The nurse will go through a series of questions on a checklist to make sure you are ready for surgery. They ask you to:
- tell them when you last had something to eat and drink
- change into a hospital gown
- put on a pair of surgical stockings
- take off any jewellery (except for a wedding ring)
- remove contact lenses if you have them
- put on 2 hospital identification bands usually on each wrist
If you have false teeth you can usually keep them in until you get to the anaesthetic room.
Shaving
For some types of surgery, you’ll need to shave the skin over the operation area. Or your nurse can shave it for you. They might do this when you’re under anaesthetic in the operating room.
Medicine to relax
Your nurse might give you a tablet or an injection to help you relax. This will be an hour or so before you go to the operating theatre. This makes your mouth feel dry. But you can rinse your mouth with water to keep it moist.
Your nurse and a porter take you to theatre on a trolley if you’ve had this medicine. You can walk down to the theatre if you haven't had any.
Having an anaesthetic
You have an anaesthetic so that you can’t feel anything during the operation. You have this in the anaesthetic room, next to the operating theatre.
All the doctors and nurses wear theatre gowns, hats and masks. This reduces your chance of getting an infection.
The anaesthetist puts a small tube (cannula) into a vein in your arm. You have any fluids and medicines you need through the cannula including the general anaesthetic. This sends you into a deep sleep. When you wake up, the operation will be over.
Before you go to sleep your anaesthetist might put a small tube in the space around your spine. They can attach a pump to this tube to give you pain medicines. This is for after your operation to help control your pain.
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