Preop checklist

If you are scheduled for the operating room, there are three main boxes to check: Labs, clearance, and medication changes. This does not apply to patients who are having in office procedures.

Labs: You will be instructed at the time of your visit with Dr. Bower on the plan for labs. Labs are generally drawn 2 weeks prior to surgery at either Quest or Labcorp depending on your insurance, unless you are having a kidney tumor removed where labs will be drawn at the hospital the day before surgery. Please ensure you have your labs drawn at least 2 weeks prior to surgery otherwise.

Clearance: You will either need a simple EKG and interview with a provider at MD now or a full cardiac clearance depending on your medical history. Dr. Bower will discuss this with you at the time your surgery is booked. If you are asked to go to an MD now, please proceed to one as soon as you can. The sooner we can check the clearance box, the less likely the surgery will be cancelled or delayed. If you need a cardiac clearance, a clearance request form will be sent to your cardiologists' office. Although you may not need to have an appointment with the cardiologist, we ask that you call your cardiologist's office so they are aware to be on the lookout for the clearance form. If they require an appointment for clearance and the appointment is close to your surgery date, please notify our office immediately so we can align your surgical day appropriately.

Medications:
In general aspirin should be held for 5 days prior to surgery. All supplements should be held for 5 days prior to surgery. Other blood thinners such as plavix or eliquis or coumadin need to be held according the cardiologist's instructions.

All GLP-1 receptor agonists must be stopped at least 1 week prior to surgery. These medications include:
Ozempic (semaglutide)
Wegovy (semaglutide)
Rybelsus (semaglutide)
Mounjaro (tirzepatide)
Bydureon (exenatide)
Byetta (Exenatide)
Saxenda (Iiraglutide)
Victoza (Iiraglutide)
Trulicity (dulaglutide)
Tanzeum (albiglutide)
Adlyxin (Lixisenatide)
If these medications are not stopped at least 1 week prior to surgery, your surgery will be cancelled and rescheduled

Oral diabetes medicines should be held the morning of surgery. If you are on insulin, you should take 1/2 the normal dose of your long acting insulin and hold the short acting insulin the morning of surgery.

ACE inhibitors such as lisinopril or ARBs such as losartan, diovan, valsartan, irbesartan or telmisartan should be held the morning of surgery

All other morning meds should be taken with a sip of water the morning of surgery unless otherwise instructed.


Other instructions:
Please do not have anything by mouth after midnight the evening before surgery until after the surgery is completed except for the morning medications mentioned above. 

You will be called the day before surgery with your surgery time. There are a lot of moving parts with equipment requirements, cancellations and emergencies so the time cannot be determined until the day before. Also, please be patient on your day of surgery if there is a wait between your arrival time and the time of your surgery. Please anticipate at least 2 hours from your arrival time to the time you are wheeled back for surgery. Please also anticipate at least 2 hours from the end of your surgery until the time you are discharged or brought to your inpatient room.

Prostatectomy patients should adhere to the bowel regimen given to them in the office to be administered the day before surgery.

If you have any questions, please ask. We also answer your emails at admin@bowerurology.com