West Coast Urology  –  Geelong   |   Hamilton    |   Colac   |   Winchelsea

A. PROF RICHARD GRILLS

DR KATHRYN MCLEOD

MR PATRICK PREECE

Urological Surgeons

Your procedure

Before your procedure

During your consultation, A. Prof Grills, Dr. McLeod or Mr. Preece will have explained the nature of the surgery you are having, including any potential risks and complications, and you will have signed a consent form.

Following your consultation, our admin staff will book your procedure. At the time of booking your procedure, you will be provided with an Informed Financial Consent document which will advise you of the surgical fee, the anticipated rebate from your Private Health Insurance fund and/or Medicare and approximately how much you will be out of pocket (gap payment).

Prior to your procedure, you will be contacted by the relevant hospital and the Anaesthetist who will also provide you with an estimate of their fees.

If you are required to have any pre operative tests, our staff will clearly explain where and when you are to have these.

You will need to complete the hospital admission form given to you at the time of your consultation and return it to the hospital as soon as possible. The hospital will contact you closer to your scheduled procedure date to advise you of your admission time and fasting instructions.

For certain major procedures, your surgeon request that you have a pre operative appointment with one of our practice nurses. They will go through with you in detail, what can be expected before, during and after your surgery and they will also visit you whilst you’re in hospital. Our nurses are also available to speak to you by telephone (03 5229 8550) during business hours, or you may contact them via email nurse@westcoasturology.com.au if you have any concerns or questions regarding your upcoming surgery.

If you require a pre operative appointment with our Geelong based Continence Physiotherapist, Becky Hollows, we will arrange that for you. For Hamilton patients, we will assist in arranging an appointment with local Continence Physiotherapists.

Admission forms

If you require a procedure, Mr. Grills, Dr McLeod or Mr. Preece will complete a hospital admission form with you during your consultation. The administrative staff at West Coast Urology will then schedule your procedure and assist you with finalising the details on the admission form.

The SJOG admission form is completed online. Colac and Hamilton admission forms are completed by hand.

Please ensure your admission form is completed and forwarded to the appropriate hospital as soon as possible. Once your paper work is lodged with the pre- admissions department at the relevant hospital they will notify you of your admission time.

Admission time

St John of God Hospital, Geelong
Pre-admission staff will notify you the time you are required to present to St John of God on the day of your surgery. You can phone the Pre-admission staff at St John of God on (03) 5226 1344 between 1pm – 4pm the day prior to your surgery to clarify. 

Epworth Hospital, Geelong
The Pre-admission staff at Epworth will contact you 24-48 hours prior to your admission to tell you your admission time. If you have questions about your admission, please contact them on (03) 5271 7714 or (03) 5271 7716.

Hamilton Hospital
Pre-admission staff will notify you the time you are required to present to Hamilton Hospital on the day of your surgery. You may need to phone the Pre-admission staff at Hamilton Hospital (03) 5551 8271 between 11am – 3.30pm on the day prior to your surgery if you haven’t heard prior.

Colac Hospital
You will be required to contact the Colac Area Health Surgery Unit on the working day before surgery between 2pm and 4pm on (03) 5232 5112.

Geelong University Hospital
You will need to phone the Pre-admission staff at Geelong Hospital (03) 4215 1298 on the afternoon prior to your surgery. Pre-admission staff will notify you the time you are required to present to Geelong Hospital on the day of your surgery. 

 

 

Timing for admission for surgery

Day Surgery
Day surgery is surgery that is completed in one day, and does not require you to stay in hospital overnight. Generally, you will need to arrive at the hospital several hours before your operation is scheduled.

If you are scheduled for a day surgery procedure, you must ensure you have a responsible adult to pick you up after your procedure and that you are not left alone for at least 24 hours after your procedure.

You will not be allowed to drive home yourself after your procedure.

Day of Surgery
Day of Surgery requires you to be admitted the same day as your scheduled procedure, this is the case for most operations performed by A. Prof Grills, Dr. McLeod or Mr. Preece.

After your operation you will be transferred to a surgical ward to stay overnight or longer if required. During this time your surgeon and the nursing team will look after you and provide you with appropriate post operative care until you are well enough to go home.

Day Before Surgery
You may be required to be admitted to a surgical ward one or two days prior to your scheduled surgery. This will usually only occur if you require treatment prior to your procedure.

Tests before surgery

Usually, you will need to perform various routine tests prior to your surgical procedure. These tests will generally need to be done 5 – 7 days prior to your scheduled surgery.

Urine test – you may be given a pathology slip to perform a MSU (Mid Stream Urine) sample. The aim of this test is to determine whether you have a urine infection. If a bacteria is found in the sample, it may mean that your urine is infected and in order to treat this you may require antibiotics. This outcome should not delay or postpone your procedure, your surgeon will discuss this with you if required.

ECG – you may require an ECG (Electrocardiogram). This is a medical test that detects cardiac (heart) abnormalities by measuring the electrical activity generated by the heart when in contracts, your anaesthetist will review the results of the ECG prior to your surgery.

Blood tests – you may require routine blood tests. These tests are performed for a number of reasons prior to surgery. They examine your general state of health, to determine if any signs of infection are present, or to determine how a specific organ is functioning.

You may need to have your blood Cross-Matched. This blood test is done for major surgical procedures that may require you to have a blood transfusion and must be done within 2-3 days of your surgery.

What to bring on admission to hospital

You will need the following items during your hospital stay:

  • Night clothes: clothing should be comfortable for moving around. Ensure your clothing is not too long as it could cause you to fall.
  • Footwear: supportive enclosed slippers or shoes that fasten with laces or Velcro straps. Avoid bed socks or loose-fitting slippers as they can contribute to a fall.
  • Toiletries: Toothbrush & paste, soap, comb, deodorant and shaving kit. 
  • Medications: please bring a list of all medications you take and any recent changes that have been made. This includes all medicines prescribed by your doctor and those purchased in a pharmacy, supermarket or health food shop.
  • Glasses
  • Hearing aids: with a spare set of batteries.
  • Walking aids: your walking stick or frame.

We advise however that you do not bring jewellery or large amounts of cash into the hospital.

Fasting instructions

The practice of pre-operative fasting aims to minimise residual gastric volume and acidity prior to surgery. This helps to prevent regurgitation, inhalation and aspiration of gastric contents and in doing so makes your surgery safer. Your fasting requirements will be confirmed by the Pre-admissions staff the day prior to your surgery.

Generally however the following apply :

Morning Operation
You will be asked to fast from midnight the day before your procedure. This will require you to not eat or drink the morning of your operation.

Afternoon Operation
You may be able to have a light early morning breakfast (cereal or toast), generally before 6am on the day of your operation.

The Pre-admissions staff will notify you of the exact time you are required to fast from. You must have not anything to eat or drink from this time.
If you have any questions regarding these fasting instructions, please contact the Pre-admissions staff of the relevant hospital or West Coast Urology.

Medications

You will need to provide your specialist with a list of your current medication. Some procedures may require you to stop taking certain medications prior to your surgery. In some cases (e.g. antibiotics) you may need to commence taking them before your procedure.

Please check with your surgeon or the Specialist Urology Nurse if you have any questions with regard to any other medications that you should cease or commence taking prior to surgery.

You should bring all your medications in their original boxes with you when you come into hospital for your surgical procedure.

Anti-Coagulation and Anti-Platelet agents (“Blood Thinners”)
You may be asked to cease taking these medications prior to your procedure:

  • Warfarin (Coumadin) must be stopped at least 5 days prior to surgery. If you are taking Warfarin you will need to talk to your surgeon about stopping it. INR testing will usually be required a day before surgery or on the morning of surgery to ensure that your Warfarin levels are low enough for surgery to go ahead. You may need to be given Clexane injections whilst you are not taking your Warfarin. Not everyone needs these injections but if you do this will be discussed with you and we will organise this for you.
  • Dabigatran (Pradaxa), Apixiban (Eliquis), Rivaroxaban (Xarelto) medications may need to be ceased between 2-5 days prior to your surgery
  • Aspirin (eg. Astrix, Cartia), Clopidigorel (Plavix, Iscover), Ticagrelor (Brilanta), Dipyridamole (Asasantin, Persantin) may need to be ceased 7-10 days prior to your procedure, please discuss this with your surgeon or the Specialist Urology Nurse.


Other Medications

  • Diabetes medications often need to be stopped before surgery (e.g. empagliflozin, dapagliflozin, Ozempic). Your surgeon will advise if your diabetes medications can be continued or not leading up to your procedure.
  • Some medications that interfere with wound healing and may need to be stopped in the lead up to surgery (e.g. methotrexate). Your surgeon will advise if this is the case. 
  • Most other medications should be continued leading up to your surgery.
  • Morning medications should be taken with a sip of water.
  • On some occasions, you will be given instructions to commence antibiotics prior to your procedure. You should take these as prescribed.
Bowel preparation

There are only a few types of surgery that require bowel preparation. Your surgeon or the Specialist Urology Nurse will instruct you if that is the case.

Prostate Biopsy

A Microlax enema cleans out the lower part of your bowel before the biopsy is performed. This will be administered once you have been admitted to the hospital for your procedure.

How to use Microlax

  • Twist and pull the seal off the nozzle
  • Squeeze the tube gently so that a drop of the Mircolax lubricates the tip of the nozzle (this makes insertion easier)
  • Insert the nozzle fully into the rectum (back passage)
  • Squeeze out the rest of the contents of the tube
  • Keeping the tube squeezed tightly, withdraw the nozzle
  • Microlax takes up to 30 minutes to take effect. Due to the nature of the emema and the bowel stimulation it creates, you may have the urge to open your bowels shortly after you have administered the enema. However, to ensure the enema has taken the full effect required, please try to keep the contents in your rectum for at least 15 minutes. 


Neobladder formation and other complex abdominal/ pelvic surgery

Although uncommon, you may be prescribed full bowel preparation prior to complex abdominal or pelvic surgery. This is usually self-administered at home the day before your surgery.
Picolax / Fleet / PicoPrep / ColonLYTELY etc. – these are liquids which you drink in order to fully empty the entire bowel.

Smoking

It is important to stop smoking as soon as your surgery is scheduled or at the very least 2 weeks prior to your surgery. This will help your breathing and reduce the risk of a chest infection and other complications post operatively.

If you would like to quit smoking, see your GP or you can contact the Quitline on 137 848.

Nurse education

Extensive education is routinely given to patients requiring a Radical Prostatectomy, Nephrectomy or Cystectomy. You will require a pre-operative appointment with one of our Specialist Urology nurses, Teresa Smilovic or Stu Willder, prior to your particular procedure. This appointment helps you understand further the nature of your surgery and what to expect each day during your post operative recovery. This will also provide you with the opportunity to ask and have answered any additional questions you may have related to your surgical procedure.

Education sessions are sometimes required for other procedures. If this is the case, an appointment with the nurse will be organised in the lead up to your procedure. These education sessions are also available at your request if you feel you need some extra information. Simply phone our rooms and ask for an appointment.

The Specialist Nurse services are not covered by Medicare and there is a small, non-rebatable fee required for an individual consultation with the nurse. 

Anaesthetic

Generally your anaesthetist will review you before your operation on the day of your procedure.

If there are any specific concerns your specialist may arrange for an earlier pre-operative anaesthetic review. Additionally the pre-admissions dept. of the relevant hospital may identify issues that you have listed in the hospital pre-admission questionnaire that you completed when you booked your procedure. If that is the case the anaesthetist or hospital may contact you to seek clarification.

If you have any concerns about your anaesthetic or you would like to arrange to be reviewed by the anaesthetist prior to your surgery for a specific reason, please discuss this with your surgeon or the Specialist Urology Nurse.

Depending on the type of surgery you are scheduled for, you will require one of the following types of anaesthetics. Your anaesthetist will discuss this with you and help you choose the one that is best for you.

Sedation
Sedation is generally used for minor procedures and in combination with local anaesthetic for example, a Flexible Cystoscopy. The aim is to have you in a sleepy and relaxed state without being unconscious. Generally, you will have no memories of the procedure, even though you may not be fully asleep.

Local Anaesthetic
Local anaesthetic is injected into the tissue near the surgical site. This is most commonly used to block the nerves in the particular area so no pain is felt during the procedure. Local anaesthetic is used for minor surgery for example, a Vasectomy is usually performed using this technique.

General Anaesthetic
During a general anaesthetic (GA) you will be placed in a carefully controlled medical state of unconsciousness for your entire operation. A combination of drugs and anaesthetic agents are administered intravenously via a needle or via a mask whilst you breath in an anaesthetic gas. The anaesthetist maintains this state throughout your surgery by constantly monitoring your wellbeing. General anaesthetic is used for many surgical procedures ranging from short day surgery to major operations.

Spinal Anaesthetic
A spinal anaesthetic (SA) is a type of regional anaesthetic which numbs the part of the body being operated on from the waist down, for example, a TURP, Caesarian or hernia repair. A spinal anaesthetic is performed by injecting a local anaesthetic into the fluid that surrounds the spinal cord, this produces a loss of sensation in the lower half of the body almost instantly.

After your procedure

Your specialist will visit you daily whilst you are an inpatient at any of the hospitals located in Geelong. During these visits your specialist will monitor the management and progress of your condition, ensuring you are on the road to recovery and optimal health. One of our Specialist Urology Nurses will also visit you to check on your progress. They will liaise with the ward nurses about your care in hospital and be involved in helping to organise your discharge.

If you require ongoing care and/or treatment by the district nursing service or a post operative review with A. Prof Grills, Dr. McLeod, or Mr. Preece, the nursing staff on the surgical ward and your Specialist Urology Nurse will make the necessary appointments for you, prior to your discharge. If you are discharged on a weekend or after hours you will be given instructions to call West Coast Urology during office hours to arrange your follow up appointment.

If you have any concerns after you have been discharged:

Please contact West Coast Urology or for more minor issues or problems not related to your surgery contact your GP.

Geelong Patients

Our Specialist Urology Nurse (03) 5229 8850 is available for you to contact with any issues in regard to catheter care, wound management, pre and post-operative information and any other general enquiries.

Hamilton Patients

Our Specialist Urology Nurse in Geelong (03) 5229 8850 is available for you to contact with all enquiries regarding your care and treatment.

If you have an appointment or you have been referred to Stu Wilder, Nurse Practitioner in Hamilton, he is available to be contacted on (03) 5551 8450.

Colac Patients

Our Specialist Urology Nurse in Geelong (03) 5229 8850 is available for you to contact with all enquiries regarding your care and treatment.