KEEP INCISION DRY AND DRESSINGS DRY You are not allowed to shower for at least 2-3 days and must keep the incision(s) dry to prevent infection and to aid in healing. I will tell you when you can get the incision(s) wet. Do not rub the suture area(s), but rather pat dry.

INFECTION While infection is unlikely, I wish you to watch for signs of infection, i.e., redness, swelling, green drainage. If any of these occur, please let me know within 24 hours. Do not use a hot tub or whirlpool bath until one week after your sutures are removed.

BLEEDING While bleeding is unlikely, if bleeding occurs, apply direct pressure with a gauze for 15 minutes. Call me if bleeding occurs after this.

SUTURES Usually there are no sutures that need to be removed.

INCISIONS If any part of an incision opens, please let me know within 24 hours, and if you are using a stretching device stop using it immediately.

CLOTHES/DRESSING Use boxer shorts and sweatpants as long as you have discomfort or penile swelling. When dressing, do not bend or fold your penis. You may wish to place your penis up on the abdomen for the 1st 4 days after which we want you to allow the penis to hang down in boxer shorts for 4 to 6 weeks.

PHYSICAL ACTIVITIES Light activities may be resumed in about 3 to 7 days and strenuous activities in 4 to 6 weeks.

ATHLETIC ACTIVITIES Athletic and other strenuous activities such as running or extensive walking must be avoided for at least 5 weeks. No aerobics or contact sports are allowed for at least 6 weeks. You may engage in upper body exercise after 3-4 days.

SLEEP You should sleep on your back as much as possible for 1 to 2 weeks

SEXUAL ACTIVITY You should not have penetrating sex (i.e., sexual intercourse) or sustain any genital trauma or significant pressure for 6 weeks.

SWELLING AND DISCOLORATION You may expect some swelling and discoloration of the penile shaft, scrotum, lower abdomen for approximately 1 to 2 weeks. You may elevate the scrotum and penis on a towel placed between your legs to minimize swelling.

MEDICATIONS
Levaquin 500mg, take 1 tablet once a day for 1 week
Vitamin C 500mg, 3 times a day for about a month.
Vicodin ES, 1 tablet every 4 hours for severe pain (rarely needed).
If moderate pain, use Tylenol #3, 1 or 2 tablets every 4 hours.

If you have had penile widening (albugineal/cavernosal) you should take - one half hour before sleep valium 5mg for 14 days to inhibit nocturnal erections, and Amyl Nitrite Inhaler (0.3 ml) HS for one month and during the day for one month if you have daytime erections to abort the erections. You will also take Vitamin B-6 (100 mg) once daily.

Do not take aspirin, aspirin products, or Motrin for 2 weeks (See Drugs to Avoid Pre and Post Operatively.) Continue to take all your routine medications.

PAIN MEDICATIONS Many patients do not use pain medications. You should not need pain medication after 1 week.

PENILE STRETCHING DEVICE If you have had the widening procedure (pericavernosal) alone or in combination with the lengthening procedure, you will start using a penile stretching device under my supervision between 6 and 8 weeks. If your procedure is staged, meaning it is performed in two parts, with the first procedure being the penile lengthening, you may start using the weights about 4 weeks after the surgery. Initially, you will have the weights on for 5 to 10 minutes and then off for 15 to 20 minutes. This may be repeated in sets of 4 to 5, before work in the morning and in the evening. Alternative exercise programs will be discussed with you.

These weights are extremely safe when used properly. However, potential risks include: contact dermatitis, bruising; vascular, erectile tissue and nerve injury, possibly causing or contributing to erectile dysfunction or loss of the penis. See detailed instructions from the manufacturer included with the stretching device.

After a period of time, you may gradually increase the amount of weight and length of time, determined by your comfort level and the guideline I will give you. You should never use the weights if they cause discomfort, or change in penile sensation (feeling), color or temperature of the penis. If you have any concerns you should stop using the weights and inform me before starting again. For optimal results, you may wish to use the weights for about 6 months.

VACUUM DEVICE If you have had albugineal/cavernosal penile widening, at three weeks after surgery you should begin using the vacuum device.

REMOVAL OF DRESSING The penile dressing will be removed by myself or your physician in 10 to 14 days if you had the penile widening procedure.

OFFICE VISIT An office visit is required 24 to 72 hours after surgery to observe the incision(s) and surgical sites and to change the dressing, if necessary. A second office visit is recommended one week later. Out of town patients must be seen at least one time prior to leaving town, and are requested not leave town sooner than 72 hours after surgery in case they need to see me prior to departure. Ideally, I would like out of town patients to stay in New York City for about one week, particularly if you have had a widening procedure.

FOLLOW-UP Routine follow-up visits at 1, 3, 6, 9, and 12 months after surgery are recommended.

If you have any problems, call Dr. Whitehead at 212-879-3131. If he is not available, and you are not able to reach the covering doctor, call the urology resident on call at Beth Israel Medical Center in New York at 212-420-2000 on page.