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Urology (Expert Forum)
Terrified of Urethscopic stone removal HELP!
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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Terrified of Urethscopic stone removal HELP!
by farscape66, Dec 20, 2003 12:00AM
I have never had surgery before and am terrified of hospitals. I also have a great fear of anything involving the genital area. I have a long standing felling of inadequacy in that area. I also suffer from depression. I am currently not on any medication, but in the past I have been on Prozac. I have a current prescription for Lexapro that I have yet to start.
Emotional problems: My father was a healthy man all his live, he was a coal miner, until he had hernia surgery 30 years age. After the surgery he developed blood clots in his legs, this led to his first stroke. Additional strokes occurred and he was brought back from near death 4 years ago. He spent the next 3 years in a nursing home dying. This was a horrible experience for me. I saw him with catheters and other tubes and became terrified of tubes and hospitals.
In summary, I am a big baby with a low tolerance for pain.
Here are my questions:
1). Is an IV line required, for anything other than the anesthetic? If so how soon will it be removed? I have hard to find veins and the IV in the hand usually hurts much more. I hate IV’s with a passion. IV time must be minimized.
2). Has anyone ever died from this surgery?
3). I assume I am asleep before any tubes are inserted or removed from the penis?
4). When removing the stint afterwards in your office, are you awake for this procedure? Can you be sedated or given a tranquilizer for stint removal?
5). If stint discomfort is a problem, are the antispasmodic medications prescribed up front or is an office visit required?
6). How long should soreness or bleeding in the genital area be expected to continue?
7). Does small penis size help or hinder the operation in any way?
8). If something goes wrong and open surgery is required, how long is the hospital stay involved?
9). Please do all you can to minimize my time in the hospital. I have an almost irrational fear of hospitals and may require constant sedation or tranquilizers. I am concerned as to the mental scars left from this procedure also. This could lead me into another depression and cause me to return to anti depressant medication.
I do not want to end up with blood clots and see my life destroyed like what happened to my father. I would like to have available and sign a DNR clause before surgery. My greatest fear is ending up like my father.
How do I get through this? Or do I cancel the surgery, wait for the stone to clog the kidney completly and cause kidney infection and kill me.
Emotional problems: My father was a healthy man all his live, he was a coal miner, until he had hernia surgery 30 years age. After the surgery he developed blood clots in his legs, this led to his first stroke. Additional strokes occurred and he was brought back from near death 4 years ago. He spent the next 3 years in a nursing home dying. This was a horrible experience for me. I saw him with catheters and other tubes and became terrified of tubes and hospitals.
In summary, I am a big baby with a low tolerance for pain.
Here are my questions:
1). Is an IV line required, for anything other than the anesthetic? If so how soon will it be removed? I have hard to find veins and the IV in the hand usually hurts much more. I hate IV’s with a passion. IV time must be minimized.
2). Has anyone ever died from this surgery?
3). I assume I am asleep before any tubes are inserted or removed from the penis?
4). When removing the stint afterwards in your office, are you awake for this procedure? Can you be sedated or given a tranquilizer for stint removal?
5). If stint discomfort is a problem, are the antispasmodic medications prescribed up front or is an office visit required?
6). How long should soreness or bleeding in the genital area be expected to continue?
7). Does small penis size help or hinder the operation in any way?
8). If something goes wrong and open surgery is required, how long is the hospital stay involved?
9). Please do all you can to minimize my time in the hospital. I have an almost irrational fear of hospitals and may require constant sedation or tranquilizers. I am concerned as to the mental scars left from this procedure also. This could lead me into another depression and cause me to return to anti depressant medication.
I do not want to end up with blood clots and see my life destroyed like what happened to my father. I would like to have available and sign a DNR clause before surgery. My greatest fear is ending up like my father.
How do I get through this? Or do I cancel the surgery, wait for the stone to clog the kidney completly and cause kidney infection and kill me.
Doctor's Answer
by Kevin Pho, MD, Dec 20, 2003 12:00AM
, Dec 20, 2003 12:00AM
Please note that I am not a urologist and have not performed this procedure. Here are some answers to your questions.
1) It is very likely that an IV line is required, which is routine for these kind of procedures. It is also a precaution in cause medications need to be give quickly in case of any complications.
2) I am not able to quote exact numbers to see if anyone had died from this procedure. One study I looked up suggested a ureteral complication rate of 2 percent, and no one died from this particular complication.
3) Yes, you should be asleep during the procedure.
4) The stent is removed via the ureterscope. General anesthesia would be needed if this is the case.
5) This would depend on how well your urologist knows you and how comfortable he/she is with the complication.
6) The discomfort after the procedure is variable. Most of the complications of the procedure is due to the aneshesia for the first week or so post-procedure.
7) I am unaware that a small penis size would affect the operation.
8) If open surgery is required, a hospital stay of 7-10 days is anticipated.
9) Discussion of your fears and questions should be expressed to your urologist before the procedure. I cannot make any specific recommendations in your case as I am not personally involved.
Here is some patient information about the procedure:
http://freespace.virgin.net/cd.1/ech/pif/urs.htm
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
1) It is very likely that an IV line is required, which is routine for these kind of procedures. It is also a precaution in cause medications need to be give quickly in case of any complications.
2) I am not able to quote exact numbers to see if anyone had died from this procedure. One study I looked up suggested a ureteral complication rate of 2 percent, and no one died from this particular complication.
3) Yes, you should be asleep during the procedure.
4) The stent is removed via the ureterscope. General anesthesia would be needed if this is the case.
5) This would depend on how well your urologist knows you and how comfortable he/she is with the complication.
6) The discomfort after the procedure is variable. Most of the complications of the procedure is due to the aneshesia for the first week or so post-procedure.
7) I am unaware that a small penis size would affect the operation.
8) If open surgery is required, a hospital stay of 7-10 days is anticipated.
9) Discussion of your fears and questions should be expressed to your urologist before the procedure. I cannot make any specific recommendations in your case as I am not personally involved.
Here is some patient information about the procedure:
http://freespace.virgin.net/cd.1/ech/pif/urs.htm
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Member Comments (3)
by farscape66, Dec 20, 2003 12:00AM
To: Kidney Stones
0
by DC Pyle, Dec 21, 2003 12:00AM
To: Kidney Stones
0
by farscape66, Dec 29, 2003 12:00AM
To: Kidney Stones
0
