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Halton Urology

Hospital Specific Information

Pre/Post-Surgery Information

Frequently Asked Questions

Printed Patient Materials

Hospital Specific Information

What are the procedures at the Georgetown Hospital?

Procedures at the Georgetown Hospital:

Cystoscopy

  1. Read through the cystoscopy paperwork
  2. Bring your paperwork to your cystoscopy appointment at the hospital
  3. Arrive 30 minutes before your scheduled appointment time
  4. Check in at the Day Surgery Department

Prostate Biopsy

  1. Read through the two-page prostate biopsy paperwork which includes the date and time of your procedure
  2. Fill out the questionnaire on page 2
  3. Take your antibiotics for 3 days starting the morning before your scheduled biopsy
  4. Administer the fleet enema the morning before your biopsy at home
  5. Arrive 15 minutes before your scheduled appointment
  6. Check in at the Diagnostic Imaging Department

Outpatient Day Surgical Procedures

  1. Read through your surgery package
  2. Fill out the Pre-Surgical Patient Questionnaire
  3. Have your family doctor fill out the History and Physical Form no more than 4 weeks before the date of your surgery
  4. Please call the Georgetown Hospital – Day Surgery department at 905-873-4577 to review a pre-surgical screening interview to see if you require a pre-anesthetic/pre-operative appointment or any additional blood work or tests
  5. If a pre-anesthetic/pre-operative appointment has been scheduled, please ensure that you attend otherwise your surgery may be cancelled by the anesthesiologist
  6. Arrive 2 hours before your scheduled surgery time so that you can be prepared for surgery
  7. Your must have someone drive you to and from the hospital on the day of your surgery

Inpatient Surgical Procedures

  1. Read through your surgery package
  2. Fill out the Pre-Surgical Patient Questionnaire
  3. Have your family doctor fill out the History and Physical Form no more than 4 weeks before the date of your surgery
  4. A pre-anesthetic/pre-operative appointment at the Georgetown Hospital will be scheduled for you – you will be notified either by my office or the hospital
  5. Please ensure that you attend your scheduled pre-anesthetic/pre-operative appointment otherwise your surgery may be cancelled by the anesthesiologist
  6. Arrive 2 hours before your scheduled surgery time so that you can be prepared for surgery
  7. Check in at the Admitting Department

What are the procedures at the Milton District Hospital?

Procedures at the Milton District Hospital:

Cystoscopy

  1. Read through the cystoscopy paperwork
  2. Bring your paperwork to your cystoscopy appointment at the hospital
  3. Arrive 30 minutes before your scheduled appointment time
  4. Check in at the Admitting Department (by the main entrance)
  5. Proceed upstairs to the Day Surgery Department on the 2nd floor

Outpatient Day Surgical Procedures

  1. Read through your surgery package
  2. Fill out the Pre-Surgical Patient Questionnaire
  3. Have your family doctor fill out the History and Physical Form no more than 4 weeks before the date of your surgery
  4. A pre-anesthetic/pre-operative appointment at the Milton District Hospital will be scheduled for you – you will be notified by my office
  5. Please ensure that you attend the pre-anesthetic/pre-operative appointment otherwise your surgery may be cancelled by the anesthesiologist
  6. Arrive 2 hours before your scheduled surgery time so that you can be prepared for surgery
  7. Check in at the Admitting Department (by the main entrance)
  8. You must have someone drive you to and from the hospital on the day of your surgery

Inpatient Surgical Procedures

  1. Read through your surgery package
  2. Fill out the Pre-Surgical Patient Questionnaire
  3. Have your family doctor fill out the History and Physical Form no more than 4 weeks before the date of your surgery
  4. A pre-anesthetic/pre-operative appointment at the Milton District Hospital will be scheduled for you – you will be notified by my office
  5. Please ensure that you attend your scheduled pre-anesthetic/pre-operative appointment otherwise your surgery may be cancelled by the anesthesiologist
  6. Arrive 2 hours before your scheduled surgery time so that you can be prepared for surgery
  7. Check in at the Admitting Department (by the main entrance)

What are the procedures at the Oakville Trafalgar Memorial Hospital?

Outpatient day surgical procedures

  1. Read through your surgery package
  2. Bring your Pre-Admission Clinic Envelope to all your appointments
  3. Fill out the Pre-Surgical Patient Questionnaire
  4. Have your family doctor fill out the History and Physical Form no more than 4 weeks before the date of your surgery
  5. You will be contacted by the Pre-Admission Clinic to arrange a clinic visit. If you have not been contacted within 7 days of your surgery, please call 905-338-4497
  6. Please ensure that you attend the pre-anesthetic/pre-operative appointment otherwise your surgery may be cancelled by the anesthesiologist
  7. Arrive 2 hours before your scheduled surgery time so that you can be prepared for surgery
  8. Check in at the Surgical Services/Ambulatory Procedures Unit on the 2nd Floor
  9. Your must have someone drive you to and from the hospital on the day of your surgery

Inpatient Surgical Procedures

  1. Read through your surgery package
  2. Bring your Pre-Admission Clinic Envelope to all your appointments
  3. Fill out the Pre-Surgical Patient Questionnaire
  4. Have your family doctor fill out the History and Physical Form no more than 4 weeks before the date of your surgery
  5. A pre-anesthetic/pre-operative appointment at the Milton District Hospital will be scheduled for you – you will be notified by my office
  6. Please ensure that you attend your scheduled pre-anesthetic/pre-operative appointment otherwise your surgery may be cancelled by the anesthesiologist
  7. Arrive 2 hours before your scheduled surgery time so that you can be prepared for surgery
  8. Check in at the Surgical Services/Ambulatory Procedures Unit on the 2nd Floor

Frequently Asked Questions

Here you'll find common questions patients of ours have asked previously. We've taken the time to bring it together all in one place for your convenience.

Will I be seen if I am early or late for my appointment?

All patients are given specific appointment dates and times because I do not like to run behind in my clinic and I do not like to overbook as it affects the care I am providing to you and other patients. If you are early or late, I will direct my staff to try to fit you as long as does not negatively affect other patients who are on time.

If I am able to fit you in, my priority is to see the patients at the time that they are booked. I will see you when there is an opportunity or gap in patient appointments. This may mean that you have to come back later in the day.

If I am unable to fit you in the same day because you are late for your appointment, you will be rescheduled on another day at my convenience and availability.

How do I rebook or reschedule an appointment?

If I had previously seen you with one calendar year, you will be rebooked based on the next availability as well as your clinical history after I have reviewed your medical records. Many patients often want to move their appointment to the following few days or week and while my staff will endeavour to meet your timelines, it may not always be possible depending on how booked the clinics already are and whether I am in the clinic or at the hospital performing surgery.

If I have not seen your for over one calendar year, then the MOHLTC requires that a new written referral by your physician be sent to me again requesting a new consultation (yes unfortunately, even if it is for the same urologic issue).

How do get my bone scan, CT scan, MRI, renal scan, ultrasound, X-ray booked at the hospital? How do I change the appointment at the hospital?

If you had a diagnostic imaging test (such as bone scan, CT scan, MRI, renal scan, ultrasound, X-ray, etc.) that I have requested at the hospital, I will send off the referral for that test when you are at your office visit with me. Depending on which hospital your test has been booked at as well as the clinical reason for the test, the hospital will book the test and notify my office directly by fax. They will also provide a set of instructions on how you need to prepare for this test. My office will notify you by phone of your diagnostic imaging test at the hospital and your follow-up appointment with me in the office.

If there is a conflict in the appointment time and date for the diagnostic imaging appointment at the hospital, my office cannot change this appointment for you. The hospital requests that you call them directly to change your appointment

Please notify my office of the changed DI appointment time so that we can also change your office follow-up visit.

How do I cancel an appointment?

As you can appreciate, I have a busy clinical practice and only in my office 2-3 days per week and sometimes less. As you are given an appointment at the time of your last visit in the office, please be respectful of other fellow patients who may need urgent appointments and I would then ask that you cancel your appointment and rebook as soon as you know that you will be unable to attend the booked appointment.

How do get a follow-up appointment?

All patients who are booked a follow-up visit in the office are either given a mutually agreed upon written appointment time and date at the time of your last appointment. If you are coming back to the office for follow-up visit after a procedure or a test at the hospital, then this appointment will be given to you over the phone. Please make sure that we have all the current contact numbers.

In addition, as a rule and in accordance to what the College of Physicians and Surgeons of Ontario recommends, I do not leave private or personal information on your answering machines or with family members or friends unless I have been previously instructed to do so. This would have been documented in my records to allow myself or my staff to do so accordingly.

How long does it take to get an appointment? Why haven’t I heard about my referral yet? How long do I have to wait after I was referred from the ER?

The wait time depends on a number of factors. If you are a new patient waiting for an appointment, the wait time is dependent on the following factors: clinical history as provided by your referring physician and completeness of the referral documents provided by the referring physician. Often times, when I review the referral, I am missing or requesting further information so that we can minimize any gaps in your care once you come to your appointment. Unfortunately, this is often the cause of some of delay between when you are told the referral has been made and when you are actually seen.

Based on reviewing the all-clinical information provided, I will triage the referrals based on nature of the illness or clinical history. Urgent urologic issues are seen on average within 1-2 weeks whereas less urgent or non-urgent urological may wait on average 4-6 weeks but can often be longer. Please note that the appointment time and date will be sent back to the referring physician who will then notify you of the time and date.

For patients who are referred through an Emergency Department, the same information above applies. My office will not book an appointment for you over the phone until I have received and reviewed all the information from the hospital. They will then call you directly to book the appointment based on my next availability.

How do I get an appointment?

As per guidelines set out by the Ministry of Health and Long-term Care of Ontario, I am only allowed to see patients in consultation when referred by another licensed physician in Ontario and by written request.

What is an add-on case? How to add-on cases work?

At your last appointment, we discussed that based on your medical condition, that you require surgery on an urgent or semi-urgent basis. This is what we call an “add-on” case, which means your name is added to the urgent surgical list at the hospital after the booked elective cases are completed (8:00 am – 3:30 pm). These urgent cases will proceed generally starting after 3:30 pm and they are prioritized based on the severity of illness of the patient and not on a first come first serve basis. Surgical emergencies can occur at any time of day and may result in you waiting longer for your surgery to proceed. While this may be frustrating, please understand that there is unfortunately a patient who is sicker and requires more emergent or urgent surgery than you. In rare situations, your case may be cancelled all together due to there being too many urgent cases ahead of you and we will then attempt to add you to the list again on another day.

My office will typically notify you by telephone the day before we are planning on performing the surgery. Specific instructions will be given to you by phone. The reason for the short notice is that your case is being added on to an urgent surgical list and not a pre-booked elective list. As such, there is no possibility of booking this procedure ahead of time with a specific date as this urgent surgical list changes day to day.

Please make sure that you have filled out the forms as indicated within the surgical package that you were given when you were last in my office. In addition, please make sure that the History and Physical form is filled out by your family physician.

If you have a stone and we are planning to proceed with an Ureteroscopy and laser lithotripsy, this is a day surgical procedure and you will be discharged home once the surgery is completed. You will need a ride home as you will not be fit to drive after having received an anesthetic.

How do I rebook my surgery or procedure?

If you cancelled your surgery last minute or missed your surgery date, depending on the reason, I may or may not rebook your surgery. The time I am granted at the hospital is limited as are all health care resources and as such, please appreciate that there are always patients who are waiting who may often need urgent or cancer surgeries.

If there is a conflict in your schedule with the date of surgery I have given you, please endeavour to notify this as soon as possible. We will do our best to accommodate your schedule within reason.

Why is Dr. Kwan running late in the office?

Why is nobody answering the phone? Why has no one returned my call/message/voicemail?

What are your office clinic hours? Do you have weekend or evening appointments?

What are the post-procedure patient instructions?

  1. Follow your doctor’s instructions.
  2. You may need to wear a catheter to drain your bladder after the procedure. This catheter is usually removed within 24 hours.
  3. Do not drive or operate dangerous equipment for 24 to 48 hours following anesthesia.
  4. Avoid beverages containing caffeine because they may cause bladder spasms. Also avoid carbonated beverages, citrus juices, or alcohol.
  5. Activity level: Take it easy for 2 to 3 days. Do not engage in activities requiring heavy lifting, gardening, bicycling etc. This will increase the pressure your abdomen puts on the bladder and may result in blood in your urine.
  6. Take all medications as directed. Typical medications may include:
    1. Antibiotic (prevents infection).
    2. Non-steroidal anti-inflammatory drug (reduces inflammation).
    3. A drug to reduce bladder spasms.
    4. Mild over-the-counter pain reliever as needed.
  7. Do not engage in any form of sexual activity for 2 weeks.
  8. Take a stool softener if needed to avoid becoming constipated for 14 days.
  9. Unless you have been advised to limit your fluid intake due to another medical condition, drink one glass (8 oz. or 1/4 liter) of water for every hour you are awake, about 64 oz. (or 2 liters) per day.
  10. Please call the office at (905) 875-3920 at to schedule a follow-up appointment.
  11. Please call the office immediately if any of the following symptoms appear:
    1. Bright red bleeding in urine with a heavy clot.
    2. Fever over 101° F (38°C).
    3. Inability to urinate for more than 4 hours.
    4. Feeling of bladder fullness that does not go away after urinating.

What are the pre-procedure patient instructions?

  1. Call your doctor if your condition changes, or if you develop a cold, infection or fever.
  2. Let your doctor know if you are taking any blood thinners such as aspirin, aspirin- containing medications, Coumadin® or Plavix®. Your doctor may recommend that you stop taking these medicines several days prior to the procedure.
  3. Take any antibiotics as prescribed by your doctor.
  4. Ask your doctor to write prescriptions for any medications he thinks you should take before the day of your scheduled procedure. This will allow you to have those medications “on hand” when you leave the surgery centre, instead of having to depend on someone else to take them to a pharmacy for you.
  5. Write down any questions you have about the procedure. Bring them with you. There will be plenty of time to answer your questions before, during, or after your procedure.
  6. You may eat and drink as usual the night before. Your urologist or anesthesiologist may allow a clear liquid breakfast, depending on the time of day your procedure is scheduled. If you are scheduled to have your procedure before noon, do not take anything by mouth after 12:00 midnight the night before.
  7. Wear comfortable, loose-fitting clothing to the hospital or ambulatory surgery center on the day of your procedure.
  8. Bring all medications with you on the day of the procedure.
  9. Ask your urologist or the anesthesiologist if you should take your regularly prescribed medications on the day of the procedure.
  10. Please plan to be at the hospital at least 2 hours prior to your scheduled treatment. Remember that you will also need to spend some time post procedure to recover from anesthesia prior to being discharged to home. If your doctor has indicated that you will need to stay overnight in the facility, please arrange for someone to pick you up the next morning.
  11. Arrange for transportation home; you may not drive or operate dangerous equipment for 24 hours after the procedure. (If you have spent the night in the healthcare facility, you will still need to arrange for a ride home.)
  12. If you have any questions, or cannot keep this appointment, please call (905) 875-3920.

How much pain should I expect?

Before the vasectomy you will not need any sedatives. A no-scalpel vasectomy is a virtually painless. Afterwards you may be sore for a couple of days and some patients may require Tylenol, extra strength Tylenol or Advil. The discomfort is less with the no-scalpel technique because there is minimal injury to the tissues.

When can I go back to work?

You should not do any heavy physical labour for seven days after your vasectomy. If your job does not involve this kind of work, you can go back sooner. The majority of men have their vasectomy on Fridays, so the can take it easy over the weekend and go back to work on Monday.

Will vasectomy change me sexually or my sexual function?

You should not notice any differences or changes in your sexual function including your libido, erections, orgasm and ejaculatory function, after having a vasectomy. The only thing that will change is that you will not be able to make your partner pregnant.

Will I be sterile right away?

No, after a vasectomy, there will be some live sperm in your system downstream from where the tubes are blocked. It usually takes 3 months to clear them. You and your partner should continue to use some other form of birth control until a semen test confirms that your semen is sperm free.

Is No-Scalpel Vasectomy safe?

The most recent Canadian Urological Association guidelines published in 2016, as well as many other world wide experts and organizations, have concluded that vasectomies are a safe, simple and effective procedure. Vasectomy is a surgical procedure and as such, there are potential risks but serious problems are uncommon.

Can a No-Scalpel Vasectomy be reversed?

Yes, but vasectomy reversals (vasovasostomy) are expensive (not covered by OHIP) and not always successful. You should only consider having a vasectomy when you and your partner are entirely sure that you are happy with the number of children you have, as it is considered a permanent form of birth control.

How much will a vasectomy cost?

The Ontario Health Insurance Plan (OHIP) covers the cost of a vasectomy and the tray fee. The optional Post-Vasectomy Care package is available for $50.00 for your convenience, comfort and personalized services.

When can I start having sex again?

As soon as you are comfortable, after a minimum of seven days, but remember to use some other kind of birth control until your semen analysis confirms you are sterile.

Resources

Pre-Surgery Information

Learn More

Resources

Post-Surgery Information

Learn More

Printed Patient Materials

Active Surveillance For Prostate Cancer

Download PDF

BCG Treatment for Bladder Cancer

Download PDF

Bladder Infections In Women

Download PDF

Bladder Tumour

Download PDF

Bladder Tumour Resection

Download PDF

Childhood Circumcision

Download PDF

Cystoscopy

Download PDF

Erectile Dysfunction

Download PDF

Foreskin Care For Boys

Download PDF

Hematuria

Download PDF

Kidney Stones

Download PDF

Kidney Tumours

Download PDF

Overactive Bladder

Download PDF

Peyronie’s Disease

Download PDF

Prostate Ultrasound and Biopsies

Download PDF

Prostatitis

Download PDF

Renal Colic

Download PDF

Scrotal Surgery

Download PDF

Scrotal Swellings

Download PDF

Stress Urinary Incontinence

Download PDF

Transurethral Resection of the Prostate (TURP)

Download PDF

Transurethral Resection of the Prostate (TURP)

Download PDF

Ureteric Stenting

Download PDF

Ureteroscopy

Download PDF

Urethral Catheter Care

Download PDF

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