Patient information

General Urological Procedures

CYSTOSCOPY

WHAT IS A CYSTOSCOPY?

A cystoscope is a thin tube with a camera and light on the end. It is a procedure that allows your doctor to examine the lining of your bladder and the tube that carries urine out of your body -urethra. Your doctor might order this test if you have urinary problems, such as frequency or if you find urination painful. Your doctor might also order the procedure to investigate reasons for blood in your urine, frequent urinary tract infections (UTIs), an overactive bladder, or pelvic pain.
A cystoscopy can reveal several conditions, including bladder tumours, stones, or cancer. There are 2 types of cystoscopy, a flexible cystoscopy which means the cystoscopy is flexible or a rigid cystoscopy meaning the tube has no flexibility. Cystoscopy is a day procedure / outpatient.

WHAT TO EXPECT BEFORE THE PROCEDURE

Your urologist will give you a request slip to have a urine test approximately 1 week before your procedure to make sure you do not have an infection. You will need to complete the hospitals pre-admission form and ensure the hospital receives this before the procedure. You will need to fast from food and water for a minimum of 6 hours before your procedure. If you take regular blood thinning medications you can continue to take these (ensuring they have been taken 6 hours before the procedure). You will be admitted on the same day as your procedure and asked to sign the final consent form of your admission forms confirming that you understand the procedure and are happy to proceed. The anaesthetist will come to see you to discuss what type of anaesthesia he/she will be using before the procedure begins.

WHAT HAPPENS DURING THE PROCEDURE?

A hollow tube (cystoscope) equipped with a lens is inserted into your urethra and slowly advanced into your bladder so the doctor can visualise the inside of your bladder. Your urethra is the tube that carries urine out of your bladder. Magnified images from the camera are displayed on a screen where your doctor can see them. Different angled lenses on the end of the cystoscope allow the urologist to view the entire bladder. The bladder is drained and then filled with sterile water or an alternative solution. The bladder is examined as it is being filled and is periodically drained. During some procedures, the bladder is continuously irrigated. The flexible scope can be used with the person lying flat, but can only be used for very minor procedures. More frequently, the rigid cystoscope is used. This requires the person to be placed in a position similar to the way a woman is situated during a pelvic examination. When the cystoscopy has been completed, fluid is drained from the bladder.
WHAT ARE THE POSSIBLE RISKS / SIDE EFFECTS?

Some possible complications in rare cases include:
• Swollen urethra (urethritis): This is the most common complication. It makes urination difficult. If you aren’t able to urinate for more than eight hours after the procedure, contact your doctor.
• Infection: In rare cases, germs enter your urinary tract and cause infection. Fever, strange smelling urine, nausea, and lower back pain are all symptoms. You might need antibiotics.
• Bleeding: A few people suffer from more serious bleeding.
WHAT TO EXPECT AFTER THE PROCEDURE

Most people undergoing cystoscopy will be able to go home the same day as the procedure. Recovery depends on the type of anaesthesia. If only local anaesthetic is used, you can go home immediately. If you had a general anaesthetic or sedation, a recovery period of 1-4 hours is necessary. During this observation period, the anaesthetic will wear off, and you will need to be able to urinate prior to leaving.

WHAT TO EXPECT AND DO AFTER DISCHARGE AT HOME

You need to rest for 24 hours after the administration of anything but a local anaesthetic. No driving or any other complex or dangerous tasks should be performed. Your doctor will instruct you on any physical limitations, including sexual activity. Even though the surgery is performed internally, there still may be a risk of bleeding with exertion. Take all antibiotics as prescribed. It’s normal to have a burning sensation while urinating for a few days after the procedure. You may need to urinate more frequently than usual. Don’t try to hold it, as the blood in your bladder could clot and create a blockage. Blood in the urine is also common, especially if you had a biopsy. Drinking lots of water helps ease the burning and bleeding.

Surgery for an enlarged prostate

TURP

WHAT IS A TURP?

Transurethral resection of the prostate (TURP) is the surgical removal of part of the prostate gland. It is one option to relieve the symptoms of an enlarged prostate or other benign prostate disease. It involves inserting a slender instrument through the urethra into the bladder. Only the middle part of the prostate is removed to allow you to pass urine more easily. TURP is used most often for non-cancerous blockage, but may also be used in some cases of prostate cancer. This is the most common form of surgery (around 95% of surgical procedures). The average hospital stay is three to four days. The surgery takes approximately 40-60 minutes.
WHAT OTHER ALTERNATIVE PROCEDURES ARE AVAILABLE?

1/ Open prostatectomy – this involves making a cut in the abdomen to remove a very enlarged prostate. This is the least common form of surgery. The average hospital stay is seven to 10 days.
2/ Laser TURP – a laser is used to remove prostate tissue from the middle part of the prostate, which has the advantage of less bleeding and therefore safer for people on anti-coagulation therapy for other problems, including coronary stents, heart valve or vascular disease.
3/ Transurethral incision of the prostate (TUIP) – is similar to TURP except that no prostate tissue is taken out. One to three cuts are made in the prostate near the bladder neck to release the ‘ring’ of enlarged tissue and make a larger opening around the urinary tract.
WHAT TO EXPECT BEFORE THE PROCEDURE

You will usually be admitted into hospital on the same day as your surgery. You will normally receive an appointment for a ‘pre-assessment’ to assess your general fitness, to screen you for MRSA and do some baseline investigations. If you take regular blood thinning medications such as Asprin, you must discuss this with your urologist prior to the surgery as you may need to cease them for a short period before your surgery. You will need to fast from food and drink for a minimum of six hours before your surgery. When you are admitted you will be asked to sign the consent section of your admission form, showing that you understand the procedure and consent to go ahead with it. The anaesthetist will come to see you to discuss what type of anaesthesia he/she will be using before the procedure begins.
WHAT HAPPENS DURING THE PROCEDURE?

The anaesthetist will give you a general anaesthetic to put you to sleep. The operation is performed by passing a telescopic instrument in through the penis along the urethra and into the area where the prostate gland is obstructing. A special electrode is used to cut away the prostate tissue. The prostate fragments are removed using suction and sent for analysis. At the end of the procedure, a catheter is inserted and usually kept in place from between one to three days after surgery.

WHAT ARE THE POSSIBLE RISKS / SIDE EFFECTS?

* Bleeding: the risk of having significant bleeding is very small and it is very uncommon to need a blood transfusion. It is not uncommon though, to have blood in your urine for up to a couple of weeks after the operation and if you do see blood you should:
• increase your oral fluid intake to at least two to three litres of fluid per day (unless you have medical reason not to do so) reducing fluids when your urine clears
• reduce your mobilisation and increase your rest time.
NB: seek medical advice if you are passing heavy blood or clots.

Infection: There is a small risk of developing an infection in the urine. This risk is however minimised by routine administration of antibiotics at the time of surgery.

Retrograde ejaculation: most men will experience retrograde ejaculation following a TURP. This means the semen goes into the bladder instead of down the urethra during ejaculation. The semen is passed out when you empty your bladder.

Irritative urinary symptoms: following surgery it is usual to have frequency of urination and urgency. Initially you might even find it difficult to reach the toilet in time. It is often thought that drinking less will resolve the frequency and urgency symptoms however it can actually add to the problem. It is therefore important to maintain the recommended fluid intake amount while you are experiencing these symptoms. Over the counter remedies such as Ural and Panadol may assist in relieving these symptoms.

Incontinence: in less than 0.5 per cent of cases incontinence can occur.

Penile erection: approximately 1-2% of men who are sexually active before surgery will lose their ability to have a penile erection—however there are effective treatments available if this does occur.

WHAT TO EXPECT AFTER THE PROCEDURE

You will stay in the recovery room within the theatre suite after the operation while you waken from anaesthetic. You will be transferred on your bed to your room in the ward. It is important that you remain on bed rest following your surgery until the next morning. Reducing your activity allows your body to recover from the anaesthetic and reduces the possibility of bleeding.You will have a urinary catheter in place draining blood stained urine. Irrigation fluid will be attached and is used to flush the bladder of any blood or clots. Blood in the urine is normal after this type of operation. Irrigation fluid and increased oral fluids help flush the bladder and clear away any clots or blood.
While the catheter is in place you may experience bladder spasms or contractions. This can be caused simply by the bladder reacting to the catheter being in place or because the bladder is not emptying properly. The spasms make you feel like you need to pass urine and may cause leakage around the catheter. These spasms are unpleasant but do not cause long-term damage. If your bladder feels full please notify your nurse. They will be able to assist you.
You will have IV fluids to help re-hydrate you. Your IV is usually removed the day after your operation.
It is best to introduce food and fluids slowly following your surgery as the anaesthetic can cause you to feel nauseated. Begin with sips of water and ice then progress gradually to a normal diet, as tolerated. When you are able to tolerate fluids it is important for you to drink plenty to help flush any blood out of the bladder.
It is essential you do not become constipated or strain when opening your bowels. This may cause bleeding. Constipation can be avoided by fluids, diet and aperients.
Your catheter is usually removed day one or day two after surgery.After your catheter has been removed your nurse will monitor your urination by measuring your urine each time you pass it (you will be needing to use a bottle).Once your catheter has been removed your bladder needs time to readjust to ‘working properly’. Drinking large volumes of fluid at one time can cause the bladder to overfill. It is recommended that you keep maintaining the two to three litres of fluid however it is important to divide the amount over the entire day.
You will be given your medications and advised when to recommence those that have been stopped.

WHAT TO EXPECT AND DO AFTER DISCHARGE AT HOME

As you have an open wound that is still healing you should avoid strenuous activity and heavy lifting for 6-8 weeks, strenuous activities including heavy lifting (over 4.5 kg), long walks, sports or sexual intercourse until you have fully healed or as directed by physician, straining during bowel movements. Rest for the first two days after you are discharged from hospital. Initially you may experience burning during urination, a loss of some control of urination or need to urinate frequently. These symptoms are normal and will eventually settle down.
Approximately 9-14 days after your surgery the scab which forms on the healing prostate surface will begin to peel away. You may notice some tissue and fresh blood in your urine at this time which is normal. However, if you experience difficulty passing urine or develop a fever you should contact your surgeon or report the emergency centre.

 

Prostate cancer

TRANSPERINEAL PROSTATE BIOPSY

WHAT IS A TRANSPERINEAL PROSTATE BIOPSY?

Biopsy of the prostate gland is required when there is a suspicion of prostate cancer. It involves taking multiple small samples of prostate tissue with a biopsy needle using ultrasound guidance, which are then assessed by a pathologist. The perineum is the part of the body between the scrotum and anus. A transperineal prostate biopsy is performed under a general anaesthetic. It is a day procedure done under general anaesthetic and takes approx 10-15 minutes.
WHAT OTHER ALTERNATIVE PROCEDURES ARE AVAILABLE?

The alternative to a transperineal prostate biopsy is a transrectal ultrasound biopsy (TRUS) which may be performed under local anaesthesia and involves biopsies taken with a needle through the rectum to access the prostate. This is quick and simple to do, but some prostate cancers may be missed on the first biopsy as this method does not provide good access to the anterior (front) part of the prostate which is away from the rectum. The risk of a serious infection is higher with this method (1-2%) as the needle is passing through a contaminated area before reaching the prostate.

WHAT TO EXPECT BEFORE THE PROCEDURE

You will be given the hospital’s pre-admission forms to complete and send back to the hospital prior to your procedure. As the procedure is performed under general anaesthesia, you should have nothing to eat or drink for a minimum of 6 hours prior to treatment. Regular medications can be taken with a very small sip of water with the exception of blood thinning medications. If you take these types of medicines, please discuss with your surgeon as you may need to cease them temporarily prior to the procedure.

WHAT HAPPENS DURING THE PROCEDURE?

You will be admitted on the day of your procedure and asked to sign the final consent section of the pre-admission forms to confirm you understand the procedure and consent to having it done. The anaesthetist will come to see you prior to the procedure to check on your current health status and discuss your anaesthesia with you. After the anaesthetic has been given, your legs will be placed in special supports, which allow the surgeon to reach the skin behind your testicles. The surgeon will examine the prostate through the back passage (anus) before inserting the ultrasound probe into the rectum. This probe is as wide as a man’s thumb and approximately 4 inches long. In order to take samples (biopsies) of the prostate, a special grid is used so that all areas of the prostate can be included. The biopsy needles are inserted into the prostate through the skin of the perineum, guided by the ultrasound probe (pictured). After the biopsies have been done, a dressing will be applied to the perineum.

WHAT ARE THE POSSIBLE RISK / SIDE EFFECTS?

Most patients do not suffer any problems but some possible side effects include:
• Blood in the urine  (2-3 days)
• Blood in the faeces (2-3 days)
• Discolouration of the ejaculate (up to 6 weeks)
• Difficulty with urination (up to 2 weeks)

WHAT TO EXPECT AFTER THE PROCEDURE

You will remain in the recovery area for a short while and monitored until you wake from the anaesthetic. You should begin taking small sips of water or sucking on some ice and wait until you are feeling better before eating. Once you are fully awake and lucid you will be discharged. You may be given a course of antibiotics to take to avoid possible infection.

WHAT TO EXPECT AND DO AFTER DISCHARGE AT HOME

You may experience mild or moderate discomfort in the perineum for which you can take paracetamol. Blood in the urine is common for 2 – 3 days, with the occasional blood clot, but this should clear quickly if you increase your fluid intake. You may expect to see blood in the semen for up to six weeks. It is important that you:
• Sit quietly at home for the first 48 hours after the biopsies.
• Drink twice as much fluid as you would normally for the first 48 hours.
• Maintain regular bowel function.
• Avoid physically demanding activities.
• Complete your three-day course of antibiotics.

 

 

Bladder Cancer

TURBT

WHAT IS A TURBT?

Bladder cancer is caused by the uncontrolled growth of cells that line your bladder wall. If the cancer is just in the lining and has not grown into the muscle of your bladder, it’s called superficial or non-muscle invasive bladder cancer.  Non-muscle invasive bladder cancer can be treated by removing it from the bladder wall in a TURBT operation. Transurethral resection of bladder tumour (TURBT) is a minimally invasive operation for removing non invasive tumours from the bladder. This procedure is usually done if a tumour has been identified in your bladder during a telescopic examination (cystoscopy). The bladder tumour is removed using a scope inserted through the urethra into the bladder. No cuts are made on the outside of the body. The procedure takes approximately 20-40 minutes.
WHAT ALTERNATIVES ARE AVAILABLE?
. Open surgical removal of bladder.
• Chemotherapy.
• Radiotherapy.

WHAT TO EXPECT BEFORE THE PROCEDURE

You will be given a form to have routine pre operative blood and a urine tests. You should have these tests approx 1 week prior to your surgery to exclude infection. If you are taking any blood thinning medications such as Aspirin or Warfarin, you must discuss this with your urologist as these may need to be stopped prior to your surgery. You will need to complete pre-admission forms for the hospital and send these to the hospital before your surgery. You will be asked to fast from food and drink for a minimum of 6 hours before your surgery. When you are admitted you will be asked to sign the consent section of your pre-admission form showing that you understand the procedure and consent to go ahead with it. The anaesthetist will come to see you to discuss what type of anaesthesia he/she will be using before the procedure begins.

WHAT HAPPENS DURING THE PROCEDURE?

The procedure is performed under general or spinal anaesthesia and the anaesthetist will put you to sleep. Removal of the tumour is carried out using a slightly larger version of a cystoscope, called a resectoscope, which is passed through the urethra and into the bladder.  The cancer is removed by shaving away the tumour until it is resected flush with the bladder wall. The shavings of tumour are washed out of the bladder for analysis under the microscope and any bleeding is controlled.  TURBT enables both removal of the tumour and an accurate diagnosisBiopsies of the tumour bed are performed to assess for any deeper invasive cancer cells, and samples may be taken elsewhere in the bladder. A catheter will be inserted to assist with drainage.

WHAT ARE THE POSSIBLE RISKS / SIDE EFFECTS?

Common
• Temporary mild burning, bleeding or frequency of urination after the procedure.
• Need for additional treatments to bladder in attempt to prevent recurrence of tumours, including drugs instilled into bladder.
• Need for regular checks due to risk of recurrent tumours.
Occasional
• Urine infection requiring antibiotics.
• No guarantee of cancer cure by this operation alone.
• Recurrence of bladder tumour and / or incomplete removal.
Rare
• Delayed bleeding requiring removal of clots or further surgery.
• Damage to drainage tubes from kidneys (ureters) requiring additional therapy.
• Injury to urethra causing delayed scar formation.
• Perforation of the bladder requiring temporary insertion of a catheter or open surgical repair.

WHAT TO EXPECT AFTER THE PROCEDURE

After your operation you will normally go back to the ward. You should begin taking small sips of water or sucking on ice until you are fully recovered from the anaesthetic and then you can start eating and drinking as normal.
You may experience pain and discomfort in your bladder and urethra which usually settles after a day or two.
You can expect to have blood in your urine which may last anywhere up to 6 weeks.
Uncommon side effects may include a urinary tract or bladder infection. You may be given antibiotics to help prevent this but you should also drink enough fluids to help flush your bladder and reduce your risk of an infection.
A catheter may remain for 24-48 hours to drain urine and wash out any blood clots. You may experience some discomfort from the catheter, but this is usually easily treated with mild painkillers such as paracetamol.
WHAT TO EXPECT AND DO AFTER DISCHARGE AT HOME

You may experience burning and some mild discomfort when urinating for several days. It is also common to experience a change of the flow of your stream for several days, perhaps even 1-2 weeks.
Bleeding (including clots) is very common after this procedure. You may notice blood or small clots in your urine for up to 6 weeks on and off.
It is important to avoid any strenuous activity that involves straining or exertion for at least 4 weeks. Such activities include heavy lifting (for example, grocery shopping, picking up children etc). During this time you should not mow the lawn or play any sports that may involve some exertion such as golf, football or tennis.
It is important that you do not strain when using your bowels. Therefore, try to have plenty of fibre in your diet so you can avoid problems with constipation.
Keep your fluid intake up and drink regularly throughout the day.
If at any time you begin to experience difficulty voiding or are unable to pass urine, or begin to have severe pain and/or fevers, contact your urologist or attend the closest emergency department.

 

Kidney Stones

URETEROSCOPY & LASER

WHAT IS A URETEROSCOPY?

Ureteroscopy is a safe and minimally invasive method of treating stone disease in the kidneys and ureter. A ureteroscope is an instrument for examining the inside of the urinary tract which is long and thin and used to see beyond the bladder into the ureters, the tubes that carry urine from the kidneys to the bladder. Some ureteroscope’s are flexible like a thin, long straw and others are more rigid and firm. Through the ureteroscope, the doctor can see a stone and then remove it with a small basket or laser it to dust. It is a day procedure and takes approx 15-60 min.

WHAT ALTERNATIVES ARE THERE?

An alternative to ureteroscopy is ESWL – extracorporeal shock wave lithotripsy which is a non-invasive treatment using an acoustic pulse.

WHAT TO EXPECT BEFORE THE PROCEDURE

You will be given the hospital’s pre-admission forms to complete and send back to the hospital prior to your procedure. Your urologist will give you a request form to have a urine test approx 1 week before the procedure to ensure the urine is sterile before treatment is undertaken. As the procedure is performed under general anaesthesia, you should have nothing to eat or drink for a minimum of 6 hours prior to treatment. Regular medications can be taken with a very small sip of water with the exception of blood thinning medications. If you take these types of medicines, please discuss with your surgeon as you may need to cease them temporarily prior to the procedure.
WHAT HAPPENS DURING THE PROCEDURE?

You will be admitted on the day of your procedure and asked to sign the final consent section of the pre-admission forms to confirm you understand the procedure and consent to having it done. The anaesthetist will come to see you prior to the procedure to check on your current health status and discuss your anaesthesia with you. The surgeon gently inserts the tip of the ureteroscope into the urethra and slowly glides it up into the bladder and then into the ureter. A sterile liquid flows through the scope to slowly fill the bladder and stretch it so the doctor has a better view of the bladder wall. The surgeon will then remove the stone with forceps or a basket or depending on the size, for larger stones; may need to begin fragmenting the stone with a laser. A basket may be used to remove the fragmented particles and some particles may be sent for analysis. A urinary stent will most likely be inserted to ensure there is adequate drainage.

WHAT ARE THE POSSIBLE RISKS / SIDE EFFECTS?

Complications are more likely when the stone is close to the kidney and some possible risks are
Injury to the ureter
Urinary tract infection
Bleeding
Abdominal pain or general discomfort / pain due to the stent

WHAT TO EXPECT AFTER THE PROCEDURE

You will remain in the recovery area for a short while and monitored until you wake from the anaesthetic. You should begin taking small sips of water or sucking on some ice and wait until you are feeling better before eating. You may possibly be given a course of antibiotics to take to prevent possible infection. Once you are fully awake you will be able to go home.

WHAT TO EXPECT AND DO AFTER DISCHARGE AT HOME

For several hours after the procedure you may have a burning feeling when you urinate. This feeling should go away within a day. Drinking a lot of water can help reduce the burning. It is normal to feel the need to pass urine frequently and you may also notice a small amount of blood in your urine that last for approx 2-3 days which is normal.You will sometimes have a temporary urinary stent which may cause some discomfort or pain. Simple analgesics such as Panadol and Nurofen are usually all that is required to alleviate this although occasionally stronger medication (eg. Panadeine Forte) may be necessary.You need to drink at least 8 glasses of water a day.You will not be able to drive for at least 24 hours after surgery as you have had a general anaesthetic. Your doctors office will notify you when the next procedure is due to remove your stent.

 

PYELOSCOPY & LASER

WHAT IS A PYELOSCOPY ?

Pyeloscopy is where a thin fibre-optic telescope is introduced into the kidney from the bladder via the urethra. The diameter of the instrument is less than 3mm and allows visualisation of the entire kidney drainage system due to the flexible nature of the scope. It contains a small instrument port which allows the introduction of laser fibres to efficiently fragment stones, and micro-baskets to retrieve stone fragments. Kidney stones up to 2 cm in size can be treated using this approach. It is a day procedure done under general anaesthetic and takes approx 15-60 minutes.
WHAT ALTERNATIVES ARE THERE?

An alternative to pyeloscopy is ESWL – extracorporeal shock wave lithotripsy which is a non-invasive treatment using an acoustic pulse.

WHAT TO EXPECT BEFORE THE PROCEDURE

You will be given the hospital’s pre-admission forms to complete and send back to the hospital prior to your procedure. Your urologist will give you a request form to have a urine test approx 1 week before the procedure to ensure the urine is sterile before treatment is undertaken. As the procedure is performed under general anaesthesia, you should have nothing to eat or drink for a minimum of 6 hours prior to treatment. Regular medications can be taken with a very small sip of water with the exception of blood thinning medications. If you take these types of medicines, please discuss with your surgeon as you may need to cease them temporarily prior to the procedure.

WHAT HAPPENS DURING THE PROCEDURE?

You will be admitted on the day of your procedure and asked to sign the final consent section of the pre-admission forms to confirm you understand the procedure and consent to having it done. The anaesthetist will come to see you prior to the procedure to check on your current health status and discuss your anaesthesia with you. The procedure will usually take 60 minutes and involves the surgeon gently inserting a pyeloscope into the urethra and slowly glides it up into the bladder through the ureter and up to the kidney. A sterile liquid flows through the scope to slowly fill the bladder and stretch it so the doctor has a better view of the bladder wall. The pyeloscope also has a small instrument port through which a laser fibre is introduced. Once the stone is located within the kidney, the laser is used to fragment the kidney stone. Micro baskets are then used to remove the fragmented stones. Usually, a temporary urinary stent is left in place for a short period to ensure that stone fragments are drained from the kidney and ureter without the risk of blockage.

WHAT ARE THE POSSIBLE RISKS / SIDE EFFECTS?

This is generally considered a very safe operation. Some possible risks include:
Injury to the ureter, kidney or bladder
Urinary tract infection
Bleeding
Abdominal pain or general discomfort / pain due to the stent

WHAT TO EXPECT AFTER THE PROCEDURE

You will remain in the recovery area for a short while and monitored until you wake from the anaesthetic. You should begin taking small sips of water or sucking on some ice and wait until you are feeling better before eating. You may possibly be given a course of antibiotics to take to prevent possible infection. Once you are fully awake you will be able to go home.

WHAT TO EXPECT AND DO AFTER DISCHARGE AT HOME

For several hours after the procedure you may have a burning feeling when you urinate. This feeling should go away within a day. Drinking a lot of water can help reduce the burning. It is normal to feel the need to pass urine frequently and you may also notice a small amount of blood in your urine that last for approx 2-3 days which is normal.You will sometimes have a temporary urinary stent which may cause some discomfort or pain. Simple analgesics such as Panadol and Nurofen are usually all that is required to alleviate this although occasionally stronger medication (eg. Panadeine Forte) may be necessary.You need to drink at least 8 glasses of water a day.You will not be able to drive for at least 24 hours after surgery as you have had a general anaesthetic. Your doctors office will notify you when the next procedure is due to remove your stent.