Children’s urology associates, pa


Rafael Gosalbez, M.D., FAAP
Kevin Olson, PA-C
Andrew Labbie, M.D., FAAP
Rigoberto Acosta, PA-C
Kristin Kozakowski, M.D.
Juddie M. Munar, ARNP
Miguel Castellan, M.D.
Natalie Hunter, ARNP miguel.castel Hypospadias Post-Operative Instructions
Upon hospital discharge, your child will be provided with a prescription for pain medication (usually acetaminophen with codeine), which should be administered for up to 2 days postoperatively. After, you may start administering regular acetaminophen as the acetaminophen with codeine may cause constipation. Also, a prescription for antibiotics and a bladder antispasmodic (oxybutinin/Ditropan) will be provided. A possible effect of anesthesia is facial flushing, which may last from a few hours to a day. It will resolve on its own. Constipation caused by anesthesia may last up to 2-3 days. You may use over-the counter glycerin suppositories and/or prune/pear juice to treat constipation. Some fever, although unusual, may occur during the first 24 hours.
Surgical site care:

A large bandage and a small urine catheter will be left in place after the surgery. It is
expected that the bandage gets soiled as the days progress, but it is necessary to keep it as dry and clean as possible. In the case of infants/toddlers, using a double diaper is recommended to ensure dryness of the bandage. In addition, small amounts of blood may stain the bandage and are expected. It is very important that the catheter is draining appropriately. Small blood clots that are expelled from the catheter are expected. Ensure that the catheter is not kinked as it may not drain properly. Both the bandage and catheter will be removed at the surgeon’s discretion, during your child’s post-operative visits. Absorbable sutures are used for incision closure. Therefore, there are no stitches to be removed. After the catheter is removed, your child may feel discomfort/pain while urinating, causing him to hold his urine. You may sit him in the bath tub in lukewarm water to relieve this discomfort for up to 5 minutes at a time. Sponge baths are recommended until the bandage is removed, after which, your child may shower/bathe.
Activity restrictions are as follows:
Avoid extraneous activities/sports that include straddling (i.e. bicycling, horse back
riding, martial arts, football, etc.) until the first follow-up visit. Your practitioner will inform you of the restrictions thereafter.

Contact MD immediately if:

You notice active bleeding (large amount of red blood in the bandage) The catheter is not draining urine appropriately. The catheter is dislodged or the bandage falls off.
Business Office – 3200 S.W. 60 Court Suite 104Miami, Florida 33155Tel:305-669-6448Fax:305-663-8485
Miami Office – Miami Children’s Hospital Medical Arts Building3200 S.W. 60 CourtSuite 104Miami, Florida 33155
Pembroke Pines Office – Professional Centre at Pembroke Lakes Mall 700 N. Hiatus Road Suite 216
Pembroke Pines, Florida33026Tel: 954-433-5300 Fax: 954-433-5340
Boca Raton Office – WestBocaMedicalOfficeBuilding 9980 Central Park Blvd. N. Suite 302 Boca Raton, Fl 33428
Boca Raton Tel: 561-483-0332 Fax: 561-483-5530


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Microsoft word - lesson 42.doc

LESSON 42 I Will Write It In Their Hearts Jeremiah 16, 23, 29, 31 OVERVIEW: Scattering and gathering of Israel. Gospel to be restored for the last time. Jews to be in captivity for 70 years. Ephraim has the birthright and will make a covenant with the Lord in the last days. The overall theme of Jeremiah is covenant. SCRIPTURES: Utter ruin of the Jews foreseen Israel rejected

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