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Perioperative Care

Comprehensive perioperative management for genitourinary reconstructive surgery — organized around the surgical timeline plus the crosscutting protocols that span it.

Preoperative Assessment​

  • Risk CalculatorsACS NSQIP, RCRI, Apfel score, frailty indices, and GU-relevant surgical risk tools
  • Cardiovascular RiskCardiac evaluation before non-cardiac surgery, RCRI, MACE risk, and β-blocker management
  • FrailtyFrailty assessment tools, prehabilitation, and surgical risk in the frail patient
  • DiabetesPerioperative glucose targets, insulin management, and hypoglycemia prevention
  • SteroidsStress dosing protocols, adrenal suppression evaluation, and perioperative steroid management
  • ImmunosuppressionPerioperative management of transplant patients, biologics, and chronic immunosuppressive therapy

Intraoperative Care​

  • AnesthesiaGeneral, regional, MAC, and local anesthesia; airway management; neuromuscular blockade; malignant hyperthermia; depth monitoring
  • AnalgesiaMultimodal pain management, opioid-sparing strategies, regional anesthesia adjuncts
  • Nerve BlocksRegional nerve block techniques applicable to GU and pelvic reconstructive surgery
  • Nausea & VomitingPONV risk stratification, prophylaxis protocols, and rescue antiemetic therapy
  • Positioning & Nerve InjuryLithotomy, steep Trendelenburg, lateral, prone, Galdakao-Valdivia — position-specific nerve, compartment, and pressure risks

Postoperative Management​

  • ConstipationOpioid-induced constipation, bowel regimens, and return of bowel function after pelvic surgery
  • Electrolyte AbnormalitiesPerioperative electrolyte disturbances — sodium, potassium, magnesium, phosphate
  • Pulmonary EmbolismPE recognition, risk stratification, anticoagulation, and surgical timing considerations
  • NutritionScreening, preoperative optimization, immunonutrition, EN/PN hierarchy, TPN vs PPN, refeeding syndrome, and GU-specific nutrition considerations

Perioperative Protocols​

Crosscutting pathways that span the pre-, intra-, and postoperative phases.