What to Expect After Prostate Surgery

Have peace of mind. After robotic prostatectomy you should expect to return to normal. It is expected for you to have excellent cancer control, normal urinary control, and the ability to have sex. Robotic prostatectomy generally has fewer complications and allows for a quicker return to normal activities when compared to open surgery or radiation therapy. If you have any questions, contact Dr. Gholami.

After prostate surgery you should plan on:

  • Spending one night in hospital. Most patients go home within 24-hours
  • Being back to normal activities within 1-2 weeks
  • An early return of urinary control and sexual function
  • A short period of catheterization
  • A low complication rate

After Your Robotic Prostatectomy

Most of our patients start walking within 4 hours of surgery with help from our nursing staff. After you arrive home, try walking every hour for at least 10 minutes. Within a week, you should increase the amount you are walking. It is recommended to abstain from sexual activity for two weeks after prostatectomy. By 4 weeks you should be walking 40 minutes each day to help strengthen your pelvic floor muscles. You can resume biking, golfing, horseback riding, lifting, tennis, and running six weeks after surgery.

Your first follow-up visit will be within four to ten days after robotic prostate surgery. This appointment is to check your recovery, remove your catheter, and discuss the final prostate cancer pathology. After prostate surgery, the majority of our patients are back to work within 1-2 weeks. Men with jobs that require heavy lifting need to be on light duties for four to six weeks.

Specific Instructions after your prostatectomy

While robotic prostatectomy is performed routinely, it is still a relatively major surgery that will take some time and effort to recover from. Life will be harder for at least a few weeks, if not months after surgery, however it is certainly preferable to the life-threatening hardships of letting the cancer progress unchecked. So stay positive, you can get through this.

  • Patients can generally be discharged from the hospital about 24 hours after surgery.
  • All patients will go home from the hospital with a urinary catheter in place. This catheter is known as a Foley catheter and is held in place by a balloon inside the bladder. It allows continuous drainage of the bladder into a small external collection bag which is emptied as needed. Absolutely, do not try to remove this catheter on your own. It must stay in place until you heal enough that it is no longer needed. Read further down in these instructions for more information.
  • Since you will not be cleared to drive yourself, you will need someone to drive you home. You should not drive until the catheter is removed.

Activity after robotic prostatectomy

  • After one week once the catheter is out, you can resume driving and most activities. Refrain from vigorous activity (running, golf, exercising, horseback riding, motorcycles, bicycling) however, for six weeks after surgery to give yourself time to heal. After six weeks you may resume full activities
  • You should attempt to walk and climb stairs as much as you can tolerate to help rehabilitate yourself.
  • Avoid sitting still in one position for too long (more than 45 minutes).
  • Avoid bathtubs, swimming pools, hot tubs or othewise submerging yourself in water for four weeks. Showering is fine 48 hours after surgery.
  • When you may return to work depends on your occupation and how fast you recover. Most patients return to work in 2-3 weeks. Use common sense.

Medication after robotic prostatectomy

  • Most of our patients experience only minimal discomfort, and we recommend that you try ibuprofen or Tylenol (acetaminophen) for pain first, as they usually suffice. Stronger, prescription pain killers tend to be extremely constipating and so it is better to avoid them if possible. However, if you still have significant pain despite Motrin or Tylenol, contact your physician for a prescription for stronger pain medication, which will typically be hydrocodone or codeine.
  • Upon discharge from the hospital, you will also be prescribed an oral antibiotic, which will most likely be Levaquin. You will take this daily with food until they are finished.
  • You may resume any of the usual daily medications you may have been taking before surgery for other medical conditions, as soon as you are discharged. Coumadin can be restarted 3 days after surgery, unless otherwise instructed by your cardiologist or primary care physicians.
  • At the time of discharge, you will be given a stool softener to be used for constipation. We recommend that in addition to the stool softener you also drink prune juice or milk of magnesia until you have your first bowel movement after surgery. You many continue taking the stool softener as needed to combat constipation.
  • You may experience bladder spasms while the catheter is still inserted. Bladder spasms are typically associated with a sudden onset of lower-abdominal discomfort, a strong urge to urinate, or with sudden leakage of urine from around the catheter. We can provide you medications to ease these symptoms if the discomfort is severe. Do not take these medications however, within 24 hours of catheter removal, as it can prevent you from properly voiding.

Food after prostate surgery

  • To make it easier on you immediately out of the hospital, you may initially want to stick to a mostly liquid diet until you have your first bowel movement. Avoid carbonated beverages.
  • Once you have had a bowel movement, you should move to a soft food diet and then work your way back to your normal diet as you feel comfortable.
  • Try to spread out eating throughout the day with snacks and small meals, to avoid eating large meals at once for a few days after surgery.

Clothing to wear after prostate surgery

  • Immediately after surgery, your abdomen will be slightly bloated so you may have trouble fitting into your regular clothes. For comfort, wear lose fitting clothing such as sweatpants or other loose fitting pants. You will probably need to do so initially anyway to accommodate the catheter and collection bag.

Wound Care

  • Two days after surgery, remove the clear gauze covering your wound sites. You may shower after the second post-operative day. We encourage you to shower 1-2 times a day at home. For example, if your surgery was on Tuesday, you may remove the dressing and resume showering on Thursday. The collection bag may be removed during showering. Gently pull the colored catheter straight off of the clear plastic tubing from the bag and allow urine to run into the shower. After showering, gently pad the suture sites (do not rub or otherwise irritate them) with a towel.
  • Application of antibiotic or other ointments (such as Neosporin) to incision sites is not recommended.
  • Sutures were utilized which will dissolve on their own, there is no need to have them removed. A small amount of redness at the edges of the incision sites, as well as a small amount of clear or bloody leakage from the wound, is acceptable. Drainage of sufficient quantity to soak dressings, or redness greater than 1/2 inch from the incision should be repo
    rted to the physician.

Catheter Care

  • As mentioned above, you will be discharged from the hospital with a Foley catheter in place which continuosly drains urine from your bladder. It must stay in place while your anastamosis heals. Do not attempt to remove this on your own. If it should accidentally fall out, you MUST IMMEDIATELY notify your urologistto have it replaced. Do NOT allow a non-urologist (even if they are a nurse or a doctor) to replace it. The catheter was carefully placed by your urologist with specific regard to your prostatectomy and cannot be replaced by just anyone.
  • You can use K-Y Jelly or antibiotic cream/ointment to lubcricate the outside catheter where it enters the tip of your penis (the uretheral meatus.) This ointment will reduce inflammation to the uretheral meatus and reduce discomfort. Apply the ointment as needed.
  • You will be provided with a strap around your thigh to hold the catheter tubing in place. Adjust this strap as necessary to prevent tension from being applied to the catheter. You may also purchase an ACE bandage to hold the catheter in place.
  • You will be provided with two urine collection bags of different sizes, a smaller bag to be worn under your pants during the day( leg bag), and a larger bag to be used at night. The smaller bag usually lasts about 3-4 hours before needing to be emptied, but of course this varies with how much liquid you consume. The larger bag should last you all night, so you do not need to wake up to empty it. Remove, empty, and exhange these two bags as needed.
  • Alert the surgeon if the catheter does not drain well, or if you have any other serious problems with it. Don’t watch the catheter drain urine. Urine drains inconsistently. If your urine is very yellow, you will need to increase your fluid intake to make your urine more dilute.
  • This catheter will stay in place for 5-7 days while you heal, and can generally be removed by your urologist at the end of this time. Sometimes it may have to stay in place longer if you are not sufficiently healed, perhaps two weeks instead of one. You should have already scheduled a follow-up appointment for this purpose. Remember as stated above, to continue to take your antibiotics.
  • Do not do any Kegel exercises while this catheter is in place. However, once the catheter has been removed, resume doing male kegel exercises.
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