Best Postoperative Care Guide for Radical Prostatectomy Patients
Radical prostatectomy, whether performed through open, robotic, or laparoscopic methods, is a standard treatment for localized prostate cancer. While this procedure is routine for addressing organ-confined prostate cancer, it remains a significant surgery requiring dedicated postoperative care to ensure proper recovery and long-term health outcomes. This guide provides essential postoperative care instructions for patients recovering from a radical prostatectomy, ensuring an optimal healing process.
Leaving the Hospital After Radical Prostatectomy
Patients typically stay in the hospital for 3 to 4 days after radical prostatectomy surgery. Upon discharge, most patients will have a urinary catheter (Foley catheter) in place. This catheter facilitates bladder drainage through an external collection bag, allowing the surgical site to heal properly.
Important: Never attempt to remove the catheter on your own. The catheter remains essential until the anastomosis (surgical connection) has healed. Removal should be handled only by your uro-surgeon.
At Home: Postoperative Care Instructions
Activity Restrictions
- Driving: Avoid driving for at least 2–3 weeks post-surgery to prevent strain on the surgical site.
- Physical Activities: Refrain from strenuous activities like running, exercising, and riding motorcycles or bicycles for at least six weeks. Allow your body sufficient time to recover.
- Stair Climbing: Avoid using stairs as a form of exercise.
- Bathing: Do not submerge yourself in water (bathtubs, swimming pools, hot tubs) while the catheter is in place. Showering is safe from the day you return home.
- Return to Work: Most patients can resume work within 2–4 weeks, depending on the nature of their job and the speed of their recovery.
Medications
- Pain Management: Most patients experience minimal discomfort and find paracetamol sufficient for pain relief. Stronger prescription painkillers can cause constipation and are best avoided unless necessary. If pain persists, consult your physician.
- Antibiotics: You may be prescribed oral antibiotics to prevent infections while the catheter is in place.
- Other Medications: Resume your regular medications for pre-existing conditions unless advised otherwise. Carefully review your discharge summary to understand the required medications.
Clothing Recommendations
Immediately after radical prostatectomy surgery, your abdomen may be slightly bloated so you may have trouble fitting into your regular clothes. For comfort, wear loose-fitting clothing such as sweatpants or other pants with elastic (not button) waistbands. You will probably need to do so initially anyway to accommodate the catheter and collection bag.
Wound and Catheter Care
Wound Care
- Showering: Start showering the day after discharge. Ensure the catheter collection bag is secure to avoid accidental pulling.
- Drying: Gently pat the incision sites dry with a towel; avoid rubbing.
- Signs of Infection: Some redness or clear/bloody leakage from the incision is normal. However, report significant redness, large amounts of drainage, or any signs of infection to your physician immediately.
Catheter Care
- The patient will be discharged with an in situ Foley catheter, which continuously drains urine from the bladder. It must stay in place while your anastomosis heals. Do not attempt to remove this on your own.
- If it accidentally falls out, immediately inform your uro-surgeon and ask them to have it replaced. Do not allow a non-urologist (even if they are a nurse or a doctor) to replace it, as your urologist carefully placed the catheter with specific regard to your prostatectomy and cannot be replaced by just anyone.
- Use two types of collection bags:
- A small leg bag for daytime use, which is discreet under clothing but requires frequent emptying (every 3–4 hours, depending on fluid intake).
- A larger overnight bag to avoid waking up multiple times to empty it.
- Alert the surgeon if the catheter does not drain well, or if you have any other serious problems with it.
Recovery Challenges After Radical Prostatectomy
Regaining Urinary Control
Urinary incontinence is common after catheter removal and can take weeks or months to improve. Leakage is typically more pronounced while standing, moving, or straining. To regain control:
- Use adult urinary pads or diapers initially.
- Perform Kegel exercises regularly to strengthen the pelvic floor muscles. These exercises help the external sphincter take over urinary control, compensating for changes caused by prostate removal.
- Be patient—recovery varies from person to person. Some men regain control within weeks, while others may take up to six months or more.
The Future of Kidney Surgery
Sexual function after radical prostatectomy may be affected due to nerve proximity to the prostate. The cavernosal nerves, responsible for erections, may be partially or completely resected during surgery to ensure cancer removal. Recovery tips:
- Nerve healing is slow and can take 6–18 months or longer.
- Erectile function varies among patients; some may require medications or additional treatments to aid recovery.
- It’s important to discuss concerns and options with your uro-surgeon.
Common Post-Surgical Symptoms and Management
- Abdominal Distension, Constipation, or Bloating:
- Take stool softeners as prescribed.
- Contact your doctor if there is no bowel movement within 24–48 hours post-surgery.
- Bladder Spasms:
- Sudden lower abdominal discomfort or urine leakage around the catheter may indicate spasms.
- Report persistent symptoms to your physician.
- Bloody Urine or Catheter Drainage:
- Mild bloody drainage is common during physical activity or bowel movements. Rest should resolve it.
- Report clots, no urine output for 2–3 hours, or persistent bleeding to your doctor.
- Bruising Around Port Sites:
- Bruising is typical and resolves as you heal. No treatment is usually required.
- Lower Leg/Ankle Swelling:
- Elevate your legs while sitting to reduce swelling. It should subside within 1–2 weeks.
- Perineal Discomfort:
- Pain in the area between the rectum and scrotum may persist for weeks but will improve over time.
- If pain is severe despite medication, contact your physician.
- Scrotal or Penile Swelling and Bruising:
- This is normal and usually resolves within 1–2 weeks.
- Elevate the scrotum with a rolled towel and wear supportive underwear (briefs) to reduce swelling.
Conclusion
Recovering from a radical prostatectomy requires patience, proper care, and adherence to medical advice. By following these guidelines, patients can minimize complications and ensure a smoother recovery process. For expert care and guidance during and after surgery, consult Dr. Gaurav Aggarwal, a leading uro-oncologist in Kolkata. With extensive experience in radical prostatectomy and robotic surgeries, providing exceptional treatment and personalized care for his patients.
Contact Dr. Gaurav Aggarwal today for a consultation and experience world-class radical prostatectomy care in Kolkata.
