What is recovery like after a prostatectomy and this includes both robotic assisted and open. Most of my patients' greatest complaint will be from the urethral catheter which stays in anywhere from 7 to 10 days following the surgery. Catheter can be quite annoying, particularly at the tip of the penis, so I recommend that when men shower, they wash carefully, clean off the tip of the catheter and not let any mucus that adheres to the catheter stay on there, just wash it off with soap and water, applying an ointment such as bacitracin or Neosporin can be helpful. If the catheter is very painful, you can ask your urologist to give you a little lidocaine ointment which can alleviate some of the discomfort associated with the catheter. Most men can walk around wearing pants and they wear what's called a leg bag which attaches to your leg and the urine can drain through the catheter into that bag. At night, in order to sleep through the night, you can change that leg bag over to a larger bag that can just hang off the side of your bed. You should not sit in a position where your legs are crossed or bent for long periods of time as any kind of pelvic surgery puts you at risk for developing a blood clot in your leg called a deep vein thrombosis. So it is actually beneficial to be up and moving about walking as often as you can.
You can sit for meals with family or watch TV for a little while, but after 30 minutes or so, you should stand up and move around. You should avoid any long car trips or airplane rides while the catheter is in place. I don't recommend men driving while they have the catheter in following surgery and I usually wait until the catheter comes out before they start driving. The urine in the catheter can be bloody on occasion and that is normal, don't get alarmed. The catheter is scratching the surface of the bladder and can give a little blood in the urine and that is normal. Just drink a lot of fluids to help trying keep that clear.
Other things to be careful about after surgery is getting constipated. If you are taking any narcotic pain medicines, it can set you up for constipation. So you might want to try a little stool softener using docusate sodium or Colace and Senokot can sometimes help.
If you are prone to it, you may want to get a little MiraLax and you can take a capful once a day just to keep your bowels regular. Showering is fun, but I would avoid submersing yourself in a pool or a tub of water in order to avoid getting infections in your bladder. Otherwise, I recommend in the immediate postoperative period eating foods that are easy to digest such as pastas, soups, cereals, try not to eat foods that are hard to digest such as steaks and pig meat. Your surgeon will typically give you some pain medicine if needed, but Tylenol or Advil is usually okay to take. Some prostate cancers are high risk, aggressive, and more likely to spread. Others are low risk, least likely to have bad outcomes.
The biopsy says cancer, but correct diagnostic tools provide limited information about how aggressive a man's individual disease is, so most men decide to treat prostate cancer immediately. Once treated, many men experience serious long term side effects, like incontinence and sexual impotence. Immediate treatment is not always needed, but right now a man cannot be sure if his cancer is the kind that is likely to require treatment or if he is okay to wait for now. What if there was a test that could determine how aggressive prostate cancer is? Genomic Health is developing a new test to do just that. By reviewing the underlying biology of the tumor and using genes for multiple biologic pathways, the test can predict the aggressiveness of prostate cancer when diagnosed, allowing a man to make a more informed treatment decision with confidence, taking care of himself with more information, and greater peace of mind.
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