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The prostate gland is an organ that surrounds the urethra (urethra carries urine from bladder to the penis in men). Its function is to secrete fluid which mixes with sperm to make semen. Prostatectomy is a surgical procedure to remove part or whole of prostate. The main indications for its removal are:
You may have presented to the doctor with difficulty emptying your bladder (urinary retention), frequent urinary tract infections, frequent bleeding from the urethra, and bladder stones with prostate enlargement, extremely slow urination or symptoms of renal damage due to long standing urinary retention. The doctor will have evaluated you in detail by doing a blood test for prostate specific antigen (PSA-raised in prostatic cancer) and also by a digital rectal examination.
Once the diagnosis is confirmed doctor decides that you need a prostatectomy, simple prostatectomy (removes the inner part of the prostate eg. enlarged prostate) or a radical prostatectomy (removes the entire prostate with some of the surrounding tissue eg. Localised Prostate cancer) depends on your diagnosis. This operation is done under spinal/general anaesthesia.
The different ways of performing the resection are open method, laparoscopic or transurethral resection of prostate (commonly known as TURP). Again the diagnosis plays a major role in deciding the operation approach.
1 to 2 units of blood can be stored and used at the time of surgery if it is necessary.
Do not eat or drink anything after midnight the night before your surgery. Take all the recommended medications. The procedure takes about 1-4hrs but again this depends on the method adopted.
Wear special stockings on your legs to prevent blood clots
you have a catheter placed in your bladder, care of the catheter is
very important. Be sure to clean the catheter where it exits from your
penis, twice a day with soap and water.
Also empty the urine bag frequently.
If at all you have a drain from the incision site note the contents coming out.
Move your feet even when you are in bed but once you are out of anesthesia.
You can start walking on day 2 of surgery.
day after the surgery you will be taught some exercises to keep blood
flowing, and coughing or deep breathing to prevent pneumonia.
Do not drive until your catheter is removed and you have weaned off pain medications.
If you have undergone an open surgery keep the incision clean and dry.
You can take a shower once the dressings are removed.
Common things to expect at home:
Over all recovery takes about 4-6 weeks.
You may feel spasms in your bladder
Your bladder control may be poor for few weeks after the catheter is removed.
may have erectile problems after the surgery. In some it recovers by 3
months. But most of the time it takes 6-12 months. Discuss with your
doctor about this problem as there are few medicines which help you
You'll probably resume your sexual activity 6 to 8 weeks after surgery.
and bruising of the penis and scrotum is expected especially after a
radical prostatectomy. Do not worry it resolves by 4-7 days. Elevation
of the scrotum with a rolled towel while in bed will be helpful. Consult
your doctor if swelling persists.
Small amounts of blood or urine may leak from around the catheter.
You can start with light exercises such as walking, jogging and stretching.
Walking is best started the morning after the surgery. This encourages early return of bowel function, promotes effective breathing, mobilizes secretions from the lungs, improves circulation, prevents stiff joints and relieves pressure. It is recommended that you get out of bed at least 6times a day. To make it easy you may remember it as 2 times after breakfast, 2 times after lunch and 2 times after dinner.
Your doctor will teach you to do pelvic floor exercises called KEGEL exercise. Empty your bladder before starting. Contract the rectum as if you are avoiding passing of stools, for 3-5 seconds and relax them for 3-5 seconds. Do 5 to 7 exercises at a time, minimum 3 times a day. Later on, you can gradually increase once you feel you are fit. This will help to improve your bladder control and regain your continence at the earliest.
Wait for 2-3 weeks for playing golf or tennis.
Avoid heavy abdominal exercise like sit-ups and cycling for up to six weeks.
Drink plenty of water, at least 2-3 litres per day
Follow a well balanced diet with lots of fruits, vegetables, whole grains, lean proteins and low-fat dairy products.
Avoid spicy and fatty foods especially in the first week of surgery
Constipation is very common after the procedure either due to pain killers or medications given for bladder spasms. So take plenty of fluids, increase roughage in your diet or use stool softeners. As a last resort you can take laxatives but only after consultation with your doctor.