First 72 hours

[Auman]

I'm scheduled for a radical robotic prostatectomy in two weeks. Can anyone describe what the first 72 hours after surgery is like?

Thanks

[Bcgkelly]

It wasn’t at all as bad as I was expecting. I was sore but had no real pain. Was out of bed the next day and walking around the day after that. I was in hospital for three nights. They took the drainage tube out before I went home and I had the catheter for 10 days but I think they leave it in longer in Ireland than other places. The catheter was hard to manage and make sure to ask lots of questions before you leave hospital. Best of luck.

[Auman in reply to Bcgkelly]

Thanks. Any advice on what questions I might overlook?

[Bcgkelly in reply to Auman]

Just make sure you ask about managing the catheter, washing, changing, sleeping etc so that you are comfortable with it. Also the bags come in different lengths. At the start I had one that was very long and it was causing me to feel I wanted to wee all the time. I was much better with a short one.

[Auman in reply to Bcgkelly]

Thanks

[Auman]

Four weeks. Ouch. Thanks for the reply.

[dlestercarlson]

I went home the next day with a catheter. The first 3 days were not so bad. I went back to the doctor 3 days later. When they pulled out the catheter I pee'd all over the floor. That day was probably the worst because I had so little control over my bladder. After that day everything improved fairly quickly. A lot of how everything turns out depends on the experience of your doctor.

[Auman in reply to dlestercarlson]

Thank you. I think I'm more concerned about bladder control than most of the other things.

[AlanMeyer Moderator]

Auman,

There's an interesting website at yananow.org

It's got a wealth of information about each of the many possible treatments. In addition, there were over a thousand personal stories the last time I looked and you could search them to find men who had specific treatments.

Best of luck on your surgery.

Alan

[Auman in reply to AlanMeyer]

Thank you.

[EETOFF]

Hi Auman as previous the Catheter was uncomfortable but manageable. I had my prostatectomy done 4 months ago. Keep moving do pelvic floor as soon as you can.

Time moves quickly and you will soon n be well on way to recovery

[Auman in reply to EETOFF]

Thanks. Appreciate your response.

[Hidden]

First 72 hours shouldn't be as bad as you might imagine. You may be able to go home within that time.

You'll have a few small holes in your abdomen and one will be a bit larger. The smaller ones are for the instruments and the larger one (about 3 - 4 cm) is the incision through which the gland is removed.. You may have stitches or staples. Staples will have to be removed later. The drain tube will be stitched to your skin. be careful you don't pull on it. It'll probably be removed within 24 hours.

I didn't find the wounds or tubes particularly uncomfortable, I was still a bit hazy after the anaesthetic. I was under for a few hours. I had a LOT of discomfort form the gas which they pump into your abdomen which inflates it and pushes all your organs apart so they can get at your prostate. If they don't get it all out - it hurts. In which case - walk about a lot.

Of course, you will have a catheter in. It may have two tubes attached at first, one is to let an irrigation fluid IN, the other is to let it (+urine) OUT (drainage). The bag with irrigation fluid in, should be ABOVE you and the drainage bag should be BELOW you. When the irrigation fluid bag gets empty, the drainage bag should be full. When that happens DON'T let the nurses swap them round!

There may be some blood in the drainage fluid at first. More drainage should be coming out than irrigation fluid AND whatever you drink goes in. The irrigation will be stooped fairly quickly. If AT ANY TIME nothing is coming out of the catheter or you are drinking more than is coming out, it may be blocked. Keep an eye on that.

When you go home you should have two kinds of drainage bag. One you can use at night and hang on the edge of your bed. The other should be a leg bag, you can tie it round your ankle. Always make sure that the drainage bag is BELOW your groin and that it isn't trapped or kinked. If or when you detach one bag tube from the catheter and attach the other, make sure that you don't

get anything into the tubes or the catheter. There should be a cap you

can put on the end of the tube. Use it, don't lose it. Never put the exposed ends of the tubes down on anything.

You need to keep clean where the catheter goes into your penis. Pull the meatus of your penis back a little from the catheter so it is more exposed and clean it with warm soapy water, shower or bath is OK, Shower is better. If you're not circumcised carry out your normal foreskin hygiene routine. If you haven't got one, start one.

Your main risks are bleeding, a blocked catheter or infection. Take these precautions and you should be OK. Worry about other things as you come to them.

I was only joking about the nurses swapping the bags round!

[Auman]

Thanks for the response. I appreciate the detail. And I'm glad I read it to the end.

[MichaelDD]

I had robotic surgery 2016 June. Five and a half hour surgery. I was rolled into my room at 8pm at night and with help from a nurse I was walking at midnight. I went home the next day noon with a catheter. The catheter bag they give you at the hospital is nothing like the one you take home. Mine was more compact and something you could strap along your leg. At night I went to sleep with one slightly bigger. The uncomfortable part you will find is trying to to take a bowel movement and feeling like you will force your catheter out. It won't happen but I found myself holding it in while I did both. Expect to take an easy week. I wore sweatpants to the hospital and they easily covered the catheter when I left. If you are not doing Kegel exercises now I strongly suggest you start . They will help with control after they pull your catheter. I have done kegels for years and was very fortunate. When they pulled my catheter I waited for everything to start. Waiting for a "water fountain". My other half is OR RN. She preaches to me about everything I need to do prior to a procedure. Kegal and lung strengthening (funny device they give you to hold the ball in the air with your breath). These two religiously done before my robotic. I was totally continent from the time they pulled the catheter. No runs no drips. I kept asking when's it going to start and she told me just don't worry about it it's not going to happen. It didn't. That first night I slept in my underwear and have done so since.. I still can go four to six hours without going to the bathroom to urinate. What I have to regulate is what I put in as far as liquids. The difference now is that when I need to go I need to go! I have advanced (persistent) PC. 3 months later I was in for 39 sessions of radiation. I'm continuing my fight and will soon be having chemo/hormonal therapy.

Best of luck to you on your voyage. For all of us it's our own unique trip.

[Auman in reply to MichaelDD]

Thank you for your reply. This was helpful. I wish I had started my Kegels earlier but not much I can do about that. Sorry to learn about your chemo. Hope all goes well as you go forward.

[Paulo1968]

Hi Auman, I think everything was said. I am just telling you here my experience in a few words:

1st I didn’t feel much pain. It was quite manageable. It was rather more the discomfort of the drain, then the catheter and last swollen belly. Drain was out in day 2 after surgery, catheter removed in day 6 after surgery and the swollen belly lasted for 2 weeks but became less and less of a problem over time.

My 2nd worry was gaining continence. I was not the luckiest of then all but I am happy now. So I got fully continence 3 months after surgery. I never wore more than a pad a day and after 1,5 months I sensed considerable improvements and my mood went up. I suggest you start doing the kegel exercises now and after catheter removal. Do them while walking. They did me the most that way.

All the best and good luck with your surgery.

[Auman in reply to Paulo1968]

Thank you. Hadn’t thought about levels while walking. I’ll do that.

[DanWinters]

Pain was manageable. I walked around 7 p. M. Came out of surgery at noon. I really had no appetitive but did eat some peanut butter crackers. I was going to fight using opioids due to side effects of constipation. So my first med was IV Toredol. Similar to BY mouth Motrin. I later did take 2 Norco. Bit was more to help me sleep and deal with the irritation of the catheter. I never did any IV morphine even though it was ordered. Remember In men the catjheter makes them feel like they need to Pee constantly. 90 percent of men wake up saying I need to P. Remember you don’t. Your bladder is draining. Move about as soon as you can. It will make your stronger. A little local anesthetic ointment on the tip of the penis will help with the discomfort

[Auman in reply to DanWinters]

Thank you. I don't know what to expect for pain. I'm going to be optimistic but I have no idea what my tolerance for pain is. Guess I'll find out.

[dentaltwin in reply to DanWinters]

I'm a little surprised--my docs are pretty cautious about NSAIDS and bleeding. But I think I did get Toradol (ketorolac) after my inguinal hernia repair. And yes, I'd love to avoid opioids, though I've been told I would be discharged after my surgery with Norco (hydrocodone). After my hernia surgery, the constipation was by far the most painful thing I had to deal with. Can anyone comment on how big a problem (pain) constipation was in the immediate postop period?

[Auman]

I will get that OTC medication.

[Ken51]

I stayed at hospital overnight. Badly bruised. Start walking as soon as you can. Even just around the halls works. Keep the incisions medicated/moist. Helps reduce scarring. I had little pain, max out on Advil if you can rather than the stronger stuff. Use a wide zero gravity chair to sleep in if you can. Cath. was not that big of a deal, just don't step on it ! Taking the blood thinner made the blood pool into my groin area. That makes it look really bad. Get to the doctor right away for anything you think looks or SMELLS off. Delaying just one extra day lets bacteria grow quickly.

[Auman in reply to Ken51]

Thank you for the advice. Hope the warning about stepping on the cath was anecdotal and not from experience.

[Jeff85705]

My surgery took 5 hours. It was a Thursday. I was out of the hospital Saturday. My hospital experience was physically uneventful, but I went through a feeling of profound loneliness mixed with boredom on Friday. Didn't want to see relatives. I had some pain that they treated with morphine the first day, but Tylenol after that. The day I was released, they took out the drainage tube and gave me instructions and some freebies. I had a male nurse that day, and that was really helpful. The catheter was somewhat uncomfortable to wear, but worth it to be rid of the prostate. Overall, I recommend getting out of the hospital as soon as is safely possible. 2 days was plenty for me. Could hardly wait to get out. Good luck! I know what you are going through. Everything should be fine. But ask lots of questions.

[Jeff85705]

Jeez. Four weeks with the catheter! Were you having complications? Mine was out in 10 days.

[Auman]

Thanks. I'm scheduled to stay one night. Hopefully that's all it will be. I'm guessing loneness and boredom are part of the process. I hope it ended for you when you got home.

[Hidden]

Some very varied experience here. Don't expect a lot of pain, but don't expect no pain. I had one shot of oral morphine because the gas they'd pumped into my belly was causing me unbearable discomfort all night. Otherwise I had no painkillers. If you need them don't feel guilty. Use opioid rather than NSAIDs. Paracetamol and codeine may be sufficient.

Even before my surgery I stocked up on Lactulose which is used to prevent constipation and I took it with meals. You could also use Fybogel, eat lots of fibre, wholefoods and fruit. Whilst the catheter is in you need to drink 3 litres of fluid a day.

Don't worry too much about the catheter coming out as it's kept in by a balloon inflated with water inside your bladder. They have to get the water out to get the catheter out. It's RARE that it accidentally comes out, that's usually because the balloons burst.

Do avoid straining for a bowel movement though. It can cause "by passing". This is where urine comes out ROUND the catheter instead of THROUGH it. This at best will cause irritation but may delay healing of the urethral anastomosis, (where the severed ends of you urethra are stitched together.)

[Auman in reply to Hidden]

Thank you. This is a lot of good information.

[btl258]

I'm 7 weeks removed from surgery. The pain was not bad, I took Tylenol for 5 days (nothing stronger than that - although day one and two were Tylenol 3). I went home the day after the surgery. No real pain during the first week, just discomfort from the surgery and having to deal with the catheter. I had the catheter removed on day 7 (the removal of the drain was more painful than the catheter). I was back at work (from home) on day 7, and back in the office on day 14.

[Auman in reply to btl258]

Thanks for the update. How mobile are you? Are there still activities you can't do. For example, running short distances?

[btl258 in reply to Auman]

I am very mobile, but I haven't been able to run for about 4 years due to degenerative disk disease. Today I did 30 mins of rowing followed by 30 minutes of stair master with average HR of 140 to give an idea of recovery. Was in the gym doing cardio on week 3 and weights week 6. Back up to 70-90 mins per day 6 days a week.

[brilliant17 in reply to btl258]

btl258,

I’m having my RP in a few weeks. How was it working back at the office by 3rd week? My doctor suggested I might need to still stay home in third week but said I might be able to work from home. I don’t want to push things if body is not ready but was glad to hear you can be back at work in 2 weeks.

[btl258 in reply to brilliant17]

I think I technically could have made it back into the office that 2nd week, but it takes some getting used to with the pads. Since my job is definitely doable from home, it was a no-brainer for me to get right back at it in week 2. If I didn't have a bunch of meetings with out-of-towners in week 3, I might have done one more week at home, but I don't regret going back as fast as I did. I think it also depends on your health prior to surgery, I'm a bit of a gym rat and have not taken off more than 2 days in a week for over 10 years (I always find a way to work out while on vacation or traveling for work).

[David1958]

I had robotic surgery in 2011. I was 52 at the time. As soon as I walking and did not have internal bleeding, they booted me out of the hospital. We eneded up staying in a hotel for one night just to stay close to the hospital in case we needed to go back. They told me there was nothing I had to do to take care of the incisions (5 of them). They also told me to wait two days before showering. I do not like to take pain meds and tried to get off of them as soon as possible. This worked against me when it was time to take out the drain. I think it was one week after surgery, and I decided I did not need the pain meds anymore. As soon as the doctor started pulling the drain out, I knew I was in for a world of hurt. It felt like he was pulling a sword out of my gut. I yelled for all I was worth and scared the doctor into not wanting to pull anymore of it out. I asked him how much more was left inside. He told me about half of it. So, I decided to grin and bear it, and told him to go for it. That hurt like hell, so take the meds until the drain is out. The catheter was taken out after 10 days. It took me three months to learn how to pee again. Kegals, kegals, and more kegals. Ever since then, I have been dry. However, with the prostate out of the picture, you only have one sphincter left for bladder control. Men are born with two, one on the bladder and one on the prostate. Women are born with only the one on the bladder.

Now, when you are sitting down, you do not notice any urge to pee. Yet when you stand up, you have to go pee right now. Maybe now you can understand your wife/girlfriend a lot better. Do not try to put off the urge to pee like you used to. With two sphinters to hold back the tide, no problem. With just the bladder to do it, heed the urge. You will find a few spots of wetness if you push it too far. That is your bladder firing warning shots across the bow. You will know when you have pushed away the urge to pee beyond all reason when you suddenly lose control and it runs down your leg. Heed the urge. Even if you do not think you need to go, but a bathroom is at hand, go anyway. There is always some pee in there, or maybe a lot. Your bladder knows whenever a bathroom is near. Heed the urge.

Impotence. This is the great lottery wheel of prostate cancer treatment. Maybe you will be one of the lucky ones who never misses a beat and jump in the sack a week later with no performance issues. I wish. I tried everything under the sun to get an erection. Pumps, the little blue pill, injections, and something called a viberect. That last one gave be the best orgasms ever until the batteries died (yes, it was rechargable but you can only recharge it so many times before it gives up the ghost). At $300, I was not going to rush right out and buy another one. One thing I refused to do was go the roboprick route. This is where they insert inflatable tubes into your prick where the blood used to do the hydraulic work. You use a little bulb to pump air into those sacks and voila, instant hard on. The blue pill produces side effects that made me try them once and then never again. All of these things kill spontenaity. But that is just me. I decided to pitch all of this and not worry about it ever again.

[Auman in reply to David1958]

Thanks for a lot of good information and advice. A trip to the viberect site was interesting. As for the blue pill, from my experience, the side effects seem to diminish greatly after a few uses. After some regular use the only after effect I had was the intended one.

[David1958 in reply to Auman]

The specific side effect I was alluding to is atrial fibrillation. I already had a history of a-fib and had surgery to alleviate it. I did not need a drug that would induce it. One pill was enough for me.

[dans_journey]

From a practical perspective, I had an old broomstick next to my bed to use to give me some leverage when trying to sit up in the days immediately following the surgery. I also put my large overnight catheter bag in a bucket beside my bed (the hose was long enough) to catch any leaks or mishaps (there never were any). I also had a string with an S-hook on the end of it tied to my shower curtain rod to hold the catheter bag when I showered.

Regarding the catheter and bags, I had my surgery in January while living in Indiana, so I pretty much kept the large overnight bag attached at all times because I really wasn't going out in the snow and cold. I found switching between the overnight bag and the leg bag tricky and messy (perhaps I'm just not that coordinated), so I minimized the need to do so. I just wore loose boxers and a robe for most of the time that I had it in.

Good luck and let your body dictate what you can and cannot do. Patience is a virtue during the recovery.

All the best —Dan

[Auman in reply to dans_journey]

Thank you. I wasn't aware that there was a daytime and night catheter bag. So thanks for the pee management advice.

[Auman]

Well, the surgery was last Wednesday and I'm home. Small complication kept me in the hospital for an extra day (nicked intestine.)

First, let me thank everyone for their comments. While the range of post-op results varied, your posts left me optimistic. Plus having a supportive, I'm-there-for-you-wife adds to the optimism

The only surprise, I don't think I saw it mentioned, was my scrotum is the size of a 12 inch softball. No exaggeration on the size. My surgeon and members of his team say it's nothing to worry about and the "swelling?" will go down.

Pain is almost non-existent but it has been just a few days. Hopefully it will stay that way. Will take a shower in a day or two once I think the drain wound looks healed. I've been given waterproof bandages to cover the wound but I guess I feel like waiting or at least wait until my wife complains. The catheter is in but is scheduled to be removed Friday night, nine days after surgery so one less day that normal for removal. Haven't emptied by digestive system yet, other than passing gas, since today was the first time I felt like eating anything. I'm guessing that the first time I empty my bowels will be an adventure. Nausea is not keeping me from eating, just not very interested in food - unusual for me.

Slept in a recliner last night since I normally sleep on my side while in bed. Trying to avoid laying on the catheter bag.

So my post surgery life begins, learning what life will be like without a prostate. Physical Therapy, sex and incontinence. Should be interesting.

Once again, thanks for all the supportive and informational posts.