You may have to stay in hospital for 1 to 4 days. You may need to stay in bed till the next morning after the surgery. In order to improve recovery your nurse will suggest you perform some hip exercises in the bed to improve blood flow and to perform coughing and deep breathing exercises to avoid pneumonia every 3-4 hours. You can also use a breathing device (spirometer) to help keep your lungs clear. You will be able to resume your activities about 12 weeks after an open surgery.
Drinking and eating
You can start drinking fluids shortly after the surgical procedure and you will be allowed to take solid foods afterwards.
Drains and dressings
- Wound drainage
You will have a dressing over the surgical incision which will be periodically checked for healing by the nurses and physician. Wound drain will also be placed to remove the excessive fluid discharge.
- Catheter care
You will have a urethral tube (catheter) to drain urine in a urine collection bag for a period of 1-3 weeks after the surgery. The catheter allows healing between the urinary bladder and urethra. Your physician decides the exact duration of catheter use.
You will feel pain for initial few days after the surgery which can be controlled by pain killers such as narcotic analgesics, and anti-inflammatory drugs. Discuss with your physician any concerns you have regarding pain control after the surgery.
Preventing blood clots
During the surgery and throughout the night after surgery you will be asked to wear self-inflating stockings to prevent the formation of blood clots and to reduce the chance of getting deep vein thrombosis (DVT). Stockings can be removed once you start walking on the next day after the surgery.
You can start showering only after the complete removal of dressings, usually about 2-3 days. During the initial days after the surgery sponge bath or bed bath is allowed with the assistance of your nurse or caregiver. Let water flow over the incision but do not rub. Always keep the incision dry. Steri strips over your incision will begin to peel off after 7-10 days; if not, you can remove them after the tenth day.
Diet and exercise
You will feel tired and weak after your surgery. You will need someone to drive you home from the hospital. Eat balanced and nutritious foods and avoid spicy food for the initial few days. Do light exercises such as walking and stretching. Don’t do any heavy lifting till three weeks after the surgery. Heavy exercises and driving are permitted only after the catheter removal.
It is better to keep the wound clean and dry. If you notice any tenderness, swelling, or discharge consult your physician immediately.
Swelling of scrotum is common after the procedure but is harmless and painless. In such cases, wear supportive undergarments. While resting, elevate scrotum by placing a rolled towel underneath.
You will be discharged home with a urinary catheter in place which will be removed after 1-2 weeks. Clean the catheter using a soap solution and empty the urine bag frequently. Urine bag should be placed below the level of your bladder to enable draining and prevent backflow. Use incontinence pads in case of urine leak from the catheter. For a few weeks after surgery, your urine may look cloudy with occasional bleeding. If you observe clots more than an inch in length, immediately consult your physician. In some cases, your catheter may cause irritation and cramps (spasm) which requires use of medication to obtain relief.
You will have abnormal bowel movements for a week after the surgery. For early recovery, include fibre in your diet and drink at least 6-8 glasses of water per day.
Pain and discomfort are common complaints which can be controlled by pain killers and anti-inflammatory drugs. A three day antibiotic course starting from the day of catheter removal is recommended for patients.
Special considerations after catheter removal
After removing the catheter you may have leaking and bleeding for a few days. Your physician asks you to take an antibiotic for a minimum of 3 days from the day of catheter removal.
The sexual function after surgery depends on several factors such as your age, pre-operative sexual function, and the size of the tumour. Discuss with your physician regarding any problems you may be experiencing such as abnormal erection, sexual dysfunction, and impotence.
Pelvic floor (Kegel’s) exercises
Identify the urinary system muscle that controls urine flow and do repetitive movements like stopping and relaxing the urine flow. Doing this exercise increases the chance of early recovery.
You have to visit your physician a week to 10 days after discharge for catheter removal procedure. You should visit the doctor at 6 weeks, 3 months and 6 month intervals for a physical examination, digital rectal exam, and checking laboratory test results for prostate specific antigen (PSA).