Prostate Removal

What Can I Expect During Recovery After Prostate Removal?

After a prostatectomy, a man will stay in the hospital up to five days, although the length of hospital stays for most surgical procedures continues to decrease. The length of stay will depend on a man’s overall health, speed of recovery, and the nature of the surgery.

If you will be having a prostatectomy, you should be aware of the following:

• Catheterization
• Antibiotic treatment
• Urinary bleeding
• Avoiding physical stresses and strains
• Urinary difficulties
• Ejaculation changes

Catheterization

After surgery is completed, a Foley catheter is inserted through the penis into the urethra to drain urine into a collection bag. A water-filled balloon on the end in the bladder keeps the catheter in place.

The Foley catheter is essential to remove urine from the bladder for the first several days following surgery. The presence of the catheter may cause spasms or contractions of the bladder wall the day after surgery. These contractions may be painful but will usually disappear quickly.

Antibiotic Treatment

You may be given an antibiotic after surgery to reduce the possibility of a bacterial infection. This is a preventive treatment to decrease the chance of infection.

Urinary Bleeding

During your recovery, blood may appear in your urine. Some period of urinary bleeding is normal following prostatectomy, but the bleeding should diminish or disappear by the time you leave the hospital. Drinking plenty of water during this healing period should promote healing by flushing out the bladder.

Avoiding Physical Stresses and Strains

Immediately following discharge, the organs and tissues involved in the surgery are still healing and remain vulnerable to straining. To prevent tearing the incision or damaging internal organs on which surgery was performed, men should be very careful not to lift heavy loads or put strain on their abdominal and pelvic regions during the first few weeks after surgery.

Complete healing may take two or more months. During this time:

• Avoid heavy lifting
• Avoid straining when moving the bowels (eat a balanced diet to avoid constipation, and use a laxative if constipation develops)

Urinary Difficulties

Following removal of the Foley catheter, urination may create some discomfort. Men also may experience frequent urges to urinate. This problem usually goes away after several days.

A small number of men may experience an inability to control urination (incontinence) after surgery. This problem usually lasts only a short time and goes away on its own. Special disposable undergarments may be used during this time.

Ejaculation Changes

Prostatectomy causes the seminal fluid containing the sperm cells to move backwards, into the bladder instead of the urethra. This reverse path, called retrograde ejaculation, is the result of damage to the muscle at the neck of the bladder, a consequence of surgery.

• The bladder muscle normally blocks the entrance to the bladder, causing the semen to enter the urethra at the base of the penis.
• When this muscle is damaged, the semen takes the path of least resistance and enters the bladder, where the fluid is expelled with the urine.
• This may make urine to look cloudy when next passed, but it is not harmful in any way.

Men after prostatectomy are usually sterile (unable to father children) because the semen and its load of sperm cells is not ejaculated through the penis to the outside. Being sterile is not the same as being impotent.

After prostatectomy, a small percentage of men are unable to have an erection and will experience impotence. For most men, however, the ability to have sexual intercourse and orgasm will remain relatively unchanged.

Retrograde ejaculation may require getting used to, but orgasm should remain a pleasurable experience. In men who experience retrograde ejaculation, the seminal fluid is not ejaculated to the outside during orgasm, so the ejaculation is dry.