After Your Robotic Prostatectomy
After your robotic prostatectomy surgery, the staff at UW Hospital and Clinics would like you to monitor the following things:
- Take your temperature two to three times each day. Please contact your physician if you experience a temperature over 101.5 degrees Fahrenheit.
- Make sure the catheter is draining freely, and check the output bag routinely. If there is no drainage, you may irrigate the catheter with a Tomey syringe filled with 30 mL of sterile or distilled water. Simply inject the water through the larger port on the catheter into the bladder. Try to aspirate. You may not be able to pull back, and this is okay. The tube should start draining spontaneously.
- If you experience a feeling of fullness, this may mean that your catheter is not draining. Try to irrigate.
- Keep your catheter tubing secured to your upper thigh to prevent accidental dislodgement.
- Go to the emergency room if you experience any fever, shortness of breath, chest pain or lower leg swelling.
- Be careful that your bowel movements remain soft. You will have a stool softener to assist with this. Please avoid straining with bowel movements.
- Do not lift anything over 20 pounds for four weeks.
- Stay active. Multiple small walks during the daytime are very important to your recovery.
- Do most of your sleeping at night.
- Contact your physician if your wound becomes red or has drainage.
- Your appetite will generally be suppressed, however, you may eat anything you wish. You should eat small meals initially.
- You may notice some leakage around the catheter, especially with bowel movements. This is normal. A slight bit of mucoid discharge is also common.
- Scrotal swelling and/or perineal discomfort may occur temporarily in the majority of men after this procedure. This will typically resolve in four to six weeks.
- For any abnormal or concerning findings or questions, contact your physician immediately.
One week after surgery
Roughly one week after surgery, we will ask you to return to the clinic to have a post-operative check and voiding trial. We will fill your bladder with saline through the catheter and then remove the catheter. Then you will be asked to urinate the fluid that was placed in your bladder. We will then see you and discuss regaining urinary control. We encourage the use of Kegel exercises that are designed to increase muscle strength of the urinary sphincter and pelvic floor. Typically, men who do these exercises notice a marked improvement in their incontinence within four to six weeks after the catheter is removed.
At this point, we will review your final pathology as well. We will also discuss sexual activity, erections and the use of Viagra or Cialis during this visit. An appointment will be made for the first PSA check after surgery typically in 6-8 weeks.
About Kegal exercises
Kegel exercises are performed by contracting the muscle that one uses to control the urinary sphincter and holding it for three seconds. The muscle is then relaxed. This contraction is also felt in the rectum and perineum (the muscles behind the scrotum and in front of the rectum). Repeat this 20 times per hour while you are awake. This may be done while you are sitting, standing, watching television, etc. Do not start and stop the urinary stream, but rather void to completion and do the Kegel exercises after or at any other time.
The second week after the catheter is removed, we would like you to increase the amount of time you contract the sphincter to four seconds. Then increase the time of contraction to five to 10 seconds during the third week and in progressive weeks. You will note a gradual increase in the ability to control your urine. Generally, this is better in the morning than in the afternoon.
If you have any problems urinating or note a marked decrease in urinary stream, contact your physician. This may suggest that there is some narrowing in the healing area between the bladder and the urethra.