What to Expect After Surgery

After surgery, your body needs time to recover. A prostatectomy is major surgery. Expect to stay in the hospital for one to two days after surgery, and then to recuperate at home for two to three days before returning to work. (Seattle Cancer Care Alliance patients have their surgery at University of Washington Medical Center) It usually takes about six weeks for most men to feel “back to normal.”

Most men can start to drive about a week after surgery. You should avoid heavy lifting—no more than 50 pounds—for about six weeks after surgery.

Pain Control

While you are in the hospital, you will probably be given pain medication intravenously (by IV, through a tube into your hand or arm). You will be able to control the pain medication with a special pump that releases the drug into your IV when you press a button. Patients recover faster when their pain is under control, so don’t hesitate to use the pump when you need it.

Your doctor also will probably give you a prescription for a pain killer that you can take at home once you are released from the hospital.

Catheter

You will wake up after surgery to find that you have a catheter in place. This is a tube that is inserted into your bladder through the urethra to drain the urine. The catheter will be connected to a bag that is taped to your leg.

Your nurse will show you how to handle the catheter before you leave the hospital. You will probably need to keep it for a week or two, and then your doctor will remove it during a visit to the clinic.

Abdominal Drain

In addition to the catheter, you will have an abdominal drain, which will stay in place for a couple of days while you are in the hospital. This tube drains away any lymph fluid or urine that may temporarily leak into your pelvis. Usually your doctor will remove this drain before you leave the hospital. But some men will leave the hospital with the drain and have it removed about a week later.

Support Stockings

You will wear support stockings for at least a few days after surgery to help prevent blood clots. Ask your doctor how long he expects you to continue to wear these.

Kegel Exercises (Strengthening the Sphincter)

The pelvic-floor, or levator ani, muscles originate at the back of your pubic bone in the front and your tailbone and sacrum in the back. They sit just under the prostate. Along with serving as a valve to the bladder, they support your bladder, prostate and rectum in the pelvis. Due to the proximity of these muscles to the prostate, as with any surgery, muscle weakness is inevitable. By starting to strengthen your pelvic muscles before surgery, you can minimize some muscle weakness and also the risk of incontinence.

Your pelvic-floor muscles can be found by squeezing as if you want to stop your urine stream. Try to isolate these muscles by avoiding tensing your anus and abdominal muscles. When locating these muscles for the first time, lie down on your back and place your hands on your lower stomach. You should not feel movement under your hands as you tense your pelvic floor. You can also look for a lifting of your penis during the contraction.

Before your surgery:
Lie down on your back with your knees elevated or straight, depending on your comfort. Squeeze your pelvic floor for 10 seconds, rest for 10 seconds, and repeat this exercise five times. Perform this exercise three times a day until your surgery. If this exercise seems easy for you, try the same exercise in the sitting position.

After your surgery:
If cleared by your doctor, on day seven you can begin pelvic floor exercises.

1. Lying on your back, try a gentle 25 percent–effort pelvic-floor contraction. Hold this contraction for three seconds, relax for 15 seconds, and repeat this exercise five times. Perform this exercise three times a day.
    
2. When the catheter is removed (10 to 14 days after surgery), you can increase the intensity of the contraction to 75 percent and gently start to increase the contraction time one second per day until you reach a 10-second hold. You can reduce the rest time to 10 seconds. Continue doing five repetitions, three times a day.
    
3. When you feel you are able to hold the contraction lying down using 100 percent effort without difficulty, you can start exercising in the sitting position. Start with a five-second hold and 10-second rest, and do five repetitions, three times a day. You can increase the contraction time one second per day until you reach 10 seconds. 
    
4. The next step is performing the exercises while standing. Repeat the same work intervals as in sitting (above), starting with a five-second hold and working up to a 10-second hold .

You should notice a gradual decrease in urine loss and an increase in your ability to wait longer between times you need to urinate. You should also be able to delay an urge to void for at least 15 minutes and get to the bathroom without urine loss. If you continue to have difficulty with increased frequency of urination or leakage of urine without control, please tell your doctor.