The prostate is a gland in the male reproductive system that is responsible for the production of some of the fluid that eventually carries sperm. This gland is located right in front of the rectum, underneath the bladder. At times, people need to have an operation to completely remove their prostates. This type of operation is called a prostatectomy. Possible reasons for prostatectomy is benign prostatic hyperplasia (enlargement of the prostate) and prostate cancer. Other issues could include the occurrence of urinary problems and bleeding of the prostate.
Tips for Better Prostate Surgery Recovery
Regardless of the procedure used, patients will be closely monitored after surgery. For the first few days after surgery, patients will experience quite a bit of soreness with the incision. Follow the doctor's post-surgery instructions strictly and don't forget follow-up visit. The time it will take to recover depends on the patient's overall health, the type of surgery he had, and his compliance with the doctor's instructions. For better recovery:
1. Avoid Strenuous Activity
Many recover pretty well, if not completely, a week after surgery, meaning they can resume activities such as driving after a week. However, the patient should not perform any strenuous activities such as motorcycling, running, etc. for about six weeks after the surgery.
Never climb stairs simply for the sake of exercising or sit in the same position for too long. If a catheter is used, don't use bathtubs or swimming pools or anything like that.
2. Mind Your Diet
Many patients, after such a surgery, often adhere to a mostly liquid diet. They find it easier to consume immediately after surgery. Avoid carbonated beverages. As soon as bowel movement resumes, start eating soft foods such as scrambled eggs, oatmeal, soup, etc. Then slowly work your way back to a normal diet. Foods that induce gas should be avoided. For the first few days after surgery, eat little but often, rather than a lot all at once.
3. Wear Loose Clothes
It will be a little hard to fit into normal clothes immediately after the surgery as the abdomen would be slightly bloated. Do not wear button waist bands and other tight fitting clothes during the early days of prostate surgery recovery.
4. Be Careful with the Wound
It is okay to use the shower immediately after being discharged. During the showering, the patient can remove his catheter collection bag. After showering, it is vital to avoid irritating the sore areas of the body by gently padding them dry rather than rubbing them with the towel. And do not apply ointments onto the incision sites.
The sutures used will dissolve, hence the patient need not worry about removing them. There may also be some leakage (either clear or bloody) from the wound. This is okay, too. However, if such leakage is enough to soak the wound's dressing, it should be immediately reported to the doctor.
5. Regain Urinary Control
It may be a little difficult for the patient to regain urinary control soon after the catheter has been removed. When the catheter is removed, the patient should have an adult urinary pad to use just in case. Normal urinary control may take up to (or perhaps more than) two months after surgery to resume. But it also depends. Some take an incredibly short time while others can take a while.
By removing the prostate, the surgery rendered the patient's secondary urinary control mechanisms useless. This work must now be done solely by the external sphincter muscle. For this reason, it is important that the patient strengthen this muscle with Kegel exercises.
In some cases, insufficient urinary control may last a year or more. In such cases, some men simply use urinary pads. Others have artificial urinary sphincters placed in place of the one that was taken out.
6. Regain Sexual Function
Patients may experience impotence, lasting for months or even years after surgery. This is because a number of blood vessels, nerves and muscles responsible for sustaining erections can be permanently injured during the surgery. There are several medications and devices that can be used to reverse erectile dysfunction during prostate surgery recovery.
- A device that can be used to reverse this problem is a vacuum constriction (or vacuum penile pump). Such a device is placed around the penis and helps to take blood there in order for the patient to sustain an erection.
- Another is a flexible tube with a button implanted in the patient's testicles. This tube is then pressed from the outside, allowing a liquid to flow into the tube and hence result in an erection.
7. Urine Catheter Care
The catheter typically remains in the patient's body for between six and nine days after the surgery. During the day, the patient can attach the catheter to a leg bag, which he can hide underneath his trousers. At night, however, it is highly recommended that the patient use a regular urinary bag which he can place beside his bed.
The catheter may bring about some bladder pains, though this is not always the case. It is also possible that the catheter may leak somewhat as a result of the patient's involuntary bladder contractions. The patient may choose to wear a pull-up diaper over the catheter so as to manage any possible leakages.
8. Take Medication
It's important to take pain medications for about a week after surgery to hep yourself walk around easily. Pain medications taken orally may take about half an hour to take effect, so if you need to do something, take it ahead. Also check how you respond to the various medicines given. If dizziness or unsteadiness occurs, reduce your dose.
Types of Prostate Surgery
The type of surgery will affect the process of prostate surgery recovery, common types include:
1. Traditional Open Surgery
The surgeon typically uses the retropubic approach, where he/she performs the prostatectomy by entering through an abdominal incision. This means that he/she cuts from the patient's navel all the way to his pubic bone. The patient's prostate is then taken out. When the patient is suffering from prostate cancer, the adjacent lymph nodes are removed along with the prostate. In some cases, the patient's nerves are also affected, meaning they too have to be taken out.
A possibility of this operation is temporary erectile dysfunction. However, it would be permanent if both ends of the nerves are affected, in which case they are both removed. There are a few ways in which erectile dysfunction may be reversed in such a scenario.
2. Endoscopic Surgery
Endoscopic surgery is mostly utilized when the patient's condition is caused not by cancer, but by an enlarged prostate or by some sort of obstruction. The surgeon uses a somewhat long and flexible tune with a light and lens (this is called an endoscope) to enter through the penis. With this method, the surgeon can remove part of the prostate gland.
3. Laparoscopic/Robotic Surgery
The surgeon makes several very, very small cuts in the patient's body, hence allowing him/her to insert tiny surgical instruments into the body for the operation. The surgeon uses a laparoscope (a very thin tube with a camera at the end) to see the area he/she needs to work on. With more advanced facilities, the surgeon does not perform this operation him/herself. Rather, he/she controls a robotic arm from a computer while it performs the surgery (using precise cuts). This type of surgery is very advantageous as it prevents excessive loss of blood.
4. Perineal Approach
The perineum is the space between the scrotum and the rectum. When the patient's condition does not require the removal of lymph nodes, the surgeon can perform the operation by entering through the perineum. It is a faster way of performing the operation, and it results in less pain and much quicker recovery than the abdominal method. This method is good for patients with other medical conditions which could cause difficulty with abdominal surgery.