Download Retropubic Prostatectomy

2014
Retropubic
Prostatectomy
Retropubic Prostatectomy
What is the prostate?
The prostate is a gland that makes a fluid that
helps sperm move. It also gives nourishment for the
sperm. It is about the size of a walnut. The prostate
gland is found just under the bladder. It surrounds
the urethra. The urethra is the tube that carries urine
(pee) out of the bladder.
By the age of 50, a man may have an enlarged
(bigger) prostate gland. The prostate may get
bigger in a way that does not cause problems when
urinating (peeing). However, if the prostate gets
too big, it can block the urethra. Urine then builds
up in the bladder, causing pressure. Urination
may be more difficult and you may feel like your
bladder never completely empties. A retropubic
prostatectomy may be needed to take out the
blockage.
Bladder
Prostate
gland
Urethra
Testicle
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What is a retropubic prostatectomy?
The doctor makes an incision (cut) in the lower
abdomen and removes the inside of the prostate.
The outer shell (capsule) of the prostate stays in
place.
Before surgery
You will be asked to stop eating and drinking at
midnight the night before surgery. Please read the
pamphlet Planning for Your Hospital Stay After
Surgery for more information about getting ready and
what to expect.
Just before surgery
You will have some tests before you go to the
Operating Room (OR). These tests may include
blood and urine tests, a chest X-ray, and an
electrocardiogram (ECG).
Your lower abdomen (stomach) will be shaved before
your surgery. Your incision will be in this area.
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After your surgery
You will go to a special recovery area. Your
breathing, pulse, and blood pressure will be checked
often. You will be taken to your hospital room when
you are stable.
You will have an intravenous (IV) for about 24-48
hours (1-2 days). Your IV is taken out when you are
able to eat and drink again.
Incision (cut)
• The incision is usually held together with staples.
• The bandage covering the incision will be changed
every day.
• The staples are usually taken out after 7-10 days.
Drainage tube
You may have a drainage tube in or near your
incision. This drains any fluid that collects in the
area. It will be taken out in a few days depending on
how much fluid is draining from the tube.
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Catheter and continuous bladder irrigation
You will have a catheter (a tube
through your penis into your
bladder). It will be connected
to 2 large bags of fluid that will
flush your bladder continuously to
prevent blood clots from forming
in your bladder. This is called
continuous bladder irrigation
(CBI).
The fluid will drain out through the catheter into a
collection bag. It is OK if the fluid draining out is
red. Over time the fluid will get lighter. Your catheter
can get blocked with clots. If this happens, you
may have abdominal (stomach) pain, abdominal
distension (bloating), and your tube might not be
draining well.
Let your nurse know so that they can flush your
catheter. This problem happens in some patients,
but not everyone.
Spasms
It is OK if you feel the urge to pee and fluid comes
out around the catheter. This is called a bladder
spasm. Call your nurse, who can give you some
medication for this, if it is bothering you.
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When will my catheter be taken out?
Your catheter will usually be taken out a few days
after surgery. At first, you may not have your usual
control when urinating. You may have dribbling and
pass your urine more often. This will get better in
a few days. It is very important that you drink lots
of fluid (at least one glass of water an hour). This
will dilute (water down) the amount of blood in your
urine and lower the chance of clots forming. If you
can’t urinate within 6-8 hours after the catheter is
taken out, the nurse will drain your bladder with
a new catheter. The catheter may be left in for an
extra day or two if there are problems with blood
clots.
Controlling discomfort
People differ in the amount of pain they will have.
Your nurses and doctors will make sure that you are
as comfortable as possible. There are many methods
for controlling pain. You should talk about these with
your doctor and/or nurse.
Fluids and food
An IV will give you fluids and nutrition. You will
not be able to eat or drink right away after surgery
because your bowels are not ready. The nurses and
doctors will listen to your abdomen for bowel sounds
with a stethoscope.
When you have bowel sounds and are passing gas,
you will move slowly from having clear fluids to then
going back to your usual diet.
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Deep breathing and coughing
It is important to take deep breaths in and out and
to try to cough up any phlegm (mucus).
Your nurse will give you a machine called an
incentive spirometer that will help you breathe
deeply.
Activity
• It is important to start moving as soon as possible.
A nurse should be with you the first time you get
up. Activity will help prevent blood clots from
forming and get rid of gas in your abdomen. Being
active will also help get rid of any phlegm in your
lungs.
• While you are lying in bed, try to move your legs
around and flex your feet.
• Your nurse(s) will help you do more activity.
At home
• Your stitches or staples will be taken out before
you go home.
• You may have little pieces of tape called SteriStrips™ on your incision to reinforce (strengthen)
it. Leave them on until they fall off on their own.
• It is OK to bathe or shower with Steri-Strips™ on.
Do not soak too long. Do not direct the spray of
the shower at your incision or let the water pound
on it.
6
Fluids
• You may see blood in your urine off and on for the
next couple of weeks. This is normal.
• If your urine is pale yellow, drink your usual
amount of fluid.
• If your urine is red or brown-tinged, you should
drink 8-10 glasses of fluid every day. This washes
out your bladder and helps prevent infection.
Alcohol
Alcohol slows down healing. Do not drink any alcohol
for at least one month so you can heal.
Healthy eating
You may eat the same foods as before your surgery.
Eat food high in fibre such as bran cereals, whole
wheat bread, green leafy vegetables, and fresh fruit
to help prevent constipation.
Bowel care
Your surgery was done in an area right in front of
your rectum so do not force or strain to have a bowel
movement. This could cause bleeding. Remember
that you have an incision on the inside and
outside and both need time to heal. Try to prevent
constipation. Enemas should be avoided unless
talked about with your doctor.
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Activity
• Do not do vigorous (hard) exercise for at least 6
weeks.
• You can lift up to 5 pounds, not more.
• Walking short distances is OK.
• Ask your doctor if you are not sure about any
activity.
Car rides
• Do not go for long drives. Avoid bumpy roads for
6 weeks. Sitting for a long time, or going over
a bump could cause bleeding from the prostate
area.
• Your response time may be slower than usual
while taking pain pills. Do not drive for at least 1
week. Please talk about this with your doctor.
Sex
• You can have sex after about 4-6 weeks, when you
feel ready.
• You may have mild discomfort when you go back
to having sex. This will soon go away.
• Sexual sensation, desire and erections should be
the same as before your surgery, but the amount
of semen may be less or none.
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Medications
• Take all prescribed medications as told by your
doctor.
• Check with your doctor before taking ASA
(Aspirin®) or blood thinners.
Going back to work
You can usually go back to work 4-6 weeks after your
surgery. Talk about this with you doctor.
Please note:
You will probably have some blood in your urine
when you go home (off and on for the next couple of
weeks). This should completely disappear after 3-4
weeks.
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Call your doctor right away if you have:
• Fever and/or chills.
• Are unable to urinate.
• Have a sudden onset of pain.
• Have swelling, redness, or pus in your incision.
Follow-up
Before you leave the hospital, you will get an
appointment to see your urologist. It is very
important to keep this appointment so your urologist
can make sure you are healing properly.
If you need to see a doctor, please contact your
family doctor or go to the nearest Emergency
Department unless otherwise instructed by your
Urologist.
If you have any questions, please ask.
We are here to help you.
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Notes:
Looking for more health information?
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For more information go to http://library.novascotia.ca
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Capital Health, Nova Scotia
www.cdha.nshealth.ca
Prepared by: Urology Nursing Education Committee, QEII, Halifax
Revised by: Urology Practice Council
Illustration by: LifeART Super Anatomy 1 Images, Copyright © 1994, TechPool Studios Corp. USA;
Capital Health staff.
Designed by: Capital Health Library Services, Patient Education Team
Printed by: Dalhousie University Print Centre
The information in this brochure is provided for informational and educational purposes only.
The information is not intended to be and does not constitute healthcare or medical advice.
If you have any questions, please ask your healthcare provider.
WJ85-0475 Revised September 2014
The information in this pamphlet is to be updated every 3 years.