In order to prevent complications, such as pneumonia and blood clots, you will be encouraged to do three things as soon as possible after prostate cancer surgery: walk, use your incentive spirometer (a small disposable device which encourages deep breathing), and do your leg exercises. The nurses will instruct you on how to use the spirometer and do leg exercises, and will assist you in walking after surgery until you can manage on your own. You may also may be given support stockings to wear until you are discharged from the hospital.

Going home: what to expect

Diet and exercise

It is normal to feel tired for several weeks after your surgery . Make sure someone drives you home from the hospital. Get plenty of rest, eat a well-balanced diet with plenty of protein and iron, and do some light exercise (such as walking) every day. Do *not* do any heavy lifting (more than 10 to 20 pounds) or strenuous exercise for 3 weeks following surgery. You can increase your exercise schedule gradually thereafter. Light exercise such as walking, jogging, stretching should be done initially. Golf or tennis can be played within 2 to 3 weeks. If you feel comfortable, you can increase your activity. Heavy abdominal exercise such as sit-ups as well as cycling on an upright bicycle should be avoided for 6 weeks. Driving is usually permitted after the catheter is removed if you feel comfortable. It is important that you do exercise that you feel comfortable with. Any activity that causes pain should be avoided.

Caring for the incision

The incision runs from above the base of the pubic area to below the navel. The key words here are .clean. and .dry.. Showering once a day should do it. If you notice extreme or increasing tenderness, progressive swelling, more than a small amount of drainage (i.e. teaspoon), or any pus or redness, notify your doctor right away.

Going home with a catheter

You will be discharged from the hospital with a catheter in place to drain urine from the bladder into a bag. The doctor will remove this in the office in 5 to 14 days. Be sure to clean the catheter where it exits your penis twice a day with soap and water and to empty the bag frequently.

The bag should always be positioned lower than your bladder. On occasion, the catheter may irritate the bladder, causing .bladder spasms. which can be quite uncomfortable.

If these occur, your doctor can prescribe medication that can help. Leakage of urine around where the catheter exits the penis may also occur and can be managed by wearing incontinence pads as described in the next section. It is normal for your urine to look cloudy for a few weeks after surgery . Occasionally, bleeding may occur around the catheter or be noticed within the urine. This is also common. If passage of large clots is noted (i.e. more than an inch in length) or if the catheter becomes plugged, contact your physician. No anesthesia is required for catheter removal and only a little discomfort is experienced by most patients.

Managing incontinence

After your bladder catheter is removed, you may have leakage of urine (.incontinence.). Initially, the leakage may be significant (leakage all the time). Your doctor will teach you exercises which you can do to strengthen your bladder muscles. You can buy incontinence pads such as .Attend. or .Depend. to protect your clothing and waterproof underpads to protect bedding at your local pharmacy. These can be obtained without a prescription and are available in a variety of sizes and absorbencies. Please bring one or 2 pads to your physician’s office the day your catheter is to be removed.

Your ability to maintain bladder control should improve significantly with time. Normally, continence returns in 3 phases: Phase I . you are dry when lying down; Phase II . you are dry when walking, Phase III . you are dry when you rise from a seated position, cough or exercise. Most patients regain very good control by three months. However, it may take more time for some patients. If adequate urinary control does not return by six months, consult your doctor. If you believe that the force or diameter of your urinary stream is slow or narrow, or if you have any difficulty or pain on urinating, notify your doctor immediately. On occasion, scarring may cause blockage to the normal flow of urine.

Most often, this can be treated easily by dilating the urethra which is brief procedure which can be done with using local anesthesia in an outpatient setting

Skin care

If you have any incontinence, your skin may become irritated depending on the amount of urinary leakage. You may need to protect your skin with a barrier such as Desitin or A&D ointment. If you develop a rash, notify your doctor.

Managing constipation

Constipation is a common side effect of pain medications. During the time that you are taking them, be sure to increase your fluid intake (at least 8 glasses of water a day), take stool softeners, and eat lots of roughage (whole grains, fruit and vegetables). Use laxatives only as a last resort.