How Long Do You Bleed After Prostate Surgery

What Will I Learn By Reading This

When you have prostate cancer you may need a urinary catheter to help your bladder or urethra heal or to help lessen the side effects from treatment. It is very common for men with prostate cancer to need a urinary catheter at some point during or after their treatment. In this booklet you will learn about the following:

• What a urinary catheter is
• Why you may need a urinary catheter
• What are the different kinds of urine collection bags
• What are some possible side effects of a urinary catheter
• How you can take care of yourself when you have a urinary catheter

It is important for you to think about and plan how you will take care of yourself before and after your prostate cancer treatment so that you can keep doing as many of your normal activities as possible.

When To Call Your Healthcare Provider

Contact your healthcare provider right away if:

• You have a fever of 100.4°F or higher, or as directed by your healthcare provider

• You have excessive bleeding

• You have pain not relieved by medicine

• You notice that no urine is draining from the catheter or if the catheter falls out

• You have frequent or excessive urge to urinate

• Youre not able to urinate, or notice a decrease in urine flow

How Is Postoperative Bleeding Treated

• A blood transfusion may be done to give you donated blood through an IV.
• Blood components may be given during a transfusion to help stop your bleeding. Blood components are the parts of blood that help it to clot. Examples are clotting factors, platelets, and plasma.
• Antifibrinolytic medicines may slow or stop your bleeding.
• Surgery may be done to fix the blood vessel or area that is bleeding.

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When To Call The Doctor

• You have pain in your belly that does not go away when you take your pain medicines
• It is hard to breathe
• You have a cough that does not go away
• You cannot drink or eat
• Your temperature is above 100.5°F
• Your surgical cuts are bleeding, red, warm to the touch, or have a thick, yellow, green, or milky drainage
• You have signs of infection
• Your urine stream is not as strong or you cannot pee at all
• You have pain, redness, or swelling in your legs

While you have a urinary catheter, call your provider if:

• You have pain near the catheter
• You are leaking urine
• You notice more blood in your urine
• Your catheter seems blocked
• You notice grit or stones in your urine
• Your urine smells bad, or it is cloudy or a different color
• Your catheter has fallen out

Reducing Your Risk Of Complications

You can help reduce the chance of certain complications by:

• following activity, dietary, and lifestyle restrictions and recommendations before surgery and during recovery
• notifying your doctor immediately of any concerns, such as bleeding, bloody urine, , an increase in pain, or a change in urination
• seeing your doctor as instructed before and after surgery
• taking your medications exactly as directed
• telling all members of your care team if you have any

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What Happens When My Urinary Catheter Is Taken Out

The day your catheter is taken out is a big step forward in your recovery. Taking out your catheter will only take a couple of seconds and is not painful. You may feel a slight tug or a pulling feeling as it comes out, but it does not hurt. You will probably feel very relieved to no longer have your catheter.

When your catheter is removed, you will probably leak or pass urine when you dont want to. This is called incontinence. Remember to bring an incontinence pad, like Depends, with you to the doctors office or clinic. Being unable to control your urine after your catheter is taken out is normal. This should get better over time. There are also exercises, called Kegel Exercises, which you can do to make the muscles that control your urine flow stronger. For more information, please see the IMPACT booklet, Kegel Exercises for Men. Your doctor or health care team can also give your information on how to do these exercises.

Side Effects Of Prostate Surgery

The major possible side effects of radical prostatectomy are urinary incontinence and erectile dysfunction . These side effects can also occur with other forms of prostate cancer treatment.

Urinary incontinence: You may not be able to control your urine or you may have leakage or dribbling. Being incontinent can affect you not only physically but emotionally and socially as well. These are the major types of incontinence:

• Men with stress incontinence might leak urine when they cough, laugh, sneeze, or exercise. Stress incontinence is the most common type after prostate surgery. It’s usually caused by problems with the valve that keeps urine in the bladder . Prostate cancer treatments can damage this valve or the nerves that keep the valve working.
• Men with overflow incontinence have trouble emptying their bladder. They take a long time to urinate and have a dribbling stream with little force. Overflow incontinence is usually caused by blockage or narrowing of the bladder outlet by scar tissue.
• Men with urge incontinencehave a sudden need to urinate. This happens when the bladder becomes too sensitive to stretching as it fills with urine.
• Rarely after surgery, men lose all ability to control their urine. This is called continuous incontinence.

After surgery for prostate cancer, normal bladder control usually returns within several weeks or months. This recovery usually occurs slowly over time.

There are several options for treating erectile dysfunction:

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Days Before Your Surgery

Follow your healthcare providers instructions for taking aspirin

If you take aspirin or a medication that contains aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Aspirin can cause bleeding.

Follow your healthcare providers instructions. Dont stop taking aspirin unless they tell you to. For more information, read the resource Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs , or Vitamin E.

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements 7 days before your surgery. These things can cause bleeding. For more information, read the resource Herbal Remedies and Cancer Treatment.

Potential Side Effects / Risks Of Turp Surgery

In addition to the risks associated with any surgery, some of the potential risks of TURP surgery include:

Difficulty Urinating: A temporary problem associated with post-surgery swelling. A catheter may be placed until youre able to urinate on your own.

Urinary Tract Infection : After any prostate surgery, there is a risk of a UTI. The longer a catheter is kept in place, the greater likelihood of infection. Some men experience recurring UTIs following TURP surgery.

Retrograde Ejaculation: Also known as dry orgasm, this effect causes semen to travel into the bladder instead of out the penis during ejaculation. While this doesnt normally affect sexual pleasure and isnt harmful, it can affect fertility.

Erectile Dysfunction: ED is a rare side effect of TURP surgery, but is possible.

Retreatment: Over time, the prostate may continue to grow and the need for additional treatment may arise. Its also possible that retreatment may be necessary to treat urethral stricture caused by the TURP.

This is not an exhaustive list of potential risks associated with TURP surgery. Talk to your doctor about all risks and complications prior to surgery.

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How Fast Will I Become Totally Continent After Prostate Surgery

During surgery for prostate cancer, the urethra is also affected and, depending on the experience of the surgeon, more or less of the continence function will be preserved. Due to the high precision of robotic surgery, the patient will have a catheter for roughly one week and the trauma to the urinary function will be minimum.

The discomfort that patients feel during this time is minimum, but you should expect the removal to make you feel uneasy. The catheter will be removed during a visit to your doctor, so do not try to do this at home, as it could cause infections. The degree of which the urinary function will be affected depends on how normal the function was before surgery, age and weight.

It is worth noting that most men will experience some degree of incontinence after prostate surgery, but control can be regained within several weeks or months to a year.

Preparing For A Prostatectomy

The time between a prostate condition being diagnosed and a prostatectomy being scheduled varies depending on the particular person and the advancement of their specific condition. In cases where a prostatectomy is being carried out because of prostate cancer, there is often an interval of six or more weeks between the diagnosis â which involves taking a biopsy â and the scheduling of the operation. This is to allow any inflammation, that has occurred as a result of the biopsy, to heal.

These actions and forward-planning measures are helpful in preparing to undergo a prostatectomy:

Kegel exercises: Schedule an appointment to learn Kegel exercises before the operation. These strengthen the muscles around the bladder and will assist the process of regaining normal urinary function after the catheter, which is regularly administered after surgery, is removed. They should be practiced before and after prostate surgery.

Hospital stay: A prostatectomy is an inpatient procedure that will require a hospital stay of two to three days, in general, after which it is possible to return home. Preparing for this, logistically and emotionally, will make this period run as smoothly as possible.

These medicines and dietary modifications are helpful preparations for the day before the surgery is due to take place:

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The Morning Of Your Surgery

Instructions for drinking before your surgery

You can drink a total of 12 ounces of water between midnight and 2 hours before your scheduled arrival time. Do not drink anything else.Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.

Take your medications as instructed

If your healthcare provider told you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take, this may be all, some, or none of your usual morning medications.

Shower with a 4% CHG solution antiseptic skin cleanser

Shower with a 4% CHG solution antiseptic skin cleanser before you leave for the hospital. Use it the same way you did the night before.

Dont put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.

Things to remember

• Wear something comfortable and loose-fitting.
• If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.
• Dont wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
• Dont put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
• Leave valuable items at home.

What to bring

Once youre in the hospital

Get dressed for surgery

When its time to change for surgery, youll get a hospital gown, robe, and nonskid socks to wear.

Meet with a nurse

Less Common Side Effects Of Turp

Less common unwanted effects of surgery include:

• urinary symptoms do not change sometimes surgery does not cure your urinary problems. Even though the blockage has been cleared, the bladder irritability may continue and you may still have symptoms such as being unable to empty your bladder completely, and nocturia
• erectile dysfunction some men are unable to get or maintain an erection sufficient for sexual intercourse after surgery. This is more of a problem for men who had erectile difficulties before their operation. This problem may be treated by medication
• urethral strictures when scarring occurs in and around the urinary tract, it can cause further blockage to urine flow. Strictures may need to be dilated or need further surgery
• urinary incontinence sometimes surgery results in being unable to hold or control the flow of urine. This may be due to continuing bladder problems or, less often, to sphincter muscle damage
• infertility retrograde ejaculation is not harmful, but it can result in infertility. It causes the seminal fluid to collect with the urine and it doesn’t come out as ejaculate. This makes ‘natural’ insemination impossible. However, in vitro fertilisation may be used to achieve a pregnancy. The sperm can be removed from the urine and injected into the womans harvested eggs.

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Recovery After Greenlight Laser Surgery

Please note that these recommendations apply to patients who undergo Greenlight Laser prostatectomy at New York Urology Specialists. Other surgeons may have different recommendations. Please contact your surgeon for instructions.

Patients can have a regular diet after the Greenlight laser of the prostate. For patients who undergo Greenlight laser prostatectomy at New York Urology Specialists, you may drink alcohol socially within reason once youre not taking medications.

You also may engage in regular nonstrenuous activities such as walking. Men should avoid sexual activity for 3-4 weeks after the Greenlight laser procedure to allow the prostate to heal. Similarly, biking and strenuous running should be avoided for 3-4 weeks after the procedure as it may provoke bleeding.

What Is A Prostatectomy

A prostatectomy is a major procedure, carried out by a urological surgeon , in which all or part of the prostate gland is removed in men. It can be ordered by your doctor to treat prostate cancer and as part of treating some of the other types of cancer that can affect the pelvic region.

A prostatectomy can often cure prostate cancer if it has not spread outside the prostate gland. Prostatectomies are also performed in the treatment of non-cancerous conditions affecting the prostate, such as:

• Benign prostatic hyperplasia , when the gland becomes enlarged and causes urinary problems
• Prostatitis, in which it becomes inflamed

There are several different types of prostatectomy. The prostate surgery option used depends on why the procedure is being performed:

• A radical prostatectomy will be carried out as a treatment for malignant cancer. The surgeon will remove the entire prostate gland as well as the vas deferens, the duct which conveys sperm from the testicals to the urethra, and the seminal vesicles, the glands which hold the liquid which mixes with sperm to make semen.
• A simple prostatectomy, in which only part of the prostate is removed, will be carried out to treat a more benign condition, such as BPH.

Removal of the prostate may result in complications, including impotence, which in most cases is temporary. Several different types of treatment exist to help correct erectile dysfunction after the operation. This is called penile rehabilitation therapy.

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Immediately After A Prostatectomy

After the operation, you can expect that:

• Nurses will monitor your vital signs.
• You may be given oxygen for up to 24 hours following surgery.
• You will probably be given antibiotics to prevent infection.
• For a day or so, you will have a catheter in your urethra and bladder with a continuous wash-out. This is to prevent blood building up and clotting, which could cause a blockage.
• If you had an open prostatectomy, your wound will be dressed and you will have a tube draining your abdomen. The tube will be removed after several days.
• Pain will be managed with injections, tablets or both. Pain is rarely a significant problem following TURP.

Things You Should Expect After Prostate Surgery

Prostate removal is a major type of surgery and requires time for the body to recover. Even though robotic prostatectomy using the Da Vinci robot has less severe effects on the body and the patient can leave the hospital the same day, men should expect some changes in order to know how to deal with them. The surgery is performed through small incisions that are barely sensitive at the incision sites and the scar tissue is almost unnoticeable. Typically, the recovery is fast, most men are able to go home the next day and resume driving and working in two to three weeks after the surgery.

In the immediate hours after surgery:

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What Changes Do I Need To Make To My Diet

Discuss your post-surgery diet with your doctor as you will probably want to avoid or at least minimize issues such as constipation. The lack of exercise, the medication, even the stress, might affect your bowel functions. Your diet will be focused on eating more vegetables, fruits, grains and avoiding meat, especially the red one, pasta, alcohol, fast-food, sugar and processed desserts.

Scheduling Appointments For Enlarged Prostate Treatment At New York Urology Specialists

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We offer affordable appointment prices with or without insurance. We offer weekday, weekend, and evening office hours.

Dr. Alex Shteynshlyuger is a board-certified urologist and specialist in the treatment of urinary problems in men. He is one of the few urologists who offers a full range of treatment options for BPH . He specializes in all aspects of care for men with an enlarged prostate and urinary problems, including frequent urination at night, difficulty emptying the bladder, urinary urgency, and incontinence. He has successfully treated thousands of men with urinary problems, including urinary retention, painful urination, and frequent urination.

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Bleeding After Prostatectomy: Endovascular Management

Anna Maria Ierardi1, Maria Laura Jannone1, Pietro Maria Brambillasca1, Stefania Zannoni1, Giovanni Damiani2, Umberto G. Rossi3, Antonio Maria Granata4, Mario Petrillo1, Gianpaolo Carrafiello1

1Diagnostic and Interventional Radiology Department, San Paolo Hospital, University of Milan 3Department of Diagnostic Imaging, Interventional Radiology Unit, E.O. Galliera Hospital 4Department of Urology, ASST Fatebene Fratelli-Sacco, Milan , Italy

Contributions: Conception and design: AM Ierardi, G Carrafiello Administrative support: None Provision of study materials or patients: AM Ierardi, ML Jannone Collection and assembly of data: ML Jannone, PM Brambillasca, M Petrillo, AM Granata, AM Ierardi Data analysis and interpretation: UG Rossi, G Damiani, AM Ierardi Manuscript writing: All authors Final approval of manuscript: All authors.

Correspondence to:

Background: To evaluate role of interventional radiology in post-surgical haemorrhagic complications of prostatectomy.

Methods: A retrospective study was performed. From April 2015 to January 2018, 10 patients referred to IR Department for haemorrhagic complications post radical prostatectomy . All patients were successfully treated with superselective trans-arterial embolization. We evaluated technical and clinical success and post procedural complications.

The endovascular management of significant haemorrhage after prostatectomy is safe and long-term effective, with no major ischaemic events associated to embolization.