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:
Our Primary Goal Is Cancer Cure
Overcoming cancer is our goal. Secondary goals, which also critically important, include speedy physical recovery, continence recovery, and erection recovery. Statistically, 10% of men can have an erection that supports intercourse within six weeks following surgery. About 50% of men reach this level of function at six months and about 85% will achieve normal function at one year. Recovery of erections is affected by the level of function before the surgery, age of the patient, the presence of other medical problems like diabetes and high blood pressure, while smoking, alcohol intake, stress, your partner, and a few other things are also a factor. In short, it is complicated.
Keeping Up With Appointments And Screenings
Attending your doctors appointments after youve entered remission is very important. If you need to skip an appointment, you should make another appointment as soon as possible.
Use these appointments as a time to discuss any concerns you may have with your doctor. Your doctor can also conduct tests to check for the cancers return during these appointments.
Two tests to detect recurrent prostate cancer include a digital rectal exam and a PSA blood test. During a DRE, your doctor will insert a finger into your rectum. If your doctor detects something unusual, theyll likely ask for additional follow-up tests. These tests may include bone scans and imaging studies, such as an ultrasound or MRI.
Men often experience side effects from their prostate cancer treatments. Some of these side effects may be immediate and temporary. Others may take several weeks or months to show up and never fully disappear.
Common side effects from prostate cancer treatment include:
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What Is Robotic Laparoscopic Surgery
Robot-assisted surgery in prostate cancer treatment is a new innovation. It consists of using robotic equipment which, unlike what some patients may think, is fully controlled by the doctor. The robot replicates the surgeons movements , performing the very precise movements, or orders, they execute.
These very sophisticated pieces of equipment allow surgeons to remove the prostate and surrounding tissue accurately and precisely.
It is a variant of keyhole surgery, maintaining its essential benefits while making operations quicker, more delicate and more precise.
It is a far less invasive procedure than conventional radical retropubic prostatectomy which involves an abdominal incision from the navel to the pubic region.
For patients, it translates into a shorter recovery time and shorter hospitalisation.
For patients operated on and cared for at the Instituto da Próstata, the Da Vinci System is used.
What Type Of Patients Are Candidates For Robotic Prostatectomy
Robotic laparoscopic prostatectomy is used to treat patients who have clinically localized prostate cancer. Most patients who are candidates for open radical prostatectomy are also excellent candidates for the robotic approach. In many centers including the University of Florida, the robotic approached is the treatment of choice for the surgical management of clinically localized prostate cancer.
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When Should I See My Healthcare Provider
Talk to your healthcare provider if you have any of these symptoms after your surgery:
- Bleeding, swelling or drainage from the incisions.
- Inability to have a bowel movement.
- Inability to urinate after catheter removal.
- Increased pain around the incisions.
A note from Cleveland Clinic
Radical prostatectomy is a common surgery to remove the entire prostate gland. This prostate cancer surgery may be robotic surgery or open surgery. Robotic surgery has a shorter recovery time. Full recovery can take weeks, with some side effects lasting for months. Light exercise and medication can help you heal faster.
Last reviewed by a Cleveland Clinic medical professional on 08/03/2021.
Urinary Incontinence After Prostate Surgery: Everything You Need To Know
Undergoing a prostatectomy can be difficult. And for many men, finding that they are incontinent post surgery may come as a shock.
But rest assured that there are many treatments available to manage incontinence treatment after surgery. Read below for some of the most common questions we receive about incontinence after prostate surgery.
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What To Expect After Prostate Surgery
The surgeons at AdventHealth are known for providing excellence in patient outcomes, so you can expect good results from your surgery. After surgery you should plan on:
- Spending one night in hospital. Most patients go home within 24-hours
- Being back to normal activities within 1-2 weeks
- An early return of urinary control and sexual function based on preoperative function
- A short period of catheterization
- A low complication rate
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Will I Have Erectile Dysfunction
Whether or not you experience erectile dysfunction after radical prostatectomy will depend largely on your age, your health and what your erections were like before the operation. This side effect may occur if nerves were injured during the operation.
There are two main nerves running through the pelvis that branch into many nerves covering the prostate. Urologists call them neurovascular bundles because they really are bundles of many nerves. Urologists always aim for nerve-sparing surgery, and we rarely need to remove the neurovascular bundles. But sometimes the bundles are stretched and some of the thousands of nerve fibers within an individual nerve can be damaged, says Mohler. In most men, both neurovascular bundles can usually be spared. If the cancer is advanced, sometimes one or both cannot be.
Benefits of Robotic Radical Prostatectomy
Have more questions about radical prostatectomy? Our experts give you the answers.
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Causes And Surgical Considerations For Prevention
Although the development of urinary incontinence can be explained by intraoperative injury to various structures affecting urinary continence, postprostatectomy erectile dysfunction has more simple causes, and the most important factor is injury to the cavernosal nerves. These nerves are the most important structures in maintaining healthy erectile function owing to their anatomical relationship with the prostate, running in the 3 and 9 oclock directions from the apex of the prostate, and along the posterolateral aspect of the prostate body, injury during radical prostatectomy is inevitable, and this results in postoperative erectile dysfunction. Mechanisms for this nerve injury include unintended physical damage to the nerve itself during surgery, but the extent of nerve injury is reported to differ, and neuropraxia, in particular, is known as a representative mechanism of nerve injury capable of recovery and rehabilitation . Owing to continual efforts to minimize intraoperative nerve injury, when complete resection is not oncologically necessary in patients with preserved preoperative erectile function, bilateral nerve-sparing surgery has become a major trend in modern surgery. Minimizing unintended intraoperative damage to the NBV is considered the most important principle in preserving erectile function.
Surgically Removing The Prostate Gland
A radical prostatectomy is the surgical removal of your prostate gland. This treatment is an option for curing prostate cancer that has not spread beyond the prostate or has not spread very far.
Like any operation, this surgery carries some risks.
A recent trial showed possible long-term side effects of radical prostatectomy may include an inability to get an erection and urinary incontinence.
Before having any treatment, 67% of men said they could get erections firm enough for intercourse.
When the men who had a radical prostatectomy were asked again after 6 months, this had decreased to 12%. When asked again after 6 years, it had slightly improved to 17%.
For urinary incontinence, 1% of men said they used absorbent pads before having any treatment.
When the men who had a radical prostatectomy were asked again after 6 months, this had increased to 46%. After 6 years, this had improved to 17%.
Out of the men who were actively monitored instead, 4% were using absorbent pads at 6 months and 8% after 6 years.
In extremely rare cases, problems arising after surgery can be fatal.
Its possible that prostate cancer can come back again after treatment. Your doctor should be able to explain the risk of your cancer coming back after treatment, based on things like your PSA level and the stage of your cancer.
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Mri Technology Revolutionizes Screening Results
Advances in magnetic resonance imaging technology over the past five years have revolutionized the way we screen men for elevated levels of prostate-specific antigen a protein made in the prostate and released into the bloodstream.
Men with prostate cancer typically have elevated levels of PSA. Previously, when high levels were detected through a PSA blood test, we would conduct a biopsy to collect and test prostate gland tissue for cancerous cells. This process had several drawbacks:
- PSA tests can show elevated levels when no cancer is present.
- Elevated PSA can be a sign of other conditions, such as benign prostate enlargement, a urinary tract infection, or an inflamed prostate gland.
- Not all prostate cancers are life-threatening, since the cancer is slow growing in many men. Thus, the current goal is to identify patients at high risk of having clinically significant prostate cancer while avoiding unnecessary biopsies in men at low risk.
Using advanced MRI technology, weve reduced the number of biopsies we perform by almost half while detecting the same number of cancer cases. Getting sharper, clearer MRIs also helpsclinicians and patients make better decisions about who should undergo biopsy for prostate cancerand who might benefit from certain treatments, including nerve-sparing robotic prostatectomy.
A Change In Patient Perception
Screening for prostate cancer has led to increased public awareness and early detection, as well as a decline in mortality rates. Robotic radical prostatectomy is also a contributing factor to these encouraging trends. This state-of-the-art surgical procedure can offer the best chance for complete recovery. Wristed instrumentation, tremor filtration and 3D magnification aid the surgeon in performing one of the most demanding aspects of the procedure nerve-sparing for preservation of post-operative sexual function and urinary control. Along with cancer control, these are key elements in follow-up for patients undergoing treatment.
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Your Prostate Surgery Recovery And Follow
Although rest after the surgery is important for healing, walking is just as important. Resting too long can adversely affect the way you feel and may prolong the healing process. If you were very active before your surgery, you will probably want to resume your regular routine as soon as possible. If you were only moderately active before surgery, it is still important to become active. Be sure to start slowly with more gradual, gentle exercises. Walking is the best way to get back to feeling normal again. We recommend patients take a 1015-minute walk three times a day if possible. You may resume sexual activity per your doctors instruction. There are a few restrictions after surgery:
- No lifting more than 15 pounds for at least six weeks
- No bicycle riding, horseback riding, or motorcycle riding for two months
- Use common sense
Before being discharged from the hospital, you will receive instructions from your nurse and doctor regarding diet, physical activity, and care of the urinary catheter. About one week after discharge, you may be asked to return for a post-op checkup and X-ray. During this visit, it is likely that the catheter will be removed by the nurse, while the doctor checks on your recovery progress. The physician will also review the pathology report of the tissue that was removed during the prostate cancer surgery.
Benefits And What To Expect
The mission of the GRI is to ensure that our hand-selected team is comprised of the worlds best and brightest medical staff. With that in mind, we have built a team of over 50 professionals who strive to serve our patients and support the surgical teams pursuit of excellence. We have assembled a comprehensive team to deliver the best option to each patient that comes to our Institute. We take a multi-modality and multi-disciplinary approach to patient care, collaborating with experts in radiation oncology, medical oncology and internal medicine to provide the optimal comprehensive approach to urologic cancer to our patients. Surgery is not the best option for all patients therefore, we evaluate each patient individually and assess the potential prostate treatment options of active surveillance, radiation therapy, androgen deprivation and other surgical modalities.
The state-of-the art facilities at AdventHealth are unparalleled. From the resort inspired facility at Celebration Health to the hub of Central Florida’s healthcare at AdventHealth Orlando, patients travel from all over the globe to receive their treatment at our hospital. Fine dining, hotels and entertainment abound in Orlando, and patients and families often extend their stay in Orlando to take advantage of these amenities.
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How Bad Is The Pain After Prostate Surgery
The level of pain is lower than that of open prostatectomy, due to smaller incisions. However, you will be administered pain medication both orally and intravenously, through an IV. Make sure you have someone to pick you up from the hospital, as you wont be able to drive right away. Ask your doctor to recommend some pain medication and dosages that you can take from home most common ones are Tylenol or Ibuprofen. Even though the recovery is fast, you should get plenty of rest and not force yourself with lifting weights or exercises in the first few weeks.
What Are The Patient Criteria For Robotic
The decision to surgically treat prostate cancer involves many considerations. UC Davis urologic surgeons will discuss your treatment options and help you decide the best course of action. Nearly all patients diagnosed with localized prostate cancer will have the option of choosing robotic-assisted surgery. It is the now most commonly selected prostatectomy approach in the United States. Patients with significant abdominal adhesions or obesity, however, may not be appropriate candidates for the this procedure.
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Prostate Surgery Recovery Timeline
Prostate surgery recovery varies from person to person depending on how their body heals naturally and how severe the condition was prior to surgery. Here are some tips to help you through your recovery.
Prostatectomy typically requires general anesthesia and a hospital stay of 1 to 4 days. Your physician will have you walk around the day of or the day after your procedure. You may also be instructed to do little exercises while you are in the bed. All prostate cancer patients will be discharged from the hospital with a urinary catheter in place. A catheter is a thin flexible tube that is usually left in your bladder for 1 to 2 weeks to help drain your urine. Your doctor will give you specific guidelines about how to care for your catheter at home. Bladder control may be difficult for a few months after the catheter is removed. Some males will need a urinary catheter for 5 to 10 days after surgery.
Refrain from driving for 1 week after your prostate surgery. Do not drive until your catheter is removed. Also, be aware that you should not drive on prescribed pain medications unless a doctor says its ok. After one week, it should be safe to resume driving and begin most daily activities.
After Prostate Cancer Surgery
After your operation, you will wake up in the recovery room. Once its safe to do so, you usually go back to the ward. Recovery rooms and wards are busy and often noisy places that some people find strange and disorienting. You’ll feel drowsy because of the anaesthetic and painkillers.
It takes a few weeks for you to recover after your operation. You will need to spend a few days in the hospital and then give yourself time to recover once you are home. Most people can go back to normal activities between 6 to 8 weeks after surgery.
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Why Is Robotic Prostatectomy Preferred Over Brachytherapy
- No risk of getting future cancers with surgery. Radiation increases ones risk for future new cancers.
- Fewer complications. Seeds are associated with intestinal problems and bladder bleeding.
- Reduced risk of sexual problems. Radiation can kill the nerves responsible for erections. Advanced robotic surgery can preserve these nerves.
- Less risk of urinary problems. With time, radiation can damage the bladder and sphincter causing increased urinary frequency and difficulty voiding.
What Happens During Radical Prostatectomy
You will have general anesthesia during your prostate surgery. Your surgical team inserts a catheter to drain urine.
After your surgeon removes your prostate, they check it under a microscope to see if cancer has extended beyond the edge of the prostate or into the seminal vesicles or lymph nodes. If it has, the cancer may have spread. In that case, you may need other treatment.
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What Are The Advantages Of Cleveland Clinic’s Prostate Surgery Program
These procedures are performed through small key-hole incisions that do not cut muscle. Laparoscopic and robotic prostatectomy offer surgeons unparalleled visualization of the area, thus permitting precise removal of the prostate. Patients also experience significantly less blood loss. Additionally, patients benefit from:
- Reduced hospital stay after surgery and faster healing
- Less postoperative pain and virtually no need for pain medication
- Earlier removal of catheter
- Shorter recovery time
- Quicker return to normal activity and work
- Smaller “Band-aid” incisions and less scarring