Prostate Removal Care

Your doctor may do the following:

• Physical exam
• Blood and urine tests
• Chest Electrocardiogram (ECG, EKG)-a test that records the heart's activity by measuring electrical currents through the heart muscle
• Ultrasound -a test that uses sound waves to visualize the inside of the body
• Bone scan or CT scan , if your doctor is concerned about a spreading cancer

Leading up to the procedure:

• Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
  • Aspirin or other anti-inflammatory drugs
  • Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
• The night before, have a light meal. Do not eat or drink anything after midnight.

General or spinal anesthesia will be used. With general anesthesia, you will be asleep. Spinal anesthesia will make a section of your body numb.

The procedure can be done as an open, laparoscopic , or robot-assisted surgery.

The doctor makes an incision in the lower abdomen to access the prostate. The doctor removes the inner part of your prostate gland. This procedure is not as common in the United States. It is considered when you have a non-cancerous enlargement of the prostate.

The doctor makes a cut in the lower abdomen between the navel and pubic bone. This allows him to access the prostate and pelvic lymph nodes. The doctor detaches the prostate from the bladder and urethra. The urethra is then re-attached to the bladder. The doctor will try to preserve nerve function related to bladder function and erections. In some cases, the doctor will remove lymph node tissue for testing before deciding to continue with surgery.

The doctor makes a cut in the skin between your anus and your scrotum. He then removes your prostate. This type of surgery is less common since it does not allow access to the lymph nodes. There is a higher risk of nerve damage with this procedure.

The doctor makes five small, keyhole incisions in the abdomen for robotic arms, including one with a small camera (laparoscope). This gives him a wider and more flexible range of motion. A doctor sits at a console and guides the robotic arms during the surgery. With these arms, he can cut out the prostate and other tissue. Benefits include less scarring.

A catheter tube will be inserted to drain your bladder. Water may be flushed through the catheter to reduce blood in the urine. The catheter may be left in place for up to 3 weeks. This will let you urinate more easily during the healing period. After a radical prostatectomy, a drain may be left in place to help fluid drain from the surgery site.

• Simple prostatectomy-2-4 hours
• Radical prostatectomy-2-4 hours

Anesthesia prevents pain during the procedure. You can expect some pain and discomfort for:

• 7-10 days after open surgery
• 3-4 days after laparoscopic surgery

The usual length of stay is 2-3 days. Your doctor may choose to keep you longer if complications arise.

When you return home, do the following to help ensure a smooth recovery:

• Take medicines as directed.
  • Your doctor may give you antibiotics to prevent infection and/or stool softeners to prevent constipation .
  • You may need to take a medicine for several weeks to normalize your bladder function.
  • For a while, you may need prescription pain medicines. You will then be switched to non-prescription pain relievers (eg, acetaminophen ) as needed. Avoid taking aspirin or aspirin-containing products.
• When resting in bed, keep legs elevated and moving. This will help to prevent blood clots from forming in your legs.
• To promote healing, resume normal activities as soon as possible.
• Drink plenty of liquids. It will help to clear your bladder of urine and blood.
• Shower as usual. Avoid baths until the incision has healed completely.
• Wash the incision gently with mild soap and water.
• Do not drive unless your doctor has given you permission to do so. You may need to wait up to one month.
• Avoid vigorous exercise for six weeks after surgery.
• Resume sexual activity when able.
• Avoid caffeine, alcohol, spicy foods, or any other food or drink that might aggravate your stomach, intestines, bladder, or urinary tract.
• Be sure to follow your doctor's instructions .

Complete healing from surgery usually occurs within six weeks.