Laparoscopic Prostatectomy

Care After

Refer to this sheet in the next few weeks. These instructions provide you with information on caring for yourself after your procedure. Your caregiver may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your caregiver if you have any problems or questions after your procedure.

HOME CARE INSTRUCTIONS

Medications

  • You will receive medications for pain management.

  • It is important that you do coughing and deep breathing exercises and increase your activity. It may be helpful to take pain medications prior to these activities. Take medications as directed.

  • You may be given a medicine to kill germs (antibiotic) to take following surgery. Finish all medications. Let your caregiver know if you have any side effects or problems from the medication.

Hygiene

  • You can take a shower after surgery.

  • You should not take a bath while you still have the urethral catheter.

Activity

  • You will be encouraged to get out of bed as much as possible and increase your activity level as tolerated.

  • Spend the first week in and around your home.

For 10 days, avoid the following:

  • Lifting.

  • Straining.

  • Running.

  • Strenuous work.

  • Walks longer than a couple blocks.

  • Riding in a car for extended periods.

  • Sexual relations.

  • DO NOT lift more than 5 to 10 pounds for at least 1 month.

  • Walk as tolerated. DO NOT exert yourself. Increase your activity level slowly. It is important to keep active after an operation of any type. This cuts down on the possibility of developing blood clots.

Diet

  • No special diet is ordered after a laparoscopic prostatectomy. However, if you are on a special diet for another medical problem, it should be continued.

  • Normal fluid intake is usually recommended.

  • Avoid alcohol and caffeinated drinks for 2 weeks. They are irritating to the bladder. Decaffeinated drinks are fine.

  • Avoid spicy foods.

Bladder Function

  • For the first 10 days, empty the bladder whenever you feel the desire. DO NOT try to hold urine for long periods of time.

  • Urinating once or twice a night even after you are healed is not uncommon.

  • You may see some recurrence of blood in the urine after discharge from the hospital. If this occurs, force fluids again as you did in the hospital.

Bowel Function

  • Constipation after surgery can be minimized by increasing fluids and fiber in your diet.

  • A stool softener may be prescribed or recommended. DO NOT strain to move your bowels. This increases the chances of bleeding.

Foley Catheter Care

On the day of the operation, a soft, thin, flexible rubber tube (Foley catheter) is passed through the urethra and into the bladder in order to drain urine and fluid. Do the following to care for your Foley catheter at home:

Taking Care of the Catheter

  • Keep the area where the catheter leaves your body clean.

  • Attach the catheter to the leg so there is no tension on the catheter.

  • Keep the drainage bag below the level of the bladder; BUT keep it off the floor.

  • Do not take baths. Your caregiver will give instructions about showering.

  • Wash your hands before handling the catheter or bag.

  • Use mild soap and warm water on a washcloth.

  • Clean the area closest to the catheter insertion site using a circular motion around the catheter.

  • Clean the catheter itself by wiping AWAY from the insertion site for several inches down the tube.

  • The urethra is the tube that drains the bladder. This can be a channel where bacteria can go along the catheter into the bladder and cause infection.

  • Keep a small amount of sterile lubrication at the junction of the tip of the penis and the catheter. This will allow the tube to move slightly in and out without rubbing the tip of the penis.

Taking care of Drainage Bags

  • Two drainage bags will be taken home - a large overnight drainage bag and a smaller leg bag, which fits underneath clothing.

  • It is okay to wear the overnight bag at any time, but NEVER wear the smaller leg bag at night. It must be changed for the larger bag.

  • Keep the drainage bag well below the level of your bladder. This prevents back flow of urine into the bladder and allows the urine to drain freely. This helps prevent infection.

  • Anchor the tubing to your leg. This helps prevent pulling or tension on the catheter. Use tape or a leg strap provided by the hospital.

  • Empty the drainage bag when it is 1/2 to 3/4 full. Wash your hands before and after touching the bag!

  • Periodically check the tubing for kinks or pressure on the tubing which could stop the flow of urine.

Changing the Drainage Bags

  • Clean both ends of the clean bag with alcohol before changing.

  • Pinch off the rubber catheter to avoid urine spillage during the disconnection.

  • Disconnect the dirty bag and connect the clean one.

  • Empty the dirty bag carefully to avoid a urine spills.

  • Attach the new bag to the leg with tape or a leg strap.

Cleaning the Drainage Bag

  • Whenever a drainage bag is disconnected, it must be cleaned quickly so it is ready for the next use.

  • Wash the bag in warm, soapy water.

  • Rinse the bag thoroughly with warm water.

  • Soak the bag in a solution of white vinegar and water - 1 cup vinegar to 1 quart warm water for 30 minutes.

  • Rinse with warm water.

Sexual Activity

  • It is important to know that semen movement in the opposite direction and into the bladder (retrograde ejaculation) occurs. Since the semen passes into the bladder, cloudy urine can occur the first time you urinate after intercourse. Or, you may not have an ejaculation during erection. Ask your caregiver when you can resume sexual activity.

Post-Op Visit

  • Arrange the date and time of your after surgery visit with your caregiver.

Return to Work

  • After your recovery is complete, you will be able to return to work and resume all of the activities that you participated in before surgery. Your caregiver will inform you when you can return to work.

SEEK MEDICAL CARE IF:

  • There is redness, swelling, or increasing pain in areas of the wounds.

  • You notice pus coming from a wound.

  • You have chills, fever, night sweats or an unexplained oral temperature above 102° F (38.9° C) develops.

  • You notice a foul smell coming from a wound or dressing.

  • There is a breaking open of the wound (edges not staying together) after sutures or staples have been removed.

  • You are leaking around your catheter or have problems with your catheter.

  • You develop side effects which you think are coming from your medications.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You are suddenly unable to urinate. This is an emergency.

  • You develop shortness of breath or chest pains.

  • Bleeding persists or clots develop.

  • An unexplained oral temperature above 102° F (38.9° C) develops.

  • You develop pain in your back or over your lower belly (abdomen).

  • You develop pain or swelling in your legs.

  • You notice swelling of your abdomen or sudden weight gain.

  • Any problems you are having get worse rather than better.