Transurethral Resection of the Prostate

Care After

Refer to this sheet in the next few weeks. These discharge instructions provide you with general information on caring for yourself after you leave the hospital. Your caregiver may also give you specific instructions. Your treatment has been planned according to the most current medical practices available, but unavoidable complications sometimes occur. If you have any problems or questions after discharge, please call your caregiver.

HOME CARE INSTRUCTIONS

Medications

  • You will receive medicine for pain management. As your level of discomfort decreases, adjustments in your pain medicines may be made.

  • Since it is important that you do deep breathing and coughing exercises and increase your activity, it may be helpful to take pain medicines prior to these activities. Take all medicines as directed.

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

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:

  • Straining.

  • Running.

  • Strenuous work.

  • Walks longer than a few blocks.

  • Riding for extended periods.

  • Sexual relations.

  • Do not lift heavy objects (more than 5 pounds/2.25 kilograms) for at least 1 month. When lifting, use your arms instead of your abdominal muscles.

  • You will be encouraged to walk as tolerated. Do not exert yourself. Increase your activity level slowly. Remember that it is important to keep moving after an operation of any type. This cuts down on the possibility of developing blood clots.

  • Your caregiver will tell you when you can resume driving and light housework. Discuss this at your first office visit after discharge.

Diet

  • No special diet is ordered after a TURP. 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 irritate the bladder. Decaffeinated drinks are okay.

  • Avoid spicy foods.

Bladder Function

  • For the first 10 days, empty the bladder whenever you feel a definite desire. Do not try to hold the 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 and reduce your activity.

Bowel Function

  • You may experience some constipation after surgery. This can be minimized by increasing fluids and fiber in your diet. Drink enough water and fluids to keep your urine clear or pale yellow.

  • A stool softener may be prescribed for use at home. Do not strain to move your bowels.

  • If you are requiring increased pain medicine, it is important that you take stool softeners to prevent constipation. This will help to promote proper healing by reducing the need to strain to move your bowels.

Sexual Activity

  • Semen movement in the opposite direction and into the bladder (retrograde ejaculation) may occur. 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. Retrograde ejaculation and reduced semen discharge should not reduce one's pleasure of intercourse.

Postoperative 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 activities. Your caregiver will inform you when you can return to work.

Foley Catheter Care

A soft, flexible tube (Foley catheter) has been placed in your bladder to drain urine and fluid. Follow these instructions:

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 long soaking baths. Your caregiver will give instructions about showering.

  • Wash your hands before touching ANYTHING related to the catheter or bag.

  • Using 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.

  • NEVER wipe upward as this could sweep bacteria up into the urethra (tube in your body that normally drains the bladder) and cause infection.

  • Place a small amount of sterile lubricant at the tip of the penis where the catheter is entering.

Taking Care of the 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.

  • Keep the drainage bag well below the level of your bladder. This prevents backflow of urine into the bladder and allows the urine to drain freely.

  • Anchor the tubing to your leg to 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 to make sure there is no pressure on the tubing which could restrict the flow of urine.

Changing the Drainage Bags

  • Cleanse 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 spill.

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

Cleaning the Drainage Bags

  • 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 for 30 minutes in a solution of white vinegar and water (1 cup vinegar to 1 quart warm water).

  • Rinse with warm water.

SEEK MEDICAL CARE IF:

  • You have chills or night sweats.

  • You are leaking around your catheter or have problems with your catheter. It is not uncommon to have sporadic leakage around your catheter as a result of bladder spasms. If the leakage stops, there is not much need for concern. If you are uncertain, call your caregiver.

  • You develop side effects that you think are coming from your medicines.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You are suddenly unable to urinate. Check to see if there are any kinks in the drainage tubing that may cause this. If you cannot find any kinks, call your caregiver immediately. This is an emergency.

  • You develop shortness of breath or chest pains.

  • Bleeding persists or clots develop in your urine.

  • You have a fever.

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

  • You develop pain or swelling in your legs.

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

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.