2014
Radical
Prostatectomy
Radical Prostatectomy
What is a radical prostatectomy?
During a radical prostatectomy, the entire prostate
gland, the part of the urethra that it surrounds, and
the seminal vesicles are removed. The tissue is sent
to the lab for testing. Your doctor will talk about the
results with you a few weeks after the surgery.
What is a prostate gland?
The prostate makes a fluid that helps sperm move
and gives nourishment for the sperm. It is about the
size of a walnut. The prostate gland is found just
under the bladder. It surrounds the urethra (tube
that carries urine (pee) out of the bladder).
Bladder
Prostate
gland
Urethra
Testicle
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Before your surgery
• We will teach you deep breathing, leg, and
Kegel exercises. We will teach you how to use an
incentive spirometer. This tool is used after your
surgery to help prevent breathing problems.
• You will have a catheter (hollow tube to drain
urine) in place for up to 3 weeks. We will teach
you how to care for your catheter.
• You will have an incision (cut) in your lower
abdomen (stomach). Hair will be shaved from this
area in the Operating Room. This hair will grow
back in a few months.
• Your stomach must be empty before your surgery.
The night before your surgery, you should only
drink clear fluids (fluids you can see through,
no milk or cream in your tea or coffee) between
supper and midnight. After midnight, you should
not eat or drink anything.
• Please tell your doctor or nurse at least 1 week
before your surgery if you are taking Aspirin®,
anti-inflammatory medication (medication usually
used for arthritis), warfarin, vitamin E, garlic
extracts, and any other medication that might be a
blood thinner.
• Please read the pamphlet Planning for Your
Hospital Stay After Surgery.
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After your surgery
Control of discomfort and/or pain
You will feel soreness or pain, but this is OK. Pain
medication will be given to you regularly. Stronger
medication is available if you need it. Ask your nurse
for medication before the pain becomes severe (too
much to handle). Your nurse will encourage you to
get up and walk every day, even on the day of your
surgery. This is very important because it will help
you heal faster and will help prevent complications.
Nutrition
You will get clear fluids after your surgery. An
intravenous (IV) will give the extra fluids you need.
The doctor or nurse will tell you when you can start
eating a regular diet. Most patients are able to eat
their usual diet the first day after surgery. Your IV
will be removed when you are drinking well.
Incision (cut)
• A small bandage will cover the incision. It will be
changed during your hospital stay as needed.
• You may have a special drain beside the incision
for a few days. The doctor or nurse will take it out
in 1-2 days.
• Your staples or stitches will be removed in 7-10
days. If you do not have a follow up appointment
with your urologist within this time, you will need
to make an appointment with your family doctor to
have the staples removed.
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• You may shower when you feel stronger, but not
until the drain is removed. Do not let the water
pound on your incision.
• Do not soak in a bath for about a week after
surgery or until your staples are removed.
• You may see some swelling and bruising on your
penis and scrotum. This is normal. The swelling
will go down over the next few weeks.
Catheter
• You will have a
catheter (hollow
tube to drain
urine).
• It will be
connected to a
drainage bag. The
bag can hang on
the side of your
bed or be carried
when you are
walking.
• You will get a
smaller drainage
bag (called a ‘leg’
bag) to use when
you are walking. This leg bag straps to your leg
and fits neatly under your pants.
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• You will go home with your catheter in place. It
will be connected to the leg bag.
• Your nurse will give you a larger bag to use
overnight.
• Your nurse will teach you how to care for your
catheter and drainage bags.
• It is OK to see some blood in the urine. Do not
worry as this is not dangerous.
• It is also OK to see some urine, blood, or
discharge (sometimes looking like pus) coming
from between the catheter and the urine tube.
This is a sign that the area of the bladder and
urethra is healing. Sometimes, patients have
bladder spasms (muscle gets tight and does not
relax) with squirts of urine coming out through
the same area. This is your bladder reacting to the
catheter.
• There are usually not any problems with the
catheter. Rarely, it may become blocked by blood
clots. If this happens, you will have to go to an
Emergency Department to have it flushed.
• Your nurse will give you a pamphlet, Care of
Your Urinary Catheter at Home to refer to for
reassurance.
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• If you do have to go to the Emergency Department
and the nurse or doctor has any trouble helping
you, he/she should call the urology resident on call
before removing or trying to replace the catheter:
›› QEII 902-473-2220
›› Dartmouth General 902-465-8300
Length of stay in hospital
You can expect to be in hospital for 2 days after your
surgery if you do not have any problems. Before you
go home, you will get instructions as to when your
staples and catheter should be removed.
Care at home
Healthy eating
• It may take a while for your appetite to return to
normal. During this time, it will help to eat smaller
meals more often. Eating healthy meals will help
you heal faster.
• Eat foods high in fibre (such as bran cereals,
whole wheat bread, green leafy vegetables, and
fresh fruit).
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• Drink plenty of water. Watch for constipation.
›› It is important not to strain with bowel
movements.
›› Do not get an enema. Remember, you do not
need to have a bowel movement every day to
be healthy.
Activity
• Take it easy the first few days at home. Don’t try
to do too much. Over time, walk farther distances,
from around the yard, to around the block, and
finally around your community. You may find that
you get tired easily and may need extra rest. Your
energy will come back with time.
For the next 6 weeks:
›› Do not lift anything over 10 pounds.
›› Avoid strenuous (hard) activities (such as
sports, mowing the lawn, and shoveling snow).
• Your doctor will let you know when it is safe to
drive your car again. This is usually within a few
weeks.
• Returning to work will depend on your general
health and recovery, as well as what type of work
you do. Talk about this with your doctor.
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Medication
• Take your medication as told by your doctor.
• Do not drink alcohol while taking pain pills.
Common questions
Will I be incontinent?
• Incontinence is the loss of control of your bladder.
It is OK to have this after the catheter is removed
2-3 weeks after your surgery.
• When your catheter is taken out, you can expect
dribbling or even constant leakage of urine. You
should take some incontinence pads (such as
Depends®, or Tena® pads) with you for your trip
home.
• At first, you will need a big pad. Over the next
few days to several weeks, you should be able to
switch to smaller pads. Your nurse or pharmacist
will be able to give you information on the types of
pads to buy.
• Try to exercise the muscles that help you hold your
urine. This may help you get back control of your
urine more quickly. The muscles that need to be
exercised are those that you use to give those last
few squirts of urine or to stop from passing gas.
Repeatedly squeezing and relaxing these muscles
(Kegel exercises) will make them stronger over
time.
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• It will take time for you to get back the control of
your urine. Typically, a man will be incontinent
during the week or two after the catheter is
removed.
The expected pattern of urinary incontinence is as
follows:
›› First, at rest and with any movement.
›› Second, leakage with movement but dry at
night or at rest.
›› Third, loss of urine with exertion or coughing.
›› Finally, complete control of your urine.
The length of time for a man to go through these
stages is different for everyone. It ranges from
several weeks to 6 months or more.
Will I be impotent or have erectile dysfunction (ED)?
Impotence or ED is when a man has trouble getting
or keeping an erection. This is a common problem
after this type of surgery. If often gets better on
its own but if it does not, there are treatments
available. Your doctor and/or nurse can talk about
this with you.
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Prostate cancer information and/or support
groups
There is a Hospital Visitation Coordinator available.
if you would like to speak the Coordinator before
leaving the hospital, please ask your nurse.
Support group - Halifax Region
Prostate Cancer Canada - Atlantic Region
Meetings:
This group meets on the 3rd Thursday of every
month (except July and August) at 7 p.m. You are
invited to come and bring a friend or family member.
Location:
5121 Sackville Street, Halifax, N.S.
For more information, contact Prostate Cancer
Canada - Atlantic Region at 902-420-1444 or visit
their website at www.prostatecancer.ca
Support groups outside Halifax
There are several support groups around the
province. Visit www.prostatecancer.ca to find a
contact person and the location of meetings in your
area.
Additional support
Canadian Cancer Society, N.S. Division
1-800-639-0222
Cancer Information Service of the Canadian Cancer
Society
1-888-939-3333
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Report these symptoms to your doctor:
• Fever and/or chills.
• Redness, swelling, or warmth around the
incision.
• Drainage from the incision.
• Separation of the edges of the incision.
• Increasing pain and tenderness around the
incision.
• Increased blood with clots in the urine and no
drainage from the catheter.
If you need to see a doctor, please contact your
family doctor or go to the nearest Emergency
Department unless otherwise instructed by your
Urologist.
If you have any questions, please ask.
We are here to help you.
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Notes:
Looking for more health information?
Contact your local public library for books, videos, magazines, and other resources.
For more information go to http://library.novascotia.ca
Capital Health promotes a smoke-free and scent-free environment.
Please do not use perfumed products. Thank you!
Capital Health, Nova Scotia
www.cdha.nshealth.ca
Prepared by: Urology Nursing Education Committee, QEII, Halifax ©
Revised by: Urology Practice Council
Illustrations by: LifeART Super Anatomy 1 Images, Copyright © 1994,
TechPool Studios Corp. USA; Staff at Capital Health
Designed by: Capital Health Library Services, Patient Education Team
Printed by: Dalhousie University Print Centre
The information in this brochure is provided for informational and educational purposes only.
The information is not intended to be and does not constitute healthcare or medical advice.
If you have any questions, please ask your healthcare provider.
WJ85-0245 Revised August 2014
The information in this pamphlet is to be updated every 3 years.