| Commonly Asked Questions About Prostate Cancer Surgery | |
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Preoperatively When should I stop taking aspirin or NSAIDs (i.e. ibuprofen, aleve, naprosyn)? Seven days before surgery. It is ok to take Tylenol Is it ok to take any over-the-counter supplements prior to surgery? Do not take any vitamins, supplements, or over-the-counter supplements 10 days prior to surgery. What about other blood thinners like coumadin or plavix? You must stop these medications prior to surgery. Your surgeon and your primary care physician will determine when you should stop these medications. Which of my regular medications should I continue to take prior to surgery? You will meet with the anesthesia team prior to surgery. They will instruct you what medications you should take the days before your surgery. Should I donate my own blood prior to surgery? I usually do not tell patients to routinely donate their own blood since the risk of needing a blood transfusion after radical prostatectomy surgery is less than 1%. However, if you would like to donate your own blood for personal or religious reasons, we can arrange that for you. 24 hours before Surgery What should my diet be the day before surgery? You should not eat any solid food the day before surgery. It is important to only have clear liquids the day before surgery. You should have nothing to eat or drink after midnight the night before surgery. That means you should have nothing by mouth the morning of surgery. If you are asked to take some of your regular medications the morning of surgery, you should take these pills with only a sip of water. Is there a bowel preparation that I need to take prior to surgery? You will typically be asked to clean your bowels with magnesium citrate or Fleets phosphosoda the day before surgery. You also will be asked to give yourself an enema the night before surgery. How do I find out what time to arrive at the hospital for surgery? You should receive a call about a week prior to surgery with a check-in time. They will tell you where to show up. What should I bring with me on the day of surgery? You should bring a list of your regular medications and dosages, comfortable clothing, and toiletries. Leave all valuables at home including wedding rings and watches. Bring glasses / reading glasses if you wear them. Do not wear contact lenses. Surgery How long will I be in the hospital? Most patients go home within 24-48 hours after surgery. What can I expect in the hospital after surgery? You will be asked to begin walking the night of surgery. You will be given something to eat or drink the morning after surgery. What can I do to help myself get better after surgery? Walk, walk, walk. Walking helps to prevent many complications after prostate cancer surgery including pneumonia, blood clots, and constipation problems. Also, you will be instructed on doing breathing exercises with something called an incentive spirometer which can prevent fever and pneumonia. Postoperative Care What should my diet be after surgery? Your physician will instruct you when to resume a normal diet. After laparoscopic or robotic surgery, you should stay on liquids and soups until you begin passing gas and then can begin having solid foods and resume your normal diet. Will I have pain at home after surgery and how do I manage this pain? It is normal to have some pain and discomfort after surgery (whether open or robotic). You will be given a prescription for pain medication to take as needed. Most patients only require prescription pain medication for a few days and then only need extra strength Tylenol after that. Is it normal to have pain in my perineum (under the scrotum)? Some patients have pain in this area after surgery. It will usually subside within the first two weeks after surgery. If it does not, Advil or Aleve are usually the two most helpful medications for this type of pain/discomfort. What should I do if the catheter causes discomfort at the tip of the penis? This is usually due to friction between the catheter and the penile skin. Lubricating the tip of the penis (where the catheter comes out) with Vaseline, KY jelly, or Neosporin will help to alleviate this pain. What should I do if the pain medication seems to constipate me? Constipation is a common side effect of many prescription pain medications. Drink plenty of liquids and take only the necessary amount of prescription pain medication. You may also take prunes, mineral oil, or milk of magnesia for relief. Do not take rectal suppositories or enemas unless your surgeon has told you it is ok. How do I arrange my follow-up appointment after surgery? If you do not already have your appointment scheduled, you should call your surgeon’s office for a follow-up appointment when you get home from the hospital. What will happen at my first follow-up appointment? You will discuss your pathology with your surgeon. You also will have your catheter removed. What should I bring with me to my first follow-up appointment? Please wear briefs (not boxer shorts) and bring some type of incontinence pad (i.e. Depends, Poise, or store name brand) to your first visit. These pads are available at your local grocery or drug store. Catheter and Urinary Control Do I have to go home from the hospital with a catheter? Yes. The catheter is very important to allow things to heal on the inside. It must remain in place for about one-two weeks. Who teaches me how to take care of my catheter? You will be taught how to care for your catheter by your nurse prior to discharge from the hospital. You will be given a leg bag to wear to make it easier to move around while the catheter is in place. Is it normal to have some blood in the urine or around the catheter? Yes. It is common and normal to have some blood in the catheter bag or some blood that comes out around the catheter. As long as there is urine that is draining into the catheter bag, there is usually no problem. Is it normal to have some urine drain around the catheter? Yes. This is also common. The bladder will not uncommonly spasm causing the sensation to urinate (sometimes even slight pain in the bladder area) and resulting in urine spillage around the catheter. What should I do if the catheter gets stopped up or is not draining? You should call your surgeon’s office for further instructions. What if another physician (i.e. an emergency room doctor) wants to take my catheter out? Your catheter should only be removed by your urologist’s office or another urologist if your surgeon says it is ok. Do not let any other kind of doctor remove or change your catheter unless they have spoken with your surgeon. Is it good to drink lots of fluids? It is important to drink plenty of fluids and stay well hydrated. When will my catheter be removed? Usually 7-14 days. Who will remove my catheter? Your surgeon or a nurse at your surgeon’s office. Will I leak urine when my catheter is removed? Yes. All patients leak initially after the catheter is removed. What do I do about the leakage after the catheter is removed? You will need to wear a protective pad until your urinary control returns. Should I bring a pad with me to my first post-operative visit? Yes. You should bring a pad of some type and wear briefs to hold the pad in place. How long will I need to wear a pad? Each patient is different. While most patients no longer need pads by three-six months after surgery, others will take longer for their urinary control to return. Can I do exercises to improve my urinary control? Yes. You will be instructed on how to perform Kegel’s exercises which can help your urinary control to return quicker. Activity Is it important to walk much after surgery? This is the most important thing to do after you get home from surgery. Walking will help to prevent complications after surgery particularly blood clots. Each day you should walk every couple of hours during the daytime once you get home. What are my activity restrictions after surgery? You should not do any heavy lifting (nothing over 10 pounds) or any strenuous activity for six weeks after surgery. If you have any specific questions about activity, ask your surgeon before attempting that activity. How do I know if I’ve pushed myself too much? Weakness, dizziness, fatigue, nausea, and feeling flushed may be some symptoms associated with doing too much. If you feel like you have pushed yourself too much, you probably have. When can I drive? You should usually wait at least two-three weeks. You should be having no more pain and, of course, not be taking any prescription pain medication before you resume driving. You should not drive while you have a catheter. When can I return to work? You may return to light duty or desk work (no heavy lifting or strenuous activity) when you feel like you have the energy to do so. If your job requires any heavy lifting or strenuous activity, you should wait six weeks. Sexual Function Should I use medications like Viagra, Cialis, or Levitra after surgery? Sometimes, it can be helpful to take medications like these to help erections return. Your surgeon will discuss when and how often to take these medications in the period after surgery. When can I have sexual intercourse? You may have intercourse as soon as you are comfortable enough to do so. Remember that you should not do any heavy lifting or anything strenuous for six weeks and so intercourse should be appropriately tailored during that time. If I am having erections without Viagra, Cialis, or Levitra, do I have to take these medications? No, although they may still be helpful. For men who regain erectile function, how soon will erections recover? Your recovery of sexual function after surgery depends on many variables including how good your erectile function was prior to surgery, your age, and whether you underwent a nerve-sparing procedure. Your surgeon will discuss your individual situation with you. It is important to know that the return of erectile function is a gradual process and usually takes longer than urinary control to return. It can even take up to 12-18 months before erections are as good as they will be. What will my erections be like after surgery? Many men can have erections that are very good for sexual intercourse after surgery. However, your erections are usually never quite as good as they were before surgery. Therefore, many men like to take medications like Viagra, Cialis, and Levitra to help improve their erections after surgery. What if I cannot get erections after surgery even with Viagra, Cialis, or Levitra? There are many other options for treatment of erectile dysfunction. These are more invasive treatment methods but can be quite effective. Your surgeon will discuss these in detail with you if necessary. Will my erections be shorter after surgery? Sometimes, men may see that their penis appears shorter after surgery. This does not mean your erections will necessarily be shorter. Can I have children after having prostate cancer surgery? You should not expect to have children naturally after surgery. During prostate cancer surgery, your vas deferens is divided. In other words, you undergo a vasectomy as part of this procedure. If you are concerned about not being able to have children after surgery, you should discuss this with your surgeon BEFORE surgery. HOPEFULLY, THIS HAS ANSWERED MANY OF YOUR QUESTIONS. PLEASE DO NOT HESITATE TO ASK YOUR SURGEON OR NURSES ANY OTHER QUESTIONS THAT YOU MAY HAVE. |
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