Radical prostatectomy
Discharge instructions
The prostate is a walnut-sized gland that forms part of the male reproductive system. The
gland is made of two lobes, or regions. As the diagram shows, the prostate is located in
front of the rectum and just below the bladder, where urine is stored. The prostate also
surrounds the urethra, the canal through which urine passes out of the body.
Doctors do not know all of the prostate’s functions.
One of its main roles, though, is to squeeze fluid
into the urethra as sperm move through during
sexual climax. This fluid, which helps make up
semen, energizes the sperm and makes the vaginal
canal less acidic.
The seminal vesicles are smaller glands (not shown
here) that are attached to the prostate. They also add
fluid to the semen during ejaculation.
You have had an operation called a radical
prostatectomy. During this operation, your prostate
gland and seminal vesicles were removed. You may
or may not have had lymph node tissue removed as well.
Please follow these instructions as you recover from your surgery. If you have any
questions, please be sure to ask your nurse or doctor.
Pain and swelling
 Most patients have a gradual reduction in pain during the week following surgery.
Once you are at home, your pain may be well controlled during the day with medicine
such as ibuprofen (Motrin). You will be given a prescription for stronger pain
medicine to take if you need it. It may be helpful to take the stronger medicine at
night for a while so you can rest.

As you become more active, certain movements may cause pain. Increase your
activity gradually. Don't do anything that causes a great deal of pain. Rather, work at
doing a bit more day by day. If your activity is severely limited because of pain,
please notify your surgeon.

If your pain does not gradually get better, or if you have a sudden increase in pain,
please call your surgeon.

You may notice that your penis and scrotum are swollen. Some men have swelling in
the legs and ankles as well. This should decrease in 1-2 weeks. When you are lying
down, try raising your legs on pillows and putting a towel under your scrotum. This
may help the swelling to go down more quickly.

You may also have a sore throat because of the tube that was in your throat during
surgery. This discomfort should pass quickly.
Your incision
 You have a small incision in your lower abdomen. It is normal to feel a firm ridge
under the incision. Over the next 6-18 months, the incision will fade.

If you have skin staples, there might be minor irritation around the staples.

The dressing over the incision is usually removed about 2 days after your surgery. It
is OK to leave your incision uncovered after this. Or, if it is more comfortable, you
may keep a dry dressing over the incision. Please do not put any ointments on the
wound unless your surgeon tells you otherwise.

You may see a small amount of clear or slightly red drainage coming from the
wound. This is normal. If you have a lot of drainage, you should let your surgeon
know.

If you have steri-strips (small paper strips) over the incision, they can be removed in
one week.

You may shower. Please do not take a tub bath until after you see your doctor at your
next appointment.
Activity
 You will probably feel tired for some time after you go home. You may nap
frequently, and simple tasks may exhaust you. This is normal and should pass within
a few weeks. Use this time to rest and recover, gradually increasing your activity each
day.

Sitting upright may be a little uncomfortable for a while. Avoid sitting for long
periods on any hard or narrow seat, such as an exercise bicycle seat or a bar stool. If
you must sit, try to lean back into a reclining position if you can.

You may find your sleep is disturbed while you are less active. You may sleep during
the day and be awake at night. This should get better once you become more active.

Please do not drive for at least 3 weeks after surgery. Because of discomfort from
your surgery, you may not be able to respond quickly enough in an emergency. This
is especially true if you are taking strong pain medicine. After 3 weeks, drive only if
your pain is well controlled, and you are not taking pain medicine that makes you
drowsy.

Please do not lift anything weighing more than 20-25 pounds for three weeks. (This is
about the weight of a briefcase or a bag of groceries.) This applies to lifting children,
although they may sit on your lap.

You may start light exercise, such as taking a walk or walking on a treadmill, as soon
as you feel ready. Please do not do any heavy exercise until 6-8 weeks after surgery.

You may shower, climb stairs, and go outside.

Do not swim until 4 weeks after surgery.

Please do not travel long distances until you see your doctor at your next
appointment.
Eating and drinking
 There are no restrictions on eating and drinking.

You may find that you don't have much appetite. This is a normal reaction to surgery
and should pass quickly. Keep your strength up by eating small amounts of nutritious
foods more frequently throughout the day.
Your bowels
 Constipation is a common side effect of medicine such as Percocet or codeine. If
needed, you can take a stool softener (such as Colace, one capsule) or gentle laxative
(such as Milk of Magnesia, 1-4 tablespoons) once per day. You can get both of these
medicines without a prescription.

To try to avoid constipation, work toward using strong pain medicine only at night.
During the day, take acetaminophen and/or ibuprofen to control pain.

Please do not use a suppository in the rectum or an enema. The lining of your rectum
is thin after this operation, and you could damage the area.

If you go 48 hours without a bowel movement, or have pain moving the bowels, call
your surgeon.
Your catheter
 You will be discharged with a Foley catheter. This is a small rubber tube that is in
your bladder. Your urine drains out through the tube.

In general, the urine will be clear. But you may see small blood clots in the urine, or
small amounts of blood in the urine. This is normal.

Please call your surgeon if:
 you see many large clots
 you see a lot of blood
 urine stops draining from the catheter

In rare cases, the catheter falls out. If this happens, please call your surgeon.

Your nurse will give you instructions on caring for your catheter at home. If you have
questions, please ask your nurse.

Your catheter will be removed at your next appointment with your surgeon. It will not
hurt when it is removed.

Often, there is some leaking of urine after the catheter is removed. For your comfort,
please bring an incontinence pad (such as Depends) with you to your appointment.
For most patients, urinary leakage will improve in two to four months.
Medications
 Take all the medicines you were on before the operation just as you did before, unless
you have been told differently.

You will go home with prescriptions for pain medicine. Please make sure you
understand how to take this medicine. If you do not, ask your nurse or surgeon.

You will also go home with a prescription for an antibiotic. This should be started the
night before your catheter is being removed.

Please ask any questions you may have about medication before you go home.
Your next appointment
Please make sure you have an appointment to come back and see your surgeon. If this
appointment has not already been made, please call your surgeon's office to schedule
your appointment.
Danger signs
Please call your doctor if you have any of the
following. You may call 24 hours a day, 7 days a
week.
 worsening abdominal pain
 fever of 101 or more
 vomiting
 increased drainage coming from the incision
 no urine draining from the catheter
 large amounts of blood in the urine
 a lot of large blood clots in the urine
 pain or a feeling of fullness in the bladder
 a lot of leaking around the catheter tip (a small amount is normal)
 your catheter falls out
This material was prepared by clinicians from the departments of urology, surgery, and nursing at Beth Israel Deaconess Medical Center. It is
produced and distributed by The Beth Israel Deaconess Learning Center. ©2006, Beth Israel Deaconess Medical.
MC0855 Rev. 2/06