Following your surgery, you will be taken from the operating room to recovery, an area in the operating theatre where patients are monitored very carefully immediately following a surgical procedure. Your first memory after the surgery will be waking up in recovery.
You will have a catheter in your bladder draining urine into a bag, and the amount of urine you pass will be measured over the first night to make sure you are receiving adequate fluids. The urine is often blood-stained. During your hospital visit, the urine will clear to yellow but you may have some blood in the urine intermittently for some weeks after the procedure.
You will have a wound drain that exits from the abdomen. This is usually kept in for one day following the surgery, preventing build-up of pressure from any wound ooze. It also avoids the body reabsorbing any excess fluids.
Until you are drinking adequately, you will receive intravenous fluids (usually the next day). You will also receive antibiotics through the drip to prevent any infection.
Once you are mobilising safely, are able to care for your catheter and your pain is well controlled on appropriate tablets taken by mouth, you will be able to go home. Your bowels may be slow to recover normal function after the surgery and occasionally you will be allowed to go home without having passed a bowel motion in hospital.
The following can be expected after a Robotic Prostatectomy:
Shoulder pain
This is very common and occurs in most patients for the first 24 hours after the procedure. It occurs as a result of the distension of the abdomen caused by the gases during the operation. It is usually relieved by simple analgesia i.e. Panadol or anti-inflammatory medications such as Celebrex.
Scrotal and penile swelling
Together with bruising, this may appear immediately after surgery or within 4 – 5 days. Any scrotal swelling will resolve in 7 -14 days. If scrotal swelling occurs, it can reduced by elevating the scrotum on a small towel that you have rolled up when you are sitting or lying. Even with the catheter in place, it is recommended that you wear supportive underwear.
Bloody drainage
It is not uncommon to have bloody drainage around the catheter or in the urine, especially after increasing activity or following a bowel movement. Resting for a short period usually improves the colour of the urine. Sometimes there can be intermittent bleeding in the urine even after the catheter is removed. This should be pale red and fairly clear, however if you have any concerns, please contact Dr Swindle. It is important to drink more fluids if there is blood in the urine to help keep it diluted.
Leaking
Leaking around the catheter is fairly common, especially on straining or with a bowel movement. If this happens, you may need to wear a small pad inside your underwear for protection.
Bladder spasms
These present as mild to severe pain or cramping in the lower abdomen and the sudden need to urinate. These are infrequent and are caused by irritation of the bladder from the surgery and by the catheter resting against the bladder wall. Let the nursing staff know if you have these troubles as mostly these can be relieved with appropriate medications and will lessen in time.
If the spasms remain bothersome, a bladder relaxant medication such as Detrusitol or Ditropan pills may be used. These pills often cause a dry mouth and if used in excess, can make it difficult to focus your vision. These symptoms disappear when you lower the dose or stop the medication.
Perineal pain
This occurs between your scrotum and your rectum or in your testicles and may last for several weeks after surgery, though it will resolve. Simple pain medications such as Paracetamol or Celebrex should relieve the discomfort, however please contact Dr Swindle if the pain medication does not alleviate the problem.
Swelling
Swelling pertaining to the lower legs or ankles can occur in both legs and should resolve in around 7 – 14 days. It will help if you are able to elevate your legs while sitting. Should swelling in the legs be uneven, and associated with redness or pain, please contact Dr Swindle quickly as this can be a symptom of a blood clot in the leg.
Weight gain
Weight gain is temporary and due to shifts in gas and fluid. Your weight should be back to your pre-operative weight in approximately 5 – 7 days.
Frequent urination
For some men frequent urination is common for the first few months after the operation. The bladder takes time to fill out again after it has been kept empty by the catheter for a week or so. As the bladder is able to hold more urine at lower pressure, your control will improve. Sometimes a prescribed medicine helps the bladder relax and hold more urine.
