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Recovery After Robotic Prostate Surgery

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Tom Had a Quick Recovery after Robotic Prostate Surgery at NWH

Going through prostate cancer and having your prostate removed can be a physically and emotionally trying time in life. Many men are unprepared for the extent to which they may experience bladder leaks after prostate removal and it can be disheartening to have undergone surgery only to experience a loss of bladder control for a period afterward.

Fortunately, this is usually resolved within a year. During that time though, you may find that you need someone to talk to about your experience. Finding a forum or message board filled with people who can relate can help ease some of the tensions that you may be going through.

The NAFC message boards are a great way to connect with others who may also be experiencing incontinence, due to prostate surgery or other conditions. Theyre free to join and the forum is anonymous so you can speak freely without the worry of feeling embarrassed or ashamed. NAFC is proud of this amazing group of individuals who visit the forums and courageously share their stories, offer support, and provide inspiration to each other. We encourage you to check it out!

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You Can Resume Your Normal Life As Soon As 2 Weeks After Robotic Prostatectomysex Beyond Prostate Cancer Therapy

Although the first goal of prostate cancer therapy is to rid the body of all cancer, the ability to resume a normal life after prostate surgery is another equally important issue. The possibility of sexual problems, or impotence, after prostate surgery is a real concern, as the nerves that control urinary and sexual function and are intimately associated with and attached to the prostate. With conventional surgery and prostate radiation, these nerves are often damaged as they are fragile and difficult to protect. Using the da Vinci® robotic system in the expert and experienced hands, allows Dr. Gholami to more accurately identify and preserve the vital nerve structures needed for normal sexual and urinary function. The 3-dimensional, high definintion optics of the DaVinci system allows Dr. Gholami to distinguish the cancerous tissues surrounding the prostate from non-cancerous vital tissues around the prostate to ensure cure for the patient. This advanced west coast technique has allowed for a dramatic decrease in postoperative problems. After surgery, patients are placed on an extensive rehabilitation program to minimize the time to return to a normal life.

How Do I Find My Pelvic Floor Muscles

Its important to find the right muscles before you start doing pelvic floor muscle exercises. You can do this when youre sitting, standing or lying down whatever you find most comfortable, as long as you relax your thighs and buttocks.

If you want to do this when you are sitting, sit forward on a chair with your feet on the floor, shoulder width apart.

If you are standing up, stand with your feet shoulder width apart. You may want to try standing with your back against a wall, knees slightly bent. This is a good starting position when finding your pelvic floor muscles.

If you prefer to find your pelvic floor muscles when you are lying down, lie on your back with your knees bent and slightly apart, and your feet apart on the floor.

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The First Day After Surgery

After your surgeon has seen you the oxygen can be discontinued, the drip taken down and the drains removed. You will be given a light breakfast and a catheter bag will be strapped to your thigh to allow you to move around your bed and the room freely. You will see the physiotherapist to go through breathing and pelvic floor exercises that will build your erectile function in the coming months. Drink plenty of fluids but dont eat too much as this will cause abdominal distension.

Will I Have Erectile Dysfunction

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Whether or not you experience erectile dysfunction after radical prostatectomy will depend largely on your age, your health and what your erections were like before the operation. This side effect may occur if nerves were injured during the operation.

There are two main nerves running through the pelvis that branch into many nerves covering the prostate. Urologists call them neurovascular bundles because they really are bundles of many nerves. Urologists always aim for nerve-sparing surgery, and we rarely need to remove the neurovascular bundles. But sometimes the bundles are stretched and some of the thousands of nerve fibers within an individual nerve can be damaged, says Mohler. In most men, both neurovascular bundles can usually be spared. If the cancer is advanced, sometimes one or both cannot be.

Benefits of Robotic Radical Prostatectomy

Have more questions about radical prostatectomy? Our experts give you the answers.

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How Is Cryosurgery For Prostate Cancer Performed

Cryosurgery for prostate cancer is done under either general or spinal anesthesia. Before the procedure, an ultrasound probe is placed in the rectum to give the surgeon a visual of the prostate. This allows the doctor to monitor the prostate and nearby organs/tissues during surgery.

Several probes may be placed in the prostate at locations determined before the procedure. These are positioned to avoid the area of the urethra, the tube which passes through the prostate as it carries urine out of the body from the bladder.

In addition, a warming catheter is inserted into the urethra to keep the urethra warm throughout the procedure. Other probes may be placed in and around the prostate gland in order to monitor the temperature and prevent damage to noncancerous tissue.

Cryosurgery takes under two hours and is done in two freezing cycles. In between these cycles, the prostate is allowed to warm, either on its own or with the aid of a warmer gas moving through the probe. After the second thaw, a catheter is inserted into the bladder to help with urination during the recovery period. This tube may be inserted through the urethra, or through a small cut in the lower belly. The catheter will remain in place for several days after surgery.

Days Before Your Surgery

Follow Your Healthcare Providers Instructions for Taking Aspirin

If you take aspirin or a medication that contains aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Aspirin can cause bleeding.

Follow your healthcare providers instructions. Do not stop taking aspirin unless they tell you to.

For more information, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs , or Vitamin E.

Stop Taking Vitamin E, Multivitamins, Herbal Remedies, and Other Dietary Supplements

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements 7 days before your surgery. These things can cause bleeding.

If your healthcare provider gives you other instructions, follow those instead.

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Postoperative Care After Prostate Surgery

After a healthy operation and discharge, there are some rules that you must follow. There is a risk of bleeding for the first several months after surgery. Therefore, there are some points to take into consideration. The length of the recovery period after prostate cancer surgery varies depending on some conditions. There are factors such as the type of surgery, the stage of disease, and the patientâs health status. However, overall recovery time is short.

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What Is Robotic Laparoscopic Surgery

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Robot-assisted surgery in prostate cancer treatment is a new innovation. It consists of using robotic equipment which, unlike what some patients may think, is fully controlled by the doctor. The robot replicates the surgeons movements , performing the very precise movements, or orders, they execute.

These very sophisticated pieces of equipment allow surgeons to remove the prostate and surrounding tissue accurately and precisely.

It is a variant of keyhole surgery, maintaining its essential benefits while making operations quicker, more delicate and more precise.

It is a far less invasive procedure than conventional radical retropubic prostatectomy which involves an abdominal incision from the navel to the pubic region.

For patients, it translates into a shorter recovery time and shorter hospitalisation.

For patients operated on and cared for at the Instituto da Próstata, the Da Vinci System is used.

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We Are Ready To Support You

Like many surgeries for cancer, this is a life-changing procedure that changes how the body functions. It is normal to experience some changes in the way you see your body and the way you feel. There are many resources that are available to help you cope with the way you feel and how to cope with these changes.

The First Few Days After Surgery

After the successful completion a robotic prostatectomy you will stay in hospital for one to two nights. You will be mobilised early. Most patients wake up with a catheter tube and a small drain. You will be prescribed painkillers as well.

You can expect to have this catheter in place for a week, however, some patients will require it for longer, depending on the specifics of the surgery. Your urology specialist will detail how to care for your catheter and will assist in its removal when ready.

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Prostate Surgery Recovery Timeline

Prostate surgery recovery varies from person to person depending on how their body heals naturally and how severe the condition was prior to surgery. Here are some tips to help you through your recovery.

Prostatectomy typically requires general anesthesia and a hospital stay of 1 to 4 days. Your physician will have you walk around the day of or the day after your procedure. You may also be instructed to do little exercises while you are in the bed. All prostate cancer patients will be discharged from the hospital with a urinary catheter in place. A catheter is a thin flexible tube that is usually left in your bladder for 1 to 2 weeks to help drain your urine. Your doctor will give you specific guidelines about how to care for your catheter at home. Bladder control may be difficult for a few months after the catheter is removed. Some males will need a urinary catheter for 5 to 10 days after surgery.

Refrain from driving for 1 week after your prostate surgery. Do not drive until your catheter is removed. Also, be aware that you should not drive on prescribed pain medications unless a doctor says its ok. After one week, it should be safe to resume driving and begin most daily activities.

Why Is There Less Blood Loss With Robotic

Robotic Prostate Surgery Recovery Time

The use of the robotic equipment in surgery means a more precise and less disruptive dissection, which helps control potential sources of bleeding. Blood loss is also reduced because of the pressure generated by the gas used in inflate the abdomen during surgery, which provides surgeons with a better and more expansive view of the operating area around the prostate.

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Will I Retain The Function That I Have

Men tend to recover physically more quickly, allowing them to resume their normal activities in just a few weeks. They also tend to regain bladder control and sexual function more readily simply by staying physically active. This helps to improve recovery. Subtle modifications in the procedure are tailored to the individual patient depending on the details of their cancer. However, a robotic-assisted radical prostatectomy allows the surgeon to do a more accurate and reliable procedure which improves patient outcomes and quality of life.

New Technologies And Research

Beyond the da Vinci robotic surgery system, many more technologies in the pipeline will continue to allow surgeons to deliver increasingly precise prostate cancer care.

Experimental studies and trials are using energy-based technology, such as cryotherapy, laser therapy, and high intensity focused ultrasound , to develop effective treatments that focus only on the affected tissue. Whether robotically or manually driven, energy-based therapies are the new frontier in prostate cancer treatment.

To determine if prostate cancer screening is right for you, first consider the risk factors: age over 50 being of African descent having a family history of prostate cancer or an inherited gene mutation linked to colon, breast, or ovarian cancer.

Falling into one or more of these categories doesnt mean you should be screened immediately, however. Current prostate cancer screening guidelines from the U.S. Preventive Services Task Forcerecommend that:

  • Men age 70 or older should not be routinely screened for prostate cancer.
  • Men age 55 – 69 should discuss the risks and benefits of screening with their doctor and decide together when to begin screening.

When you and your doctor decide to proceed with screening, your well-being will continue to be our highest priority.

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Managing Incontinence After Robotic Prostatectomy

After the procedure, kegel exercises are recommended by experts as a safe option for improving symptoms. You can learn how to do kegel exercises here.After surgery and after removal of the catheter, you should do this exercise in sets of ten, four times a day. Dr Samadi encourages patients to even do these before surgery to work as pre-conditioning.

Doctors also recommend behaviour modification as a natural, healthy treatment method. This involves making a number of lifestyle changes that will reduce your leakages. These include limiting fluid intake at night time and avoiding bladder irritants such as caffeine and alcohol. Quitting smoking to reduce coughing and bladder irritation can also reduce the pressure placed on the bladder. Spicy foods, carbonated drinks and citrus fruits can also worsen your symptoms and should be avoided.

Doing gentle exercise is also helpful to ensure your weight does not put additional pressure on the bladder. However, you should avoid over-exercising after your surgery. This has been proven to slow down the healing and stretching. Straining and heavy lifting are also discouraged for the first four weeks after surgery.

Experiencing incontinence can be difficult, however you should remember that there are treatment methods available.

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What Increases Risk Of Blood Clots After Surgery

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The main reason youÃre at an increased risk of developing DVT after surgery is because of your inactivity during and after the surgery. Muscle movement is needed to continuously pump blood to your heart. This inactivity causes blood to collect in the lower part of your body, generally the leg and hip regions.

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What Happens Immediately After Surgery

Once your surgery has finished, you are taken to the recovery room where you will wake up.

There will be a catheter in your bladder and sometimes a small wound drain.

You will often feel a sense of needing to empty your bladder. This is normal and is due to the irritation and spasm of the bladder caused by the catheter. This sensation slowly resolves and medication can be given to help relax the bladder. The catheter is held in place with a 3cm inflatable balloon on the catheter tip so cannot fall out with normal activity. Your catheter will remain in for approximately ten days to allow the new join between your bladder and urethra to heal.

Typically, after one hour in the recovery room, you are taken back to the ward. You will be able to sit up in bed and eat dinner on the evening of surgery and walk about the ward that day or the following morning. Blood thinners and calf compressors are used to reduce the risk of blood clots forming within the veins. Post-operative pain is well controlled through the use of regular pain medication. Once you are comfortable and confident in caring for the catheter you can head home. Hospital stay is typically 1-2 nights for robotic surgery and 2-3 nights for open surgery.

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Caring For The Catheter

You will be discharged with a Foley catheter, a tube that continuously drains urine from your bladder into a bag and that you will use for seven to 10 days. Before you leave the hospital, your nurse will teach you how to empty and care for your catheter and drainage bag. The catheter works with gravity and should be draining urine at all times, so you have to keep the drainage bag below your bladder at all times, even when you shower. If your urine is not draining, lower the bag and check the connection for kinks or loops. Loops can cause an air lock that prevents drainage. You can also try emptying the bag. Then try briefly disconnecting the catheter from the clear plastic tubing to allow a little air into the system. Your nurse will show you how to do this before your discharge.

To prevent infection, you must keep your catheter clean. This section explains how to clean the catheter, the area around the catheter and the drainage bag. It also explains how to apply your leg bag and secure the catheter to your leg.

We will provide most of the supplies you need to care for your catheter. They include:

  • StatLock Foley catheter securement device
  • Shaving supplies

You should empty the catheter bag when itâs half full. This helps prevent air locks from developing in the tubing.

To apply the leg bag:

  • Wash your hands with soap and water.
  • Remove the tape at the joint of the catheter tube and bag.
  • Swab all connecting areas with alcohol pads.
  • Drain, then remove the big drainage bag.
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    Less Time Under Anesthesia With Open Prostatectomy

    An open prostatectomy, however, is a much shorter surgery than the robotic procedure, which means patients spend less time under anesthesia. Length of anesthesia for an open prostatectomy is 2 to 3 hours, compared to 4 to 7 hours for a robotic prostatectomy.

    In several measures, there is no demonstrated difference between open and robotic prostatectomy. The risk of blood transfusion for an open prostatectomy is less than 1 percent, and fewer than 1 percent of patients have wound complications. Post-operative pain on the morning following surgery is typically 2 on a 10-point scale. The patients length of stay in the hospital is 1½ to 2 days. Approximately 85 percent of patients regain excellent urinary control, and three-quarters retain sexual potency.

    While all precautions are taken to reduce the likelihood of complications, no surgical treatment is completely without risk. Potential complications of open and robotic prostatectomies include infection, bleeding requiring blood transfusion, urinary incontinence, erectile dysfunction and injury to adjacent organs.

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