Prostatectomy

DIAGNOSIS

Doctors most often recommend a radical prostatectomy to treat prostate cancer confined to the prostate in men and people assigned male at birth (AMAB). A healthcare provider may also recommend a simple prostatectomy if you have a condition that blocks your urethra and affects how you pee, such as benign prostatic hyperplasia (BPH).

PREPARING FOR SURGERY

• Undergo a thorough medical evaluation by your healthcare team to assess your overall health, including any pre-existing conditions and medications you are taking.
• Have a detailed discussion with your surgeon about the procedure, including its risks, benefits, and potential complications. Address any questions or concerns you may have.
• Complete any preoperative tests or screenings recommended by your healthcare provider, such as blood tests, imaging studies, and electrocardiogram (ECG) to assess your baseline health status.
• Follow your surgeon's instructions regarding medication adjustments before surgery, including any changes to prescription medications, over-the-counter medications, and supplements. Some medications may need to be temporarily discontinued or adjusted to reduce the risk of bleeding or other complications.
• Follow bowel preparation instructions provided by your healthcare team to ensure your bowel is clear before surgery. This may involve a liquid diet, laxatives, or enemas to empty the bowel.

RECOVERY

Most people can resume normal activities about eight weeks after an open prostatectomy. Recovery is usually faster after a robotic prostatectomy. Most people can resume normal activities four to six weeks after a robotic prostatectomy.

However, your recovery depends on the type of prostatectomy, your health history and any other conditions you have. A healthcare provider is the best person to tell you your recovery timeline.

Some instructions you must follow can be :

• Keep your surgical wound clean.
• No driving for 1-2 weeks after surgery.
• No high-energy activity for eight weeks.
• No climbing stairs more than necessary.
• No soaking in bathtubs, swimming pools, or hot tubs.
• Taking medications as prescribed to help with the pain.

After surgery you should expect that:

• You'll be given IV pain medications.Your doctor may give you prescription pain pills to take after the IV is removed.
• Your doctor will have you walk the day of or the day after surgery. You'll also do exercises to move your feet while you're in bed.
• You'll likely go home the day after surgery. When your doctor thinks it's safe for you to go home, the pelvic drain is taken out. You may need to return to the doctor in one or two weeks to have staples taken out.
• You'll return home with a catheter in place. Most men need a urinary catheter for seven to 10 days after surgery. Full recovery of urinary control can take up to a year after surgery.
• Make sure you understand the post-surgery steps you need to take, and any restrictions such as driving or lifting heavy things:
• You'll need to resume your activity level gradually. You should be back to your normal routine in about four to six weeks.
• You'll need to see your doctor a few times to make sure everything is OK. Most men see their doctors after about six weeks and then again every three months for the first year, and twice in the second year after surgery. If you have any problems or concerns, you may need to see your doctor sooner or more often.
• You'll probably be able to resume sexual activity after recuperating from surgery. After a simple prostatectomy, you can still have an orgasm during sex, but you'll ejaculate very little or no semen. After radical prostatectomy, full recovery of erectile function may take as long as 18 months for some men.