What to Expect After Radical Prostatectomy
Surgery to remove the prostate lasts from one and a half to four hours. After the prostate and other structures are removed, your surgeon reattaches the remaining urethra to your bladder. While you’re still sleeping, your doctor will place a small tube for draining urine, called a catheter, in your penis. It will likely stay in place for one to two weeks.
Usually, you’ll be in the hospital for about three days. You may have to stay away from work for up to five weeks. (Men getting some type of laparoscopic surgery usually recover somewhat faster.) Here’s an overview of how you might feel after surgery.
For the first few days, you’re likely to have pain from the cuts, called the incisions. Your pain can be controlled with medicine. You may have an epidural catheter inserted into your lower back so that it’s easier to give you pain medication. Or you may have a patient-controlled analgesia pump. This is an intravenous form of pain medication that you control by pressing a button. The pump is removed before you leave the hospital. Talk with your doctor or nurse about your options for pain relief. Some people are hesitant to take pain medication, but doing so can actually help your healing. If you don’t control pain well, for example, you may not want to cough or turn over often, which you need to do as you recover from surgery.
You’ll leave the hospital with a urinary catheter, called a Foley catheter, in place. Your urine will drain through this catheter into a bag. You’ll likely have it for one to four weeks. When your catheter is removed, you may be taught Kegel exercises. These are pelvic muscle-strengthening exercises that help you control urination. Most men regain full control of their urination within a few months after the catheter is removed.
For the first three to 12 months after your surgery, you may not be able to have an erection. This condition is called erectile dysfunction. The younger you are, the more likely you are to recover from this side effect. You can also ask your doctor about medications or treatments that may help.
You’ll also need follow-up care after surgery. Four to six weeks after your surgery, your doctor will check your PSA level. It should decrease to an undetectable level within a month or so after the surgery if no prostate cancer cells are present. If your PSA remains undetectable for a year, your urologist may order PSA testing every six months for another year, and then yearly tests after that.
Keep in mind that after a radical prostatectomy, you may still have an orgasm, but it will be dry. That is, you won’t have any ejaculate fluid. That’s because the sources of the fluid—the prostate and seminal vesicles—have been removed and the vas deferens, or the duct that transfers sperm from an organ in the testes, has been tied off.