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Recovery from Prostate Surgery.

July 15, 2009 | Leave a Comment

Recovery from Prostate Surgery

Whatever anyone tells you, a prostatectomy is a major operation and you need to allow yourself sufficient time to recover from it bupropion. Men are notoriously impatient, especially if they have to go back to work, but you must accept that you will probably have to slow down for a while. Don’t expect miracles, and don’t be too hard on yourself. You may not have had a leg amputated, but you have nevertheless had a major operation and you must make allowances for this. You must not expect too much of yourself during your recovery period in order to give yourself the best chance to get better as quickly as possible. Any impatience may, in
the long run, only make matters worse and set you back on your road to recovery. Exactly how long it takes you to get yourself back to a state of good health depends to a large extent on how fit you were before you had the operation. It also depends on how large your prostate gland was, and on whether or not there were any complications as a result of surgery.

Remember that old cliche about time being the great healer? It may not be very original but, like a lot of cliches, it’s true. So grit your teeth and take things easy for a while. It may take as long as three months before you feel completely well again, but once you do, you’ll be utterly convinced that it was worth every minute!

Your bladder

In the first few weeks after your operation, don’t be surprised if your symptoms do not seem any better than before. They may even seem worse. This doesn’t mean that the operation hasn’t been a success - only that you haven’t healed yet. It can take anything up to about six weeks for the cut surface inside the prostate to heal over completely. Expecting everything to work perfectly before this happens is unrealistic. Until then, you will have to be prepared to make allowances. Even when your urinary system returns to a state of good health, do not be surprised if you have problems getting used to this. You’ve probably spent a long time - years maybe - getting used to having to empty your bladder all too frequently, and it may take a long time -several weeks, probably, or even months - before you succeed in unlearning those habits. Be patient and you will gradually build up confidence in your bladder again until you are able to forget about it completely.

Medication

You will probably still be taking a course of antibiotics when you leave hospital. You must be disciplined about taking these. Remember to finish the course, and don’t just stop taking the pills as soon as you feel better. This could set you back a long way and allow any leftover bacteria to multiply and mount another attack just when you’re least expecting it and you’re congratulating yourself on getting better .

AFTER AN OPEN PROSTATECTOMY

If you’ve had an open prostatectomy, you will have stitches in your abdomen and you will have been given strict instructions on what you can and can’t do. You will be tired after your general anaesthetic and you will need to look after your wound. A district nurse will probably come to your house every other day to change the dressing, and she will take the stitches out when necessary. You will have been told what movements you can make to avoid putting too great a strain on both the scar and the surrounding muscles. You should also:
• Avoid carrying anything at all heavy - even a full kettle may be too heavy, so fill it only half full.
• Get out of your chair cautiously and gently by wriggling your way to the edge of the chair before getting up.
• Build up slowly to normal activities.
• Use your common sense at all times and don’t attempt to do too much.
• STOP immediately if you suspect you are doing too much.
Even when you’ve had the stitches removed, you will still need to be careful. It takes a good six weeks for the wound to heal itself, and several months before the abdominal muscles get back to their full strength.

AFTER A TRANSURETHRAL PROSTATECTOMY (TURP)

If, on the other hand, you’ve had the more common transurethral prostatectomy (TURP), you won’t have any visible signs of your operation, like a scar, and it’s all too easy to forget that you’ve actually had an operation at all. But you have, and you mustn’t forget it. Any operation puts a great physical strain on the body and, as a result, takes a surprisingly long time for you to get over. In hospital, you will have spent most of your time sitting or lying in bed. You probably won’t have done anything more strenuous than reading or watching television. As soon as you get home, the temptation will be to resume all your favourite occupations - going for a walk in the park, perhaps, or doing a bit of gardening. But it is not a good idea to get back into the swing of things too soon. This should be a slow and gradual process, and you must be careful not to push yourself too far, or to do more than you can genuinely cope with. In the meantime, make sure that you get plenty of rest. Get up late, have a rest whenever you feel you need one, and go to bed early. Whenever you are sitting, remember that a firm seat is more comfortable than a soft one that can press upwards between the buttocks.
The problem is obviously greater for people who live alone and who are looking after themselves. But even where this is the case -perhaps even more so, in fact, because you can’t risk driving yourself so hard that you make yourself ill - you must restrict yourself at First to doing the essentials. You’ll obviously need to do the cooking and washing, but most other things can wait. There is absolutely no shame in spoiling yourself at a time like this. Your priority is to get well, and everything else comes second to that average.

BLADDER CONTROL

The great majority of prostatectomies are successful, and recovery is usually straightforward. Having said that, though, recovery can sometimes be slow, and efficient urination is something you may have to work at will.
Just after the operation, the urethra may be swollen, which may in turn be painful. This pain can make the urethral muscles contract from time to time, which can mean that the flow of urine is either slow or intermittent. Bruising of the tissues around the urethra can also prevent the muscles surrounding the urethra working properly, which can mean that the urethra neither opens nor closes completely. This can result in a low stream of urine, of continual leakage of urine. Such problems are, of course, unpleasant and debilitating, but they should disappear as soon as the swelling and bruising get better, which should take only a fortnight or so.
Another problem following the operation may be that you suffer from just as bad - if not worse - a degree of frequency and urgency of urination as you did before the operation. This is likely to be brought about by inflammation of the prostate and urethra, and may continue until the cut surface of the prostate is completely healed, which can take as long as six to eight weeks. It can last even longer 11′ you develop a urinary tract infection, which is a good reason to have your urine tested at your six-week check-up. It may surprise you to know that the opposite problem of an absence of urgency can, contrary to what you might expect, be
even more worrying than its presence. This is because if you suffered from chronic retention of urine before your operation, your bladder may have become so accustomed to holding a large amount of urine that it does not send the right signal when it is full. The danger, in this case, is that the bladder may become so full that it will be unable to contract properly and empty itself efficiently. You will have to empty it by the clock - say every hour or so - until you begin to feel the natural urge to urinate. This should happen spontaneously, if gradually. In short, you can expect your bladder to behaving abnormally for up to six weeks or so after the operation.

Bladder training

You will probably benefit from training - or retraining - your bladder to hold more urine and to last comfortably for longer periods of time. This should help reduce increased frequency and urgency of urination, as well as night-time urination.
Start by making a urination chart, or frequency/volume chart, detailing the time and amount of urine each time you go to the toilet. Equip yourself with a measuring jug, of the type you can buy in hardware or kitchen equipment shops, so as to measure the volume of urine. Continue keeping this chart while you are bladder training. You will probably be used to emptying your bladder each time you feel the slightest urge to do so, or even each time you pass a toilet ‘just in case’. Stop doing this and gradually increase the time between visits to the toilet. Start by holding on for another two minutes after you feel the need to go to the toilet, then increase this to five minutes, then another five minutes, and so on. All this is easier said than done, but there are a few ‘tricks’ that should make it easier for you to hold on between visits.
• Sit rather than stand when you feel the desire to urinate.
• Keep still rather than moving around.
• Pull up your pelvic floor muscles.
• Cross your legs.
• Hold your penis, if you can do this discreetly .
• Take regular, slow, deep breaths.
• Think about something else to keep your mind off your bladder.
• Try to do something else to take your mind off your bladder, such as making a telephone call, or reading the newspaper.
You will find that you can gradually manage to hold on for longer and longer intervals. Aim, ultimately, for an interval of three to four hours.
Bladder training can achieve a lot for most people in just four weeks. Try to keep it up for three months or, even better, six months. Don’t expect to have dealt with all your problems even after six months. Symptoms can continue to improve for as long as a year -or even longer.

RESUMING SEXUAL ACTIVITY

You can resume sexual activity as soon as you feel up to it. Some doctors are wary of advising patients to do this, in case of disturbing clots and scabs, others say that the passage of semen cannot do any more harm than the passage of urine. Be alert to how you feel, and follow your natural inclinations. You may, however, not feel like sex for some time after the operation. If this happens to you, you shouldn’t worry It does not mean that you have lost your sex drive or your potency as a result of the operation - it simply means that you have a natural degree of fatigue after what is, after all, a major operation side affects. This is even more likely if you have had a general anaesthetic.

Retrograde ejaculation

You are unlikely to ejaculate in quite the same way as you did before the operation and may experience retrograde ejaculation. This means that semen goes backwards up the urethra into the bladder, rather than forwards and down into the urethra. This often has the effect of making you sterile, and a lot of men find this a very difficult hurdle to deal with, even if they do not actually want to father any more children. In their eyes, the fact that they are now sterile seems to emasculate them in some way, to make them less of a man. It is important that a man is told that this is a likely side-effect of a prostatectomy before the operation, as this seems to help them deal with it better. Even if you do have retrograde ejaculation, this cannot guarantee that your partner won’t become pregnant and you should still use some form of contraception if this is an issue. You cannot rely on a prostatectomy to give you a reliable form of contraception medicare. It is estimated that between 5 and 10 per cent of men are still fertile afterwards. If you want a reliable and permanent method of contraception, you may want to discuss the possibility of having a vasectomy with your surgeon, as this can easily be done at the same time as a prostatectomy. Your urine will probably look a little cloudy after intercourse, as the semen that went into the bladder is washed out. You may also find that you bleed slightly after intercourse during the first six weeks or so after the operation - just as you notice a little blood in your urine - but as long as this is not a large amount of blood, you should not have anything to worry about.

YOUR SIX-WEEK CHECK-UP

By six weeks after the operation, most of your symptoms should have cleared up, though you may still be suffering from frequency and urgency of urination. You will probably have a check-up after six weeks, which is your opportunity to discuss anything that is worrying you. It is particularly important to have a test done on a urine sample, just to check that you are free of any urine infection. Some hospital clinics also like to repeat the urine flow test, which will indicate that the operation has been successful.

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