Laparoscopic Radical Prostatectomy: What to Expect at Home

A laparoscopic radical prostatectomy is surgery to remove the prostate gland. It is usually done to treat prostate cancer that has not spread beyond the prostate. The doctor made several small cuts, called incisions, in your lower belly. The doctor put a lighted tube (scope) and other surgical tools through the incisions to do the surgery. Or if you had robotic surgery, the doctor guided the robot arms to do this surgery.

You may see some bruising and swelling right after your surgery. In the week after surgery, your penis and scrotum may swell. This usually gets better after 1 to 2 weeks. The incisions may be sore for 1 to 2 weeks. Your doctor will give you medicine for pain. After a laparoscopy, you may have shoulder pain. This is caused by the air your doctor put in your belly to help see your organs better. The pain may last for a day or two.

You will have a tube (urinary catheter) to drain urine from your bladder for 1 to 2 weeks after surgery. You may have bladder cramps, or spasms, while the catheter is in your bladder. Your doctor can give you medicine to help prevent bladder spasms.

After your catheter is removed, it may take several weeks or more for you to control your urine. And it may take 6 months or more for you to be able to have erections again. But with time, most people regain urine control and much of their previous sexual function. If not, medicines or other treatments may help.

You will probably be able to go back to work or your usual activities 3 to 5 weeks after surgery. But it can take longer to fully recover.

You will need to see your doctor regularly. This includes having blood tests to measure your PSA level. PSA is a substance that can suggest whether your cancer has returned. PSA tests are usually done more often for the first several years after your surgery, but less often after that.

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation. At first, avoid hills, and try to stay on flat ground. You can climb stairs, but try to limit how often you do this. When you do climb them, do it slowly, and pause every few steps.
• Avoid strenuous activities for 2 weeks, or until your doctor says it is okay. This includes bicycle riding, jogging, weight lifting, or aerobic exercise.
• For 2 to 3 weeks or until your doctor says it is okay, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• You may shower if your doctor says it is okay. Empty the catheter bag before you start. When you shower, keep the catheter taped to your leg. Do not take a bath until your doctor or nurse has removed the catheter.
• Ask your doctor when you can drive again.
• Avoid riding in a car for more than 1 hour at a time for the first 3 weeks after surgery. If you must ride in a car for a longer distance, stop often to walk and stretch your legs.
• You will probably need to take 3 to 5 weeks off from work. It depends on the type of work you do and how you feel.

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• Your doctor may prescribe antibiotics when your urinary catheter is removed. Take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

• Wash your hands before and after touching your incisions.
• If you have strips of tape on the incisions, leave the tape on for a week or until it falls off.
• If you had stitches, your doctor will tell you when to come back to have them removed.
• Wash the area daily with warm water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• Keep the area clean and dry.

• To help with pain and swelling, put ice or a cold pack on your groin for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.

• You will have a urinary catheter for 1 to 2 weeks. Your doctor or nurse will tell you how to care for it.
• Be sure the catheter is securely taped to your thigh and attached to the large drainage bag when you are at home. Use the smaller leg bag only when you go out.
• A little urine leakage around the catheter is normal. You can place an incontinence pad in your underwear to absorb urine leaks.
• Do not have an enema or use a rectal thermometer for 3 months, or until your doctor says it is okay.