A member of our Pastoral Care team may visit you and are available on request. You will also be weighed daily if ordered by your doctor. The output from your catheter and drains will be measured and recorded. The catheter must remain securely taped to your leg to avoid being pulled. Your regular medications will be given to you. Relief for pain, nausea and vomiting will continue as ordered by your doctor. Your patient controlled analgesia may be removed.
The drip in your arm will remain in place. One of the drains may be removed. Your wound will be checked regularly. Continue with your deep breathing and leg exercises. Please continue to wear your therapeutic stockings and reapply after showering. Your discharge plan will be reviewed.
Education will begin to enable you to be able to manage your catheter and drain at home. Your nurse will discuss with you this patient information booklet and answer any questions you may have.
A member of the pastoral care team may visit you. Nursing staff will continue to encourage you to mobilise independently and take regular short walks around the ward at least four times a day. Your urinary catheter will remain in place. The drainage bag will be changed to a leg bag during the day.
You will be encouraged to care for your catheter under supervision. Your obs will be recorded regularly. The output from your drain and catheter will be measured and recorded daily. Your regular medications will be given to you plus any required for pain relief.
If your patient controlled analgesia has not already been removed it will be removed. Please let the nurses know when you have pain. If your IV is still in place it may be removed. Your wound and dressing will be checked. Your temperature, pulse, respirations and blood pressure will be monitored prior to your discharge. The condition of your wound or dressing and the output from your drain and catheter will also be noted prior to your discharge.
You will continue to take your regular medications. Tablets are available to you if you experience any pain. If your dressing is removed you may leave your wound exposed.
If your dressing is intact instructions will be given to you as to when you can remove your dressing. The nurse will give you a discharge advice form and discuss it with you. Arrangements for the removal of your catheter will be made. It is preferable that you arrange to be ready for discharge by 10 am. Please inform staff of approximate time.
The experience of surgery and what follows can affect individuals deeply. It can even cause a change in the way that people think about things in their lives and how they value them.
It may lead to the sorting out of what is now important to the individual. This change in thinking may affect all aspects of life from the most profound to the very simple and could cause feelings of surprise or even alarm. Those close to the person may also be surprised and challenged by the change in them, especially during the "sorting out" period. Some people manage to do the sorting out on their own, but others find it beneficial to seek help. The role of the Pastoral Care team at Mater Health Services is simply to be there to listen and to provide the companionship necessary to help people make sense of these issues.
They are skilled at being supportive without intruding, and their aim would be to help people find their own ways of adjusting. A member of Pastoral Care is available to you both while you are in hospital and when you return home.
While in hospital, ask a staff member to contact a team member or if you would like to talk to someone from home then you are most welcome to ring 07 ask to speak to Pastoral Care for the Mater Hospital Brisbane. You may have a waterproof dressing in place when you are discharged. If so, remove it within two to three days of discharge. You may wash the wound in the shower and cover it only if it is oozing.
All stitches are internal so there are no clips or stitches to be removed. Swelling of the scrotum is common after this surgery so wearing firm but comfortable cotton underwear can prevent this. A small amount of blood may be present in your urine and this is normal following this surgery. If a large amount of blood is present or it appears bright red then seek advice from the urology nurse or doctor.
It is very important to avoid heavy lifting or straining particularly from constipation. The bowel motions can be kept soft and easy to pass by maintaining a high fibre diet, drinking plenty of fluids and also taking a gentle stool softener such as Coloxyl, pear juice or Agarol. After a Radical Prostatectomy, the catheter usually stays in place for about 10 days.
The catheter will firstly drain into a bag that hangs on the bedside. Once you are up walking around a smaller drainage bag is fitted and strapped to your leg. This leg-bag remains in place until the catheter is removed. Please note, it is very important to ensure that the leg-bag is positioned so that it does not pull on the catheter. The leg straps need to be comfortable but securely applied so the leg bag remains high on your thigh with no tension or traction on the catheter.
This may mean that you need to adjust the leg-bag straps regularly to ensure that there is a comfortable loop of catheter between you and the bag.
Anytime a person has a catheter inserted into their bladder, there is a risk of an infection occurring. There are four main strategies that you can take that will minimise this risk:. Before you leave hospital an appointment will be made for you to have your catheter removed. Your catheter will be removed around ten days after your surgery. Arrive at 8. Present yourself to Ward 9A. The nursing staff will check your observations and then remove your catheter. Try to spread out eating throughout the day with snacks and small meals, to avoid eating large meals at once for a few days after surgery.
Clothing Immediately after surgery, your abdomen will be slightly bloated so you may have trouble fitting into your regular clothes. For comfort, wear lose fitting clothing such as sweatpants or other pants with elastic not button waist bands.
You will probably need to do so initially anyway to accommodate the catheter and collection bag. Wound Care You may now start showering the day of your discharge.
The catheter collection bag may be removed during showering. Gently pull the colored catheter straight off of the clear plastic tubing from the bag and allow urine to run into the shower. After showering, gently pad the suture sites do not rub or otherwise irritate them with a towel. Application of ointments such as Neosporin to incision sites is not recommended. Sutures were utilized which will dissolve on their own, there is no need to have them removed.
A small amount of redness at the edges of the incision sites, as well as a small amount of clear or bloody leakage from the wound, is acceptable. Catheter Care As mentioned above, you will be discharged from the hospital with a Foley catheter in place which continuously drains urine from your bladder. It must stay in place while your anastamosis heals. Do not attempt to remove this on your own. If it should accidentally fall out, you Must immediately notify your Urologist to have it replaced.
Do NOT allow a non-urologist even if they are a nurse or a doctor to replace it. The catheter was carefully placed by your urologist with specific regard to your prostatectomy and cannot be replaced by just anyone.
You will be given antibiotic ointment to lubricate the outside catheter where it enters the tip of your penis the uretheral meatus. This ointment will reduce inflammation to the uretheral meatus and reduce discomfort. Apply the ointment as needed. You will provided with a "stat-lock," a plastic clip which will be glued to your thigh to hold the catheter. This will be removed when your catheter is removed 1 week after surgery.
You will be provided with two urine collection bags of different sizes, a smaller bag to be worn under your pants during the day, and a larger bag to be used at night. The smaller bag usually lasts about hours before needing to be emptied, but of course this varies with how much liquid you consume.
The larger bag should last you all night, so you do not need to wake up to empty it. Remove, empty, and exchange these two bags as needed. Alert the surgeon if the catheter does not drain well, or if you have any other serious problems with it. This catheter will stay in place for one week while you heal, and can generally be removed by your urologist at the end of this time. Sometimes it may have to stay in place longer if you are not sufficiently healed, perhaps two weeks instead of one.
You should have already scheduled a follow-up appointment for this purpose. Remember from above, that you will start taking your oral antibiotic probably Cipro on the morning of this day. Regaining Urinary Control Most men have difficulty with urinary control after catheter removal. You should bring an adult urinary pad such as Depend Guards with you the day your catheter is removed.
You should be prepared to wear these pads for a while because normal urinary control may not be regained for 2 months from the time of your surgery. Remember, everyone is different. Some men regain control in a week, some take six months.
Don't be discouraged! Also, remember you will typically leak more standing, moving, and straining, and less when lying down and sleeping.
Remember to do your kegel exercises regularly. The operation removed your prostate and affected your secondary urinary control mechanisms. Your external sphincter muscle must now take over all responsibility for control. It will take time and effort to strengthen this mechanism. Some men may continue to have mild incontinence with straining even several years after surgery.
You can avoid a problem in these situations by wearing a small pad. Rarely, urinary control will be unsatisfactory even after a year. Following RRP, there is evolving evidence that the urethral catheter can be removed as early as POD 3 when the intraoperative anastomosis is watertight.
Several investigations have demonstrated that negative cystography allows one to remove the urethral catheter early and to do so safely. Our series suggests that an eight suture watertight VUA allows the urethral catheter to be removed at 3 days prior to hospital discharge.
Whether an eight suture VUA best simulates a running anastomosis in providing a watertight anastomosis remains to be seen, but early results are encouraging. Undoubtedly, our study and prior investigations clearly demonstrate that the longstanding non-evidence based standard catheterization period of 2 or even 3 weeks after RRP warrants further review. Walsh PC. Campbell's Urology, 7th edn. WB Saunders: Philadelphia pp — Google Scholar. Abbou CC et al. Laparoscopic radical prostatectomy: Preliminary results Urology 55 : — Guillonneau B, Vallancien G.
Nadu A et al. Early removal of the catheter after laparoscopic radical prostatectomy J Urol : — Litwin M et al. Quality-of-life outcomes in men treated for localized prostate cancer JAMA : — Dalton DP et al. Radiographic assessment of the vesicourethral anastomosis directing early decatheterization following nerve-sparing radical retropbubic prostatectomy J Urol : 79— Little J Jr et al.
Early urethral catheter removal following radical prostatectomy: a pilot study Urology 46 : — Article Google Scholar. Coogan C et al. Urethral catheter removal prior to hospital discharge following radical prostatectomy Urology 49 : — Souto CA et al. Experience with early catheter removal after radical retropubic prostatectomy J Urol : — Early catheter removal in consecutive patients undergoing radical retropubic prostatectomy BJU Int 85 : — Early removal of urinary catheter after radical retropubic prostatectomy is both feasible and desirable Urology 58 : — Kielb S et al.
Assessment of early continence recovery after radical prostatectomy: patient reported symptoms and impairment J Urology 66 : — Download references. You can also search for this author in PubMed Google Scholar. Reprints and Permissions. Albani, J. Urethral catheter removal 3 days after radical retropubic prostatectomy is feasible and desirable.
Prostate Cancer Prostatic Dis 5, — Download citation. Received : 10 February Revised : 05 April Accepted : 18 April Published : 18 December Issue Date : 01 December Anyone you share the following link with will be able to read this content:.
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