You will be transferred to your room after your surgery. You will have six small bandages over the skin incisions, a drain on one side of your abdomen attached to a vacuum container, and a urine catheter (Foley) to drain urine from your bladder. The Foley catheter will be attached to a urine bag. An intravenous (IV) line will provide you with fluids. This IV and drain are usually discontinued the day after surgery. You will be allowed to have ice chips and sips of water. Pain is generally minimal, but pain medication will be administered, if necessary.
Once you are ready, you should sit up and attempt to walk a few steps. Early walking is the key for fast recovery and return to bowel activity. It also improves blood circulation in the legs and prevents clot formation.
The next morning, you may have a light breakfast and a liquid diet thereafter. You may not have solid food until you pass intestinal gas and have a bowel movement. Most people do not pass intestinal gas for several days and do not have a bowel movement for three to four days.
Your major contribution to your speedy recovery comes on the day after surgery, when you are expected to walk in the hallways a total of one mile, or 25 laps around the hospital wing (but not in one grand sprint).
You will also be given a breathing device, called a spirometer. Using it will help expand your lungs and prevent infections. You should use this device once every hour and take 10 consecutive deep breaths with it in your mouth.
Most of Dr. Tewari's robotic prostatectomy patients are discharged and return home the day after surgery.
When you leave the hospital, you will still have the urinary catheter in place. The catheter will remain for approximately six to nine days after the operation. The catheter will be attached to a leg bag that you can hide under your trousers. At nighttime, we recommend that you switch to a regular urinary bag that you place on the side of the bed. This is a larger bag that will allow you to sleep the whole night without the necessity of getting up to use the toilet.
You may experience some bladder pain or cramps (spasms) associated with the catheter, but most people tolerate the catheter well. You may also leak minimal amounts of urine around the catheter because of involuntary bladder contractions. You may want to wear a pull-up diaper over the catheter to prevent soiling your clothing. It is also not unusual to notice pink or red tinged urine after a walk or bowel movement. Do not be alarmed. Simply increase your fluid intake until the urine becomes clear again and lie down for some time. All of these events are considered within normal range, and you should not be concerned. Learn more about urinary control after robotic prostate surgery
On the day of your scheduled catheter removal, you will come to the hospital to have a cystogram (this is only required if Dr. Tewari requests it). To perform a cystogram, a radiologist injects dye through the catheter and takes an x-ray to make sure that there is no leakage at the point where the bladder and urethra connect. You will then come to Dr. Tewari's office for removal of the catheter (a relatively pain-free procedure). Right after the catheter is removed, most men cannot control the urine sphincter and leak urine for a few days to weeks thereafter. While we encourage patients to bring diapers and protective pads with them the day of the catheter removal, many patients stop leaking within few hours or days.
A minority of patients (five percent) may have delayed healing of the bladder/urethra connection and thus require longer catheterization or may require re-insertion of the catheter because of swelling at the connection.
You can return home by car from the hospital after discharge if your drive is within two hours, but you should not drive for two weeks. If you come from out of state and are traveling by plane, make sure that you walk every half hour in the plane cabin to prevent blood clotting in the legs.
It takes three to four weeks for the abdominal incisions to heal completely, so you should avoid heavy lifting during that time. You may have some swelling in the scrotum and penis after surgery, which will resolve with time. If this occurs, elevate your scrotum using a folded towel when you lie down, and wear mildly tight underpants when you move about.
You can shower any time after surgery, but do not take a bath until after the urine catheter is removed. Leave the bandages on the skin incisions for three to four days.
You can start your daily activities (such as walking, climbing stairs, etc.) immediately when you get home. However, you should wait three to four weeks before beginning any heavy exercise, such as jogging, weight lifting, and bicycle riding. Generally, you can return to work two to three weeks after the operation depending on your type of work.