Radical retropubic prostatectomy

A radical retropubic prostatectomy is surgery to remove the prostate gland. It is usually done to treat prostate cancer that hasn't spread out of the prostate. The doctor will make a 3- to 4-inch cut (incision) in your lower belly. The cut is between the navel and the pubic bone.

You will probably stay in the hospital for 1 to 3 days after surgery. Most people can go back to work or their usual activities 3 to 5 weeks after surgery. But it can take 6 to 8 weeks to fully recover.

After surgery, your body will need time to heal. It may take several weeks or more for you to regain control of 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.

After your surgery, you won't be able to ejaculate sperm. If you want to be able to have biological children after your surgery, talk to your doctor about your options. You may be able to save your sperm before the surgery.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• 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 6 to 8 weeks, or until your doctor says it is okay. This includes bicycle riding, jogging, weight lifting, or aerobic exercise.
• For 6 to 8 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.

Diet

• 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.

Medicines

• Your doctor will tell you if and when you can restart your medicines. The doctor will also give you 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.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• 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.

Incision care

• If you have strips of tape on the incision, 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.

Ice and elevation

• 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.

Other instructions

• 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.