Perineal Prostatectomy

WHAT YOU SHOULD KNOW:

  • A perineal prostatectomy, also called a radical perineal prostatectomy, is surgery to remove your prostate gland. Your prostate gland is the male sex gland that makes the fluid part of your semen (fluid containing sperm). Your prostate gland is found below your bladder and surrounds the top of your urethra. Your urethra is a tube that carries urine outside your body. You may need a perineal prostatectomy if you have prostate cancer. Cancer occurs when abnormal cells grow and divide without control or order, often making too much tissue (tumor). With prostate cancer, the abnormal cells grow inside your prostate gland. A perineal prostatectomy is normally done when the cancer has not spread outside your prostate gland.



  • During surgery, an incision (cut) is made in your perineum. The perineum is the area between the penis and anus (where bowel movements pass out of your body). Your caregiver removes your prostate gland through the cut. Lymph nodes near your prostate gland may also be removed. Lymph nodes are small lumps of tissue that help fight infection. A perineal prostatectomy may help treat your cancer. A perineal prostatectomy may decrease the risk that your cancer will spread. The surgery may cure your prostate cancer.

INSTRUCTIONS:

Take your medicine as directed.

Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

  • Antibiotic medicine: You will be given antibiotics to prevent an infection caused by germs called bacteria. You will take antibiotics until your bladder catheter is removed. Always take your antibiotics exactly as ordered by your caregiver.

  • Pain medicine: You may need medicine to take away or decrease pain.

    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

  • Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

  • You may need to visit your caregiver to have the bladder catheter removed. You may have blood tests to check your prostate specific antigen (PSA) level. Your PSA level can show caregivers if you still have prostate cancer, or if the cancer has returned. You will also need rectal exams to check the prostate area. Ask your caregiver when, and how often, you need blood tests and rectal exams.

Bladder catheter care:

You may be sent home with a bladder catheter in place. The catheter is attached to a bag that collects your urine. Keep the bag of urine well below your waist. Lifting the urine bag higher will make the urine flow back into your bladder, which can cause an infection. Avoid pulling on the catheter, because this may cause pain and bleeding, and the catheter may come out. Do not allow the catheter tubing to kink, because this will block the flow of urine. When the catheter is taken out, you should be able to urinate on your own. Ask your caregiver how to care for your bladder catheter.

Bladder control:

After surgery, you may leak urine and have trouble controlling when you urinate. Ask your caregiver for more information about the following ways to help decrease urine leakage:

  • Avoid caffeine: Avoid food and drinks that have caffeine in them to help prevent problems when you urinate. Caffeine is found in coffee, chocolate, tea, and some soft drinks.

  • Do pelvic floor muscle exercises: Pelvic floor muscle exercises help strengthen your pelvic muscles. The exercises may help improve your bladder control, if you leak urine. These exercises are done by tightening and relaxing your pelvic muscles. Ask your caregiver how to do pelvic floor muscle exercises, and how often to do them.

  • Learn biofeedback: Biofeedback is a special way to help you control how your body reacts. Biofeedback uses pictures and words to help you learn to control your pelvic floor muscles. Biofeedback may help you learn how to strengthen your pelvic floor muscles and decrease urine leakage. Ask your caregiver for more information about biofeedback.

  • Limit your liquids: Ask your caregiver if you should decrease the amount of liquid you drink each day. Limiting your liquids may help you leak less urine.

  • Use electrical stimulation: During electrical stimulation, a small amount of electrical energy is sent to your pelvic floor muscles. The electrical energy tightens your pelvic floor muscles to make the area stronger. Electrical stimulation treatment may be used with biofeedback to decrease urine leakage. Ask your caregiver for more information about electrical stimulation.

  • Wear a pad: Wearing a pad can help absorb leaking urine and decrease the odor from leaking urine.

Bowel movements:

After surgery, you may have trouble controlling when you have a bowel movement (BM). You may regain control of your BMs over time. Ask your caregiver what you can do to increase control of your BMs and decrease the risk for leaks.

Eat a healthy diet:

Eating a diet low in fat may help decrease the risk that your prostate cancer will return. Tomatoes and foods that contain soy have nutrients that may protect against prostate cancer. Other foods, such as beans and grains, may also help decrease your risk for cancer. Talk with your caregiver about the foods you should eat. Together you can plan the best diet for you.

Exercise and activity:

Exercise makes the heart stronger and helps keep you healthy. After surgery, it is best to start exercising slowly, and do more as you get stronger. Rest when you need to. Talk with your caregiver before you start exercising. Ask when it is safe to return to your normal activities, such as work.

Having sex:

Ask your caregiver when it is safe to have sex. After surgery, you may have trouble getting, or keeping, an erection (hardening of the penis). Erection problems may go away over a period of up to three years. Devices or medicines may help resolve erection problems during that time. Talk with your caregiver if you are having erection problems.

Limit alcohol:

Limit the amount of alcohol you drink. Drinking too much can damage your brain, heart, and liver. The risk of getting certain types of cancer is greater for people who drink too much alcohol. Drinking too much alcohol also increases the risk of having a stroke. Men should limit alcohol to two drinks a day. A drink of alcohol is 12 ounces of beer, or five ounces of wine. One and one-half ounces of liquor, such as whiskey, is one drink of alcohol. If you drink alcohol, talk with your caregiver if you need help to stop.

Quit smoking:

If you smoke, it is never too late to quit. Smoking harms your body in many ways. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. Quitting smoking will improve your health and the health of those around you. Ask your caregiver for help to stop smoking if you are having trouble quitting.

Take vitamins:

Vitamins A, C, D, E, and selenium may help prevent your prostate cancer from returning. Follow your caregiver's advice about the vitamins you should take, and how often. Ask your caregiver how much of each vitamin you should take each day.

CONTACT A CAREGIVER IF:

  • You are leaking BMs.

  • You cannot get an erection.

  • You have a fever.

  • You have bright red blood in your urine, or your urine is cloudy and smells bad.

  • You have chest pain or trouble breathing that is getting worse over time.

  • Your surgery wound is red, swollen, or has pus coming from it.

  • Your urine stream becomes slower than normal, or you are urinating only small amounts.

  • You have questions or concerns about your surgery, medicine, or care.

SEEK CARE IMMEDIATELY IF:

  • You are leaking more urine than usual.

  • You have new trouble moving your legs.

  • You have pain in your lower abdomen or pelvic area that does not go away.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

  • You suddenly feel lightheaded and have trouble breathing.

  • You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.

  • Your wound is bleeding and will not stop.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Perineal Prostatectomy (Aftercare Instructions)

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