Retropubic Prostatectomy

WHAT YOU SHOULD KNOW:

A retropubic prostatectomy is surgery to remove your prostate gland.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • During surgery, your nerves, bowel, rectum, and other organs and tissues may be damaged. Blood vessels may be damaged, causing you to bleed more than expected. You may need a blood transfusion if this happens. After surgery, blood may collect in your pelvic area (between your legs and hips) that needs draining. You may have pain, and you may get an infection in your wound or urinary tract. Your urethra or bladder neck may become narrow and block the flow of your urine. Urine may leak from your bladder and collect in nearby areas, such as your abdomen. You may get a hernia in your lower abdomen. A hernia occurs when part of your intestine pushes through weak muscle in your abdomen.

  • After surgery, you may leak urine and bowel movements. Urine leakage may be short-term or permanent. You may have trouble having an erection. You may have pain or trouble ejaculating. You may get a blood clot in your arm or leg. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. Even with surgery, your cancer may not be completely removed, the cancer may spread, or it may come back.

  • Without surgery, your cancer may spread to other areas of your body and be more difficult to treat. Prostate cancer can be life-threatening .

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. You may need to wear pressure stockings before or after surgery or if you have poor circulation (blood flow).

  • Medicines:

    • Enema: You may be given an enema (liquid medicine put in your rectum) to help clean out your bowel.

    • Antibiotics: Antibiotics may be given to help prevent an infection caused by bacteria. You may get antibiotic medicine before and after your surgery.

  • Anesthesia:

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

    • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

  • Blood transfusion: You may need a blood transfusion if you lose too much blood during surgery.

During your surgery:

  • A catheter (long, thin tube) will be inserted in your urethra and into your bladder to drain your urine. An incision will be made in your abdomen below your belly button. Outer layers of skin, tissue, and muscle will be cut and secured out of the way. Your surgery may be done with a laparoscope, through small cuts in your abdomen. A laparoscope is a long metal tube with a light and camera on the end. Your caregiver may use a robot-assist device if a laparoscope is used during surgery. Ask your caregiver for more information about laparoscopic and robot-assisted prostatectomy surgery. Before your prostate gland is removed, lymph nodes may be removed and sent to a lab to test for cancer.

  • Your caregiver will cut your urethra below the prostate gland and remove the catheter. Stitches will be put into your urethra to help stop the bleeding. Your prostate gland will be cut away from your bladder neck and removed through the cut in your abdomen. The bladder neck is where the bottom of your bladder meets your urethra. Your bladder neck and urethra will be sewn back together, and a new catheter will be put in. Liquid will be flushed through the catheter to remove blood and blood clots from your bladder. A drain (thin, rubber tube) will be placed in your incision to remove blood and fluid. Your cut is closed with stitches and your wound (surgery area) is covered with a bandage.

After your surgery:

You will be taken to a room to rest until you are awake. Do not get out of bed until your caregiver says it is okay. Once caregivers see that you are not having any problems, you will be taken to your hospital room.

  • Activity: Caregivers may help you get out of bed to walk on the day after your surgery. Ask caregivers if there are exercises that you can do in bed. Exercise helps blood move through your body and may help prevent blood clots. Call for a caregiver before you get out of bed for the first time. If you feel weak or dizzy while standing up, sit or lie down right away and call for a caregiver.

  • Foley catheter: Keep the bag of urine below your waist. Lifting the urine bag higher will make the urine flow back into your bladder and cause an infection. Do not pull 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. Caregivers will remove the catheter when you no longer need it.

  • Blood and urine output: Caregivers will measure the amount of blood and urine that flows from your wound drain and catheter. The drain in your wound is removed when blood and fluid stop flowing from it.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • Medicines:

    • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you ask for more medicine.

    • Patient controlled analgesia: You may get pain medicine through an IV or an epidural line attached to a patient controlled analgesia (PCA) pump. Caregivers set the pump to let you give yourself small amounts of pain medicine when you push a button. Your pump may also give you a constant amount of medicine, in addition to the medicine that you give yourself. Let caregivers know if your pain is still bad even with the pain medicine.

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

© 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.

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