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 .

Getting Ready

Before your surgery:

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Ask your caregiver if you need to stop taking vitamins, aspirin, or any other medicine before your surgery.

  • You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.

  • You may need blood and urine tests and a transrectal ultrasound. Ask your caregiver for more information about these and other tests you may need. Write down the date, time, and location of each test.

  • You will need to be on a clear liquid diet the day before your surgery. You may drink clear liquids, including water, broth, apple juice, or lemon-lime soft drinks. You may also suck on ice chips or eat gelatin. Ask your caregiver for more information about a clear liquid diet.

  • Write down the correct date, time, and location of your surgery.

The night before your surgery:

You may need to drink a medicine the night before your surgery that cleans out your bowel. Ask your caregiver for directions about eating and drinking.

The day of your surgery:

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

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

  • You may need to take antibiotic medicine to help prevent an infection caused by bacteria. You may get antibiotic medicine before and after your surgery.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

Treatment

What will happen:

  • You may be given spinal or epidural anesthesia to numb the area below your waist for surgery. Spinal or epidural anesthesia allows you to be awake during your surgery. You may instead get general anesthesia to keep you asleep and free from pain. The hair may be removed from your groin . 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 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 will be closed with stitches and your wound will be covered with a bandage.

After your surgery:

You will be taken to a room to rest until you are awake. Caregivers will check your drain and catheter for urine and blood. You may be given medicine to decrease or take away your pain. 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.

Contact a caregiver if

  • You have a fever.

  • You cannot make it to your surgery.

Seek Care Immediately if

  • You are urinating very little or not at all.

  • You have new or increased abdominal or pelvic pain.

© 2013 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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