Suprapubic Prostatectomy

WHAT YOU SHOULD KNOW:

  • Suprapubic prostatectomy, also called transvesical prostatectomy, is surgery to remove part or all of your prostate gland. Your prostate gland is a 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 suprapubic prostatectomy if you have benign prostatic hypertrophy (BPH). BPH is a condition that increases the size of your prostate gland. With BPH, your enlarged prostate may squeeze your urethra and slow or block your urine flow. Blocked urine flow may lead to problems, such as incomplete bladder emptying, and bladder and kidney infections. You may leak urine, and urine may build up in your bladder and cause bladder stones.

  • During suprapubic prostatectomy surgery, an incision (cut) is made in your suprapubic area and into your bladder. Suprapubic means the area above your penis, in your lower abdomen. Your prostate is removed through the cuts in your skin and bladder. Your caregiver may also remove bladder stones or growths at the same time. A suprapubic prostatectomy may treat your BPH. After surgery, you may find it easier to urinate, and you may urinate less often. A suprapubic prostatectomy may also help decrease your risk for urinary tract infections.

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.

  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your healthcare provider. Do not stop taking your medicine unless directed by your healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

  • Blood thinners: This medicine helps prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. Use an electric razor and soft toothbrush to help prevent bleeding.

  • 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.

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 your bladder catheters taken out. You may need urine tests to check for infection. Tests may also be done to check your urine flow. You may have post-void residual testing to check if your bladder empties completely when you urinate. Your caregiver may do a transrectal ultrasound, and an ultrasound to look at your bladder and urinary tract.

Bladder catheters:

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

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: Avoiding food and drinks that have caffeine in them may help prevent problems with urination. Caffeine may be 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 to bring back or 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 urine less.

  • Maintain a healthy weight: Weighing more than your caregivers suggest can cause serious health problems. You are also more likely to leak urine if you are overweight. Talk with your caregiver about a weight-loss plan if you are overweight.

  • 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.

Exercise and activity:

Exercise makes the heart stronger, lowers blood pressure, 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. You may be able to return to your normal daily activities in 4 to 6 weeks after surgery. Talk with your caregiver before you start exercising. Ask when it is safe to return to your normal activities.

Having sex:

Ask your caregiver when it is safe to have sex after your surgery.

Limit alcohol:

Limit the amount of alcohol you drink. Drinking too much can damage your brain, heart, and liver. The risk of getting high blood pressure and 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. 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 how to stop smoking if you are having trouble quitting.

CONTACT A CAREGIVER IF:

  • You are not able to get an erection (a hard penis).

  • 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 sperm does not exit your body through your penis when you ejaculate.

  • 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 feel the urge to urinate, but no urine comes out.

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

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

  • You suddenly feel lightheaded and have trouble breathing.

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

  • Your scrotum (the skin sac that holds your testicles) becomes swollen.

  • 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 Suprapubic Prostatectomy (Aftercare Instructions)

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