Transurethral Prostatectomy

WHAT YOU SHOULD KNOW:

• A transurethral (trans-u-REETH-rull) prostatectomy (prah-stuh-TEK-tuh-mee) may also be called a transurethral resection of the prostate, or "TURP". This is surgery to remove or freeze part of your prostate (PRAH-stat) gland. "Transurethral" means through the urethra. Your urethra is the tube inside you that drains urine from your bladder to the outside of your body. Caregivers will not have to make incisions (cuts) to remove or freeze your prostate. It will be taken out through your urethra. You may need this surgery if your prostate has gotten too big, or for other problems.
  
  
• The prostate is a male sex gland that is normally about the size of a walnut. It is located in your pelvis, near your bladder (the organ where urine is held). The prostate gland makes semen. Semen is the fluid that comes out of your penis during an orgasm (OR-gaz-um).

AFTER YOU LEAVE:

Medicines:

• Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

• You may be given stool softeners to keep you from getting constipated (KON-stih-pa-ted). Constipation means that you are unable to have a BM for more than 3 days.
  
  
• If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

Keep all appointments:

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Bowel movements (BMs): It may be hard for you to have a BM after surgery. Do not try to push the BM out if it is too hard for at least 6 weeks. Pushing too hard can make you bleed. Walking is the best way for you to get your bowels moving. Eat foods high in fiber to make it easier to have a BM. Good examples are high fiber cereals, beans, vegetables, and whole grain breads. Prune juice may help make the BM softer. Caregivers may tell you to take fiber medicine to help make your BMs softer and more regular. Fiber medicine can be bought at drug and grocery stores.

Having a catheter (KATH-uh-ter): You will have a tube called a catheter in your bladder when you go home. The catheter will come out of your urethra and drain urine from your bladder into a bag. The catheter may make you feel like you have to pass urine. Relax and the catheter will do it for you. When the catheter is taken out, you should be able to urinate on your own.

• Your urine may be pink because there may be some blood in it. Try to rest more if there is blood in your urine. Increase the amount of liquid you drink until your urine is clear.
  
  
• A small amount of leakage or drainage of urine or fluids from around the catheter is normal. It is important to keep the catheter clean to help prevent an infection. Your caregiver will tell you how to clean it and how often you should do this. You may shower with the catheter in place.
  
  
• Do not pull on the catheter because this will make you hurt or bleed. Do not kink or lay on the catheter because the urine will not be able to drain.
  
  
• Do not lift the bag of urine above your waist. If you do this, the urine will flow back into your bladder. This can cause an infection.
  
  
• Your catheter may need to stay in for several days, or it may be taken out sooner. After it is taken out, it is important that you do not wait when you need to urinate. Find a restroom as soon as you can.

Other things to expect after surgery: You may feel like you have to urinate more often than you used to for 6 to 8 weeks after surgery. You may also feel that you have to urinate immediately. You may leak urine, have trouble starting the flow of urine, or have a weak urine stream. This is normal and should go away with time. You may pass a dark brown clump of tissue in your urine after about 6 to 8 weeks. Your urine may then be pink or blood-tinged the next few times you urinate. This is a normal part of healing and should also go away with time.

What can I do to help get control of my urination? You may do exercises to help muscles get stronger. You may start them 2 to 3 days after surgery if your caregiver says it is OK. Breathe normally while doing these exercises.

• Squeeze your stomach muscles, the muscles of your rear-end, and your perineal muscles (between your legs). Squeeze and relax these muscles 12 to 25 times each hour as often as you can.
  
  
• Squeeze your rectal (where you have a BM) muscles, while relaxing the rest of your body. Do this 12 to 25 times each hour as often as you can. Saying "squeeze" and "relax" out loud may help you do these exercises. Keep doing these exercises until you have control of your urination again.

How do I keep from getting a lung infection? Take 2 or 3 deep breaths and then cough every hour while you are awake. Do this even if you wake up during the night. Deep breathing opens the tubes going to your lungs. Coughing helps to bring up sputum (spit) from your lungs for you to spit out.

• Take a deep breath and hold the breath as long as you can. Then push the air out of your lungs with a deep strong cough. Put any sputum that you have coughed up into a tissue. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
  
  
• You may be asked to use an incentive (in-SEN-tiv) spirometer (sper-OM-ih-ter). This helps you take deeper breaths. Put the plastic piece into your mouth and take a very deep breath. Hold your breath as long as you can. Then let out your breath. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.

Using ice: Ice causes blood vessels to constrict (get small) which helps decrease inflammation (swelling, pain, and redness). Put crushed ice in a plastic bag and cover it with a towel. Place this on your groin or scrotum for 15 to 20 minutes every hour as long as you need it. Do not sleep with the ice pack because you may get frostbite.

Rest and Activity:

• You may feel like resting more after surgery. Slowly start to do more each day. Rest when you feel it is needed. Avoid lifting heavy objects.
  
  
• Do not sit in one place for hours at a time (like in a car). This can make you bleed or cause blood clots to form in your legs. Ask your caregiver how long you need to wait before starting your usual activities.
  
  
• Ask your caregiver when you can return to work.
  
  
• You may have sex in 3 to 4 weeks when you feel ready. Stop if it causes pain. You may be able to have an orgasm but you may not have semen (sperm) come out. If you do not have semen, it went into your bladder. Next time you pass urine, it will look milky. This is normal. Talk to your caregiver if you have questions or concerns.

Quitting smoking: It is never too late to quit smoking. Smoking slows healing and harms the heart, lungs, and the blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. Smoking also slows healing. Not only will you help yourself by not smoking but also those around you. If you have trouble quitting, ask your caregiver for the CareNotes™ handout about how to stop smoking.

Support: You may feel scared, confused, and anxious after having had a prostatectomy. These feelings are normal. Talk about them with your caregiver or with someone close to you. Ask your caregiver about support groups for people who have had a prostatectomy. These people can give you support and information.

Eating a healthy diet:

• Eat healthy foods from all of the 5 food groups: fruits, vegetables, breads, dairy products, meat and fish. Eating healthy foods may help you feel better and have more energy. It may also help you heal faster.
  
  
  • Avoid alcohol and spicy foods. Alcohol and spicy foods may cause pain in your bladder.
    
    
  • You may be told to eat foods that are low in fat. Ask for the "Low Fat Diet" CareNotes™ handout for more information.
    
    
  • You may also be told to limit the amount of salt you eat. Do not add salt to your food during meals or when you cook.
    
    
  • Drink at least 6 to 8 (soda pop can size) glasses of liquid each day. Follow your caregiverʼs advice if you must limit the amount of liquid you drink. Good liquids to drink are water, juices, and milk. Limit the amount of caffeine you drink. Caffeine may be found in coffee, tea, soda and sports drinks, gels and sports food bars. Drinking fluids may help prevent infection and urine problems. It will also help your stools stay soft.
  
  

Exercising after surgery: Talk to your caregiver before you start exercising. Together you can plan the best exercise program for you. It is best to start slowly and do more as you get stronger. Exercising makes the heart stronger, lowers blood pressure, and keeps you healthy. Talk to your caregiver before you start exercising. Do not exercise hard for 3 weeks after surgery.

Controlling stress: Stress may slow healing and cause illness later. Since it is hard to avoid stress, learn to control it. Learn new ways to relax (deep breathing, relaxing muscles, or biofeedback). Talk to your caregiver about things that upset you.

CONTACT A CAREGIVER IF:

• Your urine becomes cherry-colored or bright red. You may be bleeding too much. Call your caregiver if this does not go away after drinking more liquids and resting for 24 hours.
  
  
• You see the following signs that your catheter is not draining the way it should:
  
  
  • Leaking or drainage of urine or other fluids around the catheter for over 2 days after surgery.
    
    
  • More urine leaking around the catheter than draining into the catheter bag.
    
    
  • A feeling of pressure in your bladder with little or no urine draining into the catheter bag.
  
  
• You have loose BMʼs or are throwing up for more than 24 hours.
  
  
• You have a fever (increased body temperature).
  
  
• Your skin is itchy, swollen, or has a rash. Your medicine may be causing these symptoms. This may mean you are allergic (uh-LER-jik) to your medicine.
  
  
• You have questions or concerns about your prostate problems, surgery, or medicine.

SEEK CARE IMMEDIATELY IF:

• You have shaking chills.
  
  
• You have bad vomiting or abdominal cramps.
  
  
• You have pain or swelling in your legs.
  
  
• You have chest pain or trouble breathing all of a sudden. This could be a sign that you have a blood clot in your lung. It could also mean that you are allergic to a medicine you are taking. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive yourself!

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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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