Post-Operative Instructions for Da Vinci Prostatectomy surgery

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qjenxu
Regular Member


Date Joined Sep 2009
Total Posts : 187
   Posted 10/26/2009 9:00 AM (GMT -6)   
I had request a Post-Op. Care list from our surgeon's office to mail to me, I also fund this link

www.healthsystem.virginia.edu/internet/prostatectomy/archivedsitefiles/postop.cfm


(AFTER YOUR SURGERY)

DIET:
Diet, Activities, Skin Care, Catheter, Medication, Recovery Time, Handling SIde Effects, Follow Up Appointments, Contact Information, Back To Top

* Eat clear liquids such as Jello, broth, or juices (no pop or carbonated beverages) until you have a good bowel movement. You may then resume a regular diet.

ACTIVITY LEVEL:
Diet, Activities, Skin Care, Catheter, Medication, Recovery Time, Handling SIde Effects, Follow Up Appointments, Contact Information, Back To Top

* It is good for you to walk around.
* Do not sit in one place for longer than 45 minutes at a time.
* Absolutely no biking, motorcycling, or horseback riding for 4 weeks.
* You can do as much walking and stair climbing as you can tolerate.
* You may take a shower 48 hours after surgery.
* Do not drive while taking pain medications.

SKIN INTEGRITY:
Diet, Activities, Skin Care, Catheter, Medication, Recovery Time, Handling SIde Effects, Follow Up Appointments, Contact Information, Back To Top

* You will have 4-6 port sites (small incisions that we perform the surgery through) that will have steri strips (small pieces of tape) and Band-Aids over them.
* Band-Aids may come off in 48 hours. Steri strips may also come off as early as 48 hours post-surgery or they may stay in place until you are seen in clinic.
* Once your dressings are off, it is not uncommon to have a very small amount of drainage from where your dressings were. There are no staples or stitches to be taken out.

URINARY CATHETER (also called a Foley catheter):
Diet, Activities, Skin Care, Catheter, Medication, Recovery Time, Handling SIde Effects, Follow Up Appointments, Contact Information, Back To Top

* During surgery you will have a urinary catheter placed in your bladder. A urinary catheter is a tube carrying urine from your bladder to the outside of your body into a bag. This urinary catheter will stay in place until your anastamosis heals, which usually takes about 4-14 days. At home, the catheter should drain into a large bag. When you want to go out, you can wear a smaller bag under your pant leg. You and your family will also receive instructions regarding the care of your urinary catheter before discharge from the hospital.

MEDICATIONS:
Diet, Activities, Skin Care, Catheter, Medication, Recovery Time, Handling SIde Effects, Follow Up Appointments, Contact Information, Back To Top

* You may resume your daily medications as soon as you are discharged from the hospital.
* An antibiotic will be prescribed to you, to be taken by mouth. Start this the day before you come in to have your catheter taken out and continue taking this medication for 5 full days. You will receive a prescription the day of your discharge.
* A pain medication will be prescribed for you, to be taken by mouth as directed for pain. You will receive a prescription the day of your discharge.
* A stool softener should be taken by mouth two times daily. You can buy this medication over the counter and do not need a prescription. All narcotic pain medications are constipating and a stool softener will help to prevent this.

RECOVERY TIME:
Diet, Activities, Skin Care, Catheter, Medication, Recovery Time, Handling SIde Effects, Follow Up Appointments, Contact Information, Back To Top

* The operation lasts two to four hours and the hospitalization usually lasts 24 hours. Some patients go home the day of surgery. All patients go home with a catheter in place continually draining the urine into a special leg bag.
* You will be seen about 4-7 days after surgery in the clinic on K-9 to determine if the catheter will be removed at this visit.
* You will be cleared by our team to return to work generally 2 weeks after surgery.
* Most men have difficulty with urinary control at the beginning and will require some form of protection, such as a pad that fits inside your underwear. That is why it is important at the first visit to bring Depend Guards for Men pads and a pair of Jockey underwear.
* Within one to three months, most men have achieved reasonably good control and require minimum protection, if any. Sometimes, the recovery of continence is slower, but rarely more than three to six months. You can perform your routine work once the catheter is out within the limits of your pain tolerance.
* Kegel exercises should be started/resumed after the Foley catheter is removed. These exercises help to regain your continence. At first it may be hard to find these muscles, but can be done by starting and stopping your urine stream. Once you find the correct muscles, repeat the flexing and relaxing of these muscles without urinating. Begin by squeezing the muscles for a count of 3, then relax for a count of 3. Work up to repeating these exercises for 3—5 minutes two to four times a day. These will help to strengthen your muscles around the bladder that help hold the urine. For more detailed information on how to perform Kegels, please see instruction sheet enclosed in this packet.
* The recovery of potency after a prostatectomy can be slow and time-dependent. Even though the nerves to the penis can be spared, there is still some injury from trauma or stretching from the operation. These damaged nerves need time to heal. At each follow-up visit, issues regarding sexual function will be discussed with you by your health care provider. If you have any other questions or concerns, the nurse practitioner can make an appointment for you to discuss this issue in more detail.

THINGS YOU MAY ENCOUNTER AFTER SURGERY:
Diet, Activities, Skin Care, Catheter, Medication, Recovery Time, Handling SIde Effects, Follow Up Appointments, Contact Information, Back To Top

* Perineal Pain (pain between your rectum and scrotum): Call us if the pain medication does not alleviate this. You can also try elevating your feet on a small stool when you have a bowel movement, using Anusol cream, and increasing the fiber and water intake in your diet.
* Scrotal/Penile Swelling and Bruising: This is not abnormal and should not alarm you. It should resolve in about 7—10 days. You may also try elevating your scrotum on a small towel or washcloth that you have rolled up when you are sitting or lying down to decrease the swelling. It is also recommended to wear Jockey or snug-fitting underwear for support.
* Bladder Spasms: It is not uncommon with the catheter in and even after the catheter comes out to have bladder spasms. You may feel mild to severe bladder pain or cramping, the sudden, urgent need to urinate, or a burning sensation when you urinate. Call us if this persists without relief.
* Bruising around the incision sites: Not uncommon and should not alarm you. This will resolve itself over time.
* Bloody drainage around the Foley catheter or in the urine: Especially after increasing activity or following a bowel movement, this is not uncommon. While this is often alarming, it is not uncommon and usually resting for a short period of time improves the situation. Call if you see clots in your urine or if you have no urine output for one to two hours.
* Abdominal Distention, Constipation or Bloating: Make sure you are taking your stool softener as directed. If you don’t have a bowel movement 24 hours after surgery, try taking Milk of Magnesia as directed on the bottle. If after three doses of Milk of Magnesia you still have no bowel movement, it is safe to use a Dulcolax suppository.

FOLLOW-UP APPOINTMENTS:
Diet, Activities, Skin Care, Catheter, Medication, Recovery Time, Handling SIde Effects, Follow Up Appointments, Contact Information, Back To Top

* One week after surgery: You will come to the Urology clinic 7 days after your surgery. At that time, a cystogram (an x-ray of your bladder) may be taken to see if enough healing has occurred in order to remove the Foley catheter. At this appointment, you will to bring a pair or two of Jockey underwear and several Depend Guards for Men pads. Remember to start your antibiotics 24 hours prior to coming to this appointment and continue the antibiotics for 5 full days.
* One month after surgery and every three months after that: You will continue to follow up with the Urology clinic. You will get a PSA drawn prior to each appointment.
* At each visit, you will fill out questionnaires regarding your urinary continence as well as your erectile function. You will receive education materials regarding those issues as needed.
* We will also be looking for evidence of recurrence or re-growth of the tumor. That is done by drawing blood for the Prostate Specific Antigen or PSA blood test. When the prostate gland is removed (prostatectomy), we expect the PSA level to be undetectable (less than 0.2ng/ml). If any PSA is measured after your prostatectomy, then the presence of prostate cancer cells somewhere in the body has to be suspected. Prostate cancer cells that have spread to other areas also leak PSA. Even if we cannot find the areas of spread with scans or other tests, the presence of PSA means that the cancer is present. If PSA is detectable (i.e. 0.2ng/ml) after surgery, then this means that some prostate tissue (prostate cancer) remains in your body. This could be at the site of the prostate surgery, in the lymph nodes or elsewhere.


CONTACT doctor's office IMMEDIATELY IF YOU ARE EXPERIENCING ANY OF THE FOLLOWING SYMPTOMS:

* Temperature over 101° F
* Urine stops draining from your catheter into the drainage bag
* Any pain so excruciating that pain medication is not relieving it
* Large amount of blood clots in urine.
* Bladder spasms that are not relieved with pain medication


======================================================================

Please add anything you think I may need to know. Sephie alreay add some useful tips.

Thanks

Jennifer

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 10/26/2009 9:10 AM (GMT -6)   
Jennifer,

That's an excellent list, and would be well worth saving for other's coming down the path. Just about covered everything.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 10/26/2009 9:23 AM (GMT -6)   
Jennifer, wow ... you did a fabulous job collecting this information. I agree with David that this might be worth posting to James C's new thread about what you need to know before.

Great job!!
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (extraprostectic extension in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Gleason 3+4 (no change from biopsy). PSA results: April 2008 0.1; May 2008 0.0; August 2008 0.0; November 0.0; February 2009 0.0; May 2009 0.0; August 2009 0.1; September 2009 0.3. Met with radiation oncologist and began process for salvage radiation. CT scan and bone scan done on October 8. One spot on bone scan (clavicle) being investigated. Third PSA taken on October 16 - PSA IS UNDETECTABLE! Next PSA scheduled for early December. Urged not to begin radiation treatment until it's needed (no problem there!).


qjenxu
Regular Member


Date Joined Sep 2009
Total Posts : 187
   Posted 10/26/2009 9:25 AM (GMT -6)   
Thanks David and Sephie. Hopefully someone would get info they needed here.

Also I am looking for instruction for penile rehab (Sonny mentioned in his post) instruction. I am collecting these info just want be available for when my husband need.

I regret that I didn't respond well enough when his PSA score leaded him to a biopsy recommend by his urologist, if i was knowledge enough, I would suggest him to get color doppler ultrasound with the biopsy done instead of the regular biopsy.

Oh well, never a bad idea to be prepared.


Jennifer

Post Edited (qjenxu) : 10/26/2009 9:34:00 AM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 10/26/2009 9:49 AM (GMT -6)   
Jennifer, you did what you did, based on what you knew at the time, that's how most people make decisions. No harm, no foul in my book. Learning is a constantly moving line in the sand. Hopefully we learn something new every day.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 10/26/2009 10:25 AM (GMT -6)   
Bring loose fitting pants such as drawstring sweat pants, jockey brief underwear, and a loose fitting shirt to the hospital to wear home when discharged. Your abdomen will be distended and you do not want clothing that will rub against your surgical wounds.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day


qjenxu
Regular Member


Date Joined Sep 2009
Total Posts : 187
   Posted 10/26/2009 10:33 AM (GMT -6)   
I thought a night shirt + loose bathrobe would do when I take him home. smilewinkgrin

O Buddy Boy
Regular Member


Date Joined Oct 2009
Total Posts : 106
   Posted 10/26/2009 10:57 AM (GMT -6)   
My surgeon took a different approach on some of the points. I understand it reflects some newer thinking.

Most significant regarded pain medication and diet.

We used fewer opiates and more anti-inflammatory medications. Opiate-based pain killers cause constipation which require more of a liquid diet. I was on solid food six hours after surgery. No problems. In some people opiates can cause withdrawal symptoms, including more severe depression.

We had no antibiotics after release from hospital, and would only use them if a fever was present.

Using only Motrin and experiencing only a slight increase in pain from opiates (I have had to major surgeries, unrelated to PCa when I was younger) I was able to eat solid foods as desired.

I was also authorized to lift light weights, using up to 10 lb. dumbbells. Hernia is a concern here. I found 8 pound dumbbells comfortable. I'm also encouraged to stretch.

Two weeks after surgery I feel close to normal. Perinium swelling has gone down, and pain is minor. I walk 4-8 miles a day at a very fast pace, look forward to steps and stairs, and lift light weights three times a week.
y

OBB
55 yo
Dx:9/29/09
DRE: Susp
PSA: 3.5
Gleason: 3+4/7
6/12 Cores Positive; Sextants were 1%, 3%, 8%, 15%, 12%, 0%
RALP: 10/10/09
PATH:
Margins: Clear
Lymph Nodes: Clear
Seminal Vesicles: Clear
Gleason: No increase from biopsy 3+4/7
Some perineural and capsule invasion.
T2c,NO,MX


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4087
   Posted 10/26/2009 11:38 AM (GMT -6)   

Jennifer:

You state, "I regret that I didn't respond well enough when his PSA score leaded him to a biopsy recommend by his urologist, if i was knowledge enough, I would suggest him to get color doppler ultrasound with the biopsy done instead of the regular biopsy."  Since you are still pre-procecure, if you and your husband believe that a color doppler is important why don't you do it rather than regret it?

Secondly, I know you have decided upon a treatment and mean the following as no criticism of that whatsoever...I know you considered options and I wish you the best.  However, I can't help but contrast your post-op instructions with the ones I received which are as follows (word-for word I think):

1.  Take one Vicodin the night of the procedure.  That should be all you need for pain control.

2.  Take one Flomax pill each day for two-three months.  There are no dietary restrictions however you might consider moderation re alcohol and spicy foods as that may cause some increased frequecy of urination.

3.  Wait two weeks before resuming sexual activities.

4.  Come back in six months for a DRE and PSA test.

5.  Enjoy your life because you are likely cured of your cancer.

Tudpock


Age 62, Gleason 4 +3 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 9/1/09.  6 month PSA  1.4 and my docs are "delighted"!

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 10/26/2009 12:09 PM (GMT -6)   
Would you folks take the essence of these really valuable tips you are discussing and put them in the Things I Didn't know thread? They are really things that fits there perfectly. Thanks
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, Bimix .3ml PRN or Trimix .15ml PRN


qjenxu
Regular Member


Date Joined Sep 2009
Total Posts : 187
   Posted 10/26/2009 12:15 PM (GMT -6)   
Tudpock

first, there is little difference between me and my husband toward how to treat illness. if i have pc, i would rather pack up and seek better option or the better doctor. I would do anything necessary include color doppler ultrasound. My husband , on the other hand, probably only heard color doppler ultrasound from me as I mentioned to him. If he think currently he is going to have surgery and that would treat his cancer, he is happy with that. Also because his work is very heavy and stressful, he doesn't feel go see more opinion or more doctor. therefore, if I can arrange a color doppler ultrasound with biopsy before my husband had his regular one, he may go for that. but now, he think that is unnecessary.

Second, the post-op instructions i post is what I fond on internet. every hospital or clinic may has different ones. I use it as a general information that I can read now. I would follow the instruction from my surgeons office as a real guide. the one you post has the equal value as others. I can't tell which one is better.

Jennifer

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 10/26/2009 2:36 PM (GMT -6)   
Jennifer, please do not second-guess yourself regarding your husband's biopsy - it serves no purpose. All you can do is educate yourself as best you can (which you are doing brilliantly) and make decisions based on what you know. If your husband doesn't want a color doppler sonogram, then don't force him. He's comfortable with his decision so let him be. As to post-surgical instructions, your doctor's should override anything you read here. You are right - each doctor is different and each patient comes through surgery in a different way. What we've all posted here are from our own experiences and should not influence you in any way.

Tudpock: with all due respect to your doctor, I'm not crazy about item #5 in your post - "cured" is a word that most doctors who treat cancer tend to shy away from as it implies a promise. Sadly, there are stories of men who had surgery, did great for 5, 10 and even 15 years only to face a recurrence. Cancer goes into remission - that doesn't mean it won't or can't rear its ugly head down the road.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (extraprostectic extension in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Gleason 3+4 (no change from biopsy). PSA results: April 2008 0.1; May 2008 0.0; August 2008 0.0; November 0.0; February 2009 0.0; May 2009 0.0; August 2009 0.1; September 2009 0.3. Met with radiation oncologist and began process for salvage radiation. CT scan and bone scan done on October 8. One spot on bone scan (clavicle) being investigated. Third PSA taken on October 16 - PSA IS UNDETECTABLE! Next PSA scheduled for early December. Urged not to begin radiation treatment until it's needed (no problem there!).


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 10/26/2009 2:57 PM (GMT -6)   
Sephie, I am starting to believe that all PC is chronic, not so much a 100% cure. Different men will live much longer without remission then others, many will die of other causes other than PC.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4087
   Posted 10/26/2009 6:32 PM (GMT -6)   

Sephie:

Please note the word "likely" in my post.  This was clearly not a promise or a guarantee and I did not take it as one.  But, with the projected success rate for my cancer stats and procedure, "likely" is certainly appropriate...don't nitpik...

BTW, the reason for my short list is because of the non-surgical nature of my treatment.

Tudpock


Age 62, Gleason 4 +3 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 9/1/09.  6 month PSA  1.4 and my docs are "delighted"!

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 10/26/2009 7:12 PM (GMT -6)   
qjenxu
you are right, a nightshirt and bathrobe would work. But I didn't want to feel like an invalid -- I wanted to leave the hospital as a cured man not as a patient -- it is OK if the words "macho jerk" come to mind

I still recommend jockey briefs underneath. You want that catheter immobilized and not swinging around and pulling on sore stuff.

The first days at home either a nightshirt, so nothing touches the catheter or jockey briefs to holld it down were best.

When walking I sometimes taped the cath tube to my thigh to stop being jerked around.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 10/27/2009 5:07 AM (GMT -6)   
Tud, thanks for the clarification. Of course, you are correct. Sorry about the nitpicking ... didn't mean it to sound that way.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (extraprostectic extension in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Gleason 3+4 (no change from biopsy). PSA results: April 2008 0.1; May 2008 0.0; August 2008 0.0; November 0.0; February 2009 0.0; May 2009 0.0; August 2009 0.1; September 2009 0.3. Met with radiation oncologist and began process for salvage radiation. CT scan and bone scan done on October 8. One spot on bone scan (clavicle) being investigated. Third PSA taken on October 16 - PSA IS UNDETECTABLE! Next PSA scheduled for early December. Urged not to begin radiation treatment until it's needed (no problem there!).


English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2211
   Posted 10/27/2009 8:31 AM (GMT -6)   

hello all

(I tried to post this earlier in the day, but it failed to materialize on the forum, so sorry if if it some how turns up twice) 

When I had the catheter in they also put a large plaster on the top of my right thigh. The plaster had a tape attached to it which was sticky on the inside and could be tightened with a velco strip. This was for holding the catheter tube etc in place. (At the joint when the actual catheter joined the pipe to the bag).  As they also gave me a spare plaster I put that on my left thigh and could thus move the piping easily from left to right, which was very handy.

(If you sleep on your side you may fine it helpful to have an extra pillow between your knees or at your side to lean on so that you don't squash your abdomen too much or get the tubes between you legs.

 

Steristrips were mentioned, but Watch out! You may have an adverse reaction to the adhesive

My wounds were stitched (not stapled) and covered with plasters, all but one of which had been taken off by the time I came round from the anaesthetic. I was told before the op to make sure that all plasters had been removed within 24 hours. The wound left when they removed the drain was kept closed with a steristrip, but this very quickly started to itch and then when I pulled it off discovered I had pulled off my skin as it had caused blisters. (It was sore and painful for several days.)

 

Not really post op care, but I didn't see any mention of the position in which your body is put for the Da Vinci operation, and this does have a relevance to how you may be after the op. I was packed in foam padding etc and lain with my head below my feet at an angle of 45 degrees. This is so gravity can help move the intestines etc away from the operation site. A side effect of this is the extra blood flow to the head thus we were told (And partners were warned) that after the operation you might have a very red and swollen face, nose or lips. As it happens I did not, but they do not like partners not to know this might happen. It goes away after a few days.

 

Also saw so mention of the left over gas. CO2 is pumped into the abdomen to blow it up to make space for the surgeons to see. I was told that after they sew you up some of this gas will remain trapped in the abdomen. During the first week this gas will migrate through your body towards the tops of your shoulders while it is being absorbed, and it can cause shoulder pain, especially if you do not walk about enough. In my case it was also possible to feel hundreds of little bubbles just under the skin above my ribs if I pressed there - really weird! Another reason to walk about a lot. I still had bubbles about the place at the time they removed the catheter

 

And with regard to the many strange changes that happen to the penis don't forget to mention that as well as shrivelling, it may twist about or rotate along its own axis from time to time so that when you look down at it you may see it sideways on. My testicles also seem to hang lower than before and the vas def etc inside my scrotum was a little tender, but that is no doubt due to the vas def being severed further up.

 

I am a great fan of Dettol as a disinfectant, (My father, who was a doctor/surgeon/obstetrician etc was one of the first people in the world to use it) I thus have a spray containing a dilute solution iof Dettol in water that I make up myself and this was very useful to spray on my wounds and genitals in the early days when I was washing to help keep things extra clean. Also used it every time I washed my hands.

 

It's a bit hard for me to pass on to others all the things I was told, as having been operated on in Holland, where I live,  I was told them all in Dutch of course!

 

"Progress is the peeling off of ignorance"

 

Alfred.


Age at Dx 48         No Family history  of Prostate Cancer

Married 25 years, and I cannot thank my wife enough for her support.

April 2009: PSA 8.6  DRE: negative. Tumour in 2 out of 12 cores. Gleason 3+3.

RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29th July 2009. Stay 1 night.

Partial erections on 1st and 2nd Aug 2009, Catheter out on 6th Aug 2009. 

Dry at night, but wearing pads 24/7

Post-op Gleason 3+4. Seminal Vesicles invaded, but otherwise negative margins,

Erection 100% on 15th Aug 2009   Stopped wearing pads on 21st Sept 2009

Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc.

 


Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 658
   Posted 10/27/2009 8:55 AM (GMT -6)   

Thanks so much Jennifer !!!!!!!,  I copied/pasted this and sent it to my wife type person. I'm T -6 days and counting for my Da Vinci. This is a gift!

Jack


Age: 51 years,
Overall Health: Excellent
PSA: 08/31/2009   6.8
DRE: 09/10/2009 "nothing really" ????
BXY: Scheduled at 08:30 on 09/24/2009
GLEASON 3+3=6
Cores 10 of 12 positive
SURG: da Vinci Scheduled for November 2 2009 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 10/27/2009 9:13 AM (GMT -6)   
ALfred, that was a great and detailed account. Should be some good info there to help those with upcoming surgeries
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


qjenxu
Regular Member


Date Joined Sep 2009
Total Posts : 187
   Posted 10/27/2009 11:53 AM (GMT -6)   
Thanks for all great tips here. would be a big help!


and GOOD LUCK Jack for your incoming surgery!
Wish you the greatest!
Jennifer
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