Day before Preparation for RRP

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New Member

Date Joined Feb 2011
Total Posts : 2
   Posted 2/10/2011 1:23 AM (GMT -6)   

I am a 58 year-old man, and I have a Robotic Radical Prostatectomy coming up in two weeks.

Today I met a "nurse educator" for the pre-op instruction.

She told me, among other things, not to eat or drink anything after midnight the night before surgery.

She also said I can eat normal diet the day before and I do not need enema.


I have been reading many articles regarding the day-before preparation for the RRP on internet.

All articles indicate some sort of diet limitation and enema requirement.


Should I call my surgeon and confirm the nurse's instruction?

Has anyone who went through RRP surgery had similar preparation as I was told to do?



Regular Member

Date Joined Jan 2011
Total Posts : 126
   Posted 2/10/2011 4:29 AM (GMT -6)   
Hi Jay,

Welcome to the forum as a newbie. I had my RP just over 8 weeks ago and was admitted to hospital the day before. I ate and drank as normal and my water was taken away and i was declared as "Nil by mouth" at 2.00am and went down for surgery at 8.30 am. So do not worry about the nurse's instructions, they are just like i had.

Keep us up to date on how you go and no doubt you will get lots of support from all the guys in here, i know i did.

Take care, Bob.
Age 58
Prostate problems since early 40s
Ed since early 40s
April 2007 biopsy & all clear
July 2010 prostate swollen more, psa up to 5.6 August 6.7
September Biopsy again
October 7th diagnosed cancer, Gleason grade 6 at 10% mass
December 13th 2010 open radical proctatectomy
Pathology results came back Gleason grade 7 at 12% mass BUT clear margins
Catheter out Jan 5th 2011

Regular Member

Date Joined Jan 2011
Total Posts : 78
   Posted 2/10/2011 5:06 AM (GMT -6)   
Hi Jay,
My surgery is on Monday.  I am on a clear liquid diet the day before and no food after midnight.  At noon the day before I have to drink a laxative - Citrate of Magnesia.
No enema.
I was given a handout with all of my exact instructions.  It would have been helpful if you could have been given something.  I would have a hard time rememberinge everything. 
Good luck!
PSA 3.9 - October 2010 at annual physical
PSA 4.1 - November 2010 after a month of antibiotic, DRE Normal
Age 41 in December 2010 at Dx of 6 of 12 cores positive T1C and Gleason 3 + 3

Scheduled for open RP on 2/14/11 at Mass General

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2217
   Posted 2/10/2011 5:44 AM (GMT -6)   
When to stop eating rules etc seem to be different in different countries. I was treated in Holland. I was due in surgery at 11am and was told I could have a light breakfast at 7am, but once at the hospital they said it would have been okay to have breakfast at 9am.
The rules relate to the risk of vomiting during surgery and the vomit getting in the lungs and either interferring with breathing or damaging the lining of the lungs etc. Now with the robot you are lying 45 degrees to the vertical, so it is actually quite hard for any stomach contents to get into the lungs. HOWEVER...there are one or two people here who, half way through the robot, were switched to open surgery and then you would find yourself lying in a normal surgery position falt on your back, and I'm pretty certain that most anaesthetists would prefer you to have an empty stomach if that happened.

Having an enema or laxative to make an empty bowel means that the abdominal cavity has more room in it for the surgeon to get his hands or instruments to the operation site. The robot needs less sapce than the fists of a surgeon, and with the robot the belly is also inflated to make a lot of space. I had neither enema nor laxative. I just had my normal BM that morning.

I hope you were also told to check what medications you should not take or should stop taking prior to surgery, eg aspirin is a no no, and thus so are many heart medications that thin the blood etc.
Born Jun ‘60
Apr 09 PSA 8.6
DRE neg
Biop 2 of 12 pos
Gleason 3+3
29 Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
17 Nov 09 PSA 0.1
17 Mar 10 PSA 0.4 sent to RT
13 Apr CT
66Gy 28 Apr to 11 Jun 10
Tired + weird BMs
14 Sep 10 PSA <0.1
12 Jan 11 PSA <0.1
Erection OK

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4848
   Posted 2/10/2011 6:40 AM (GMT -6)   
I hate the part about no caffeine or nicotine...espicially the no nicotine. If there was ever a time to smoke a bunch - its right before surgery smhair
For some reason, I always thought the 45 degree angle was head down to reduce blood pressure to the lower part where the cuttin is done.. And if you're head down - what's in the stomach might go back towards the lungs etc...

Regular Member

Date Joined Oct 2010
Total Posts : 175
   Posted 2/10/2011 7:19 AM (GMT -6)   
Jay, I had an RRP scheduled at my first hospital a few weeks ago and the op was canceled because of an infection. The instruction these people gave was eat/drink anything, but nothing after midnight. They advised to take the magnesium citrate at 6pm and told me it would "work" within an hour.

It did not!.

That stuff started doing its magic at 1am, and I was up all night. I still felt the need to void at 7 am, as I was being prepped for surgery.

Interestingly, my instructions for new hospital (Yale) pre-op, says take the mag. citrate at noon, because of the potential for delayed onset.

The Yale staff is light years ahead of the boneheads who nearly killed me (long story, already explained)

52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.

DaVinci prostatectomy scheduled for March 4 at Yale. Lets hope attempt 2 at this goes better than my first try.

Forum Moderator

Date Joined Jan 2010
Total Posts : 7080
   Posted 2/10/2011 9:47 AM (GMT -6)   
My written instructions were no solid food or red liquids the day before - i.e. liquids / jello / broth were ok so long as not red colored.
Then nothing at all from midnight except some water to take the approved meds that morning. The doctor called the night before and said a half-cup of coffee was ok, but the admission nurses freaked out.
Aspirin and the like was forbidden for two weeks before.
DaVinci 10/2009
My IGRT journey (2010) -

Regular Member

Date Joined Feb 2011
Total Posts : 35
   Posted 2/10/2011 9:50 AM (GMT -6)   

I had a da Vinvi RRP 2 weeks ago.  My last meal was breakfast the day before surgery.

I was told I could've eaten lunch the day before.  But the laxative instructions state not to eat within 4 hours of taking the laxative.

I drank the 1 gallon of laxative around 3 PM the day before surgery.  It started working in about an hour and a half.  The laxative treatment was like a major garden hose full flush through my bowels.  By 6 PM the laxative treatment was pretty much finished.

I drank only water until midnight; after that nothing was permitted.  I was not instructed to do an enima.

Following surgery it took about 3 days to have a BM.  Even after 2 weeks my bowels are still not totally normal, but close.


Age 58; da Vinci prostatectomy on 1/26/2011
PSA History: 10/2005 = 1.7; 10/2007 = 2.8; 10/2009 = 3.6; 10/2010 = 4.9
Abnormal DRE in 2009; Increasingly abnormal DRE in 2010
Biopsy on 11/23/2010: GS = 3+4 (right side) with 4 of 6 cores positive @ 40%.
Post-OP pathology: GS=3+4; tumor = 35%; pT3b; R. seminal vesicle invasion; Extraprostatic extension into the R. bladder neck; margins uninvolved

Regular Member

Date Joined Jan 2010
Total Posts : 363
   Posted 2/10/2011 9:59 AM (GMT -6)   
Had open back in March '10, nothing but liquids after 9 P.M. no laxative. Showed up for surgery at 0630. No coffee morning of surgery was the worst part of the prep'.
07-06 PSA 2.5
01-08 PSA 5.5
09-09 PSA 6.5
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5
03-01-10 Age 55 RRP in Durango CO by Dr Sejal Quale and Dr Shandra Wilson
03-16-10 Path' G-8 (4+4+5) Bilateral involving 21% of left lobe, 3% of right lobe, SVI, Focal positive margin, pT3b NO MX

All PSA as of 1-25-11 <0.04
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