after RP . pelvic drain?

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klains
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Date Joined Nov 2010
Total Posts : 79
   Posted 5/16/2011 6:22 AM (GMT -6)   
Husband home... whooo hoo .....!! :-)
Not sure if its called the pelvic drain. The small round fillable ball that connects to the stomach . Husband had the surgery Friday, that ball stayed in until Sunday, at discharge.( one hour before going home it was removed . Saturday at 3pm it was full, . ( not sure if it was emptied through the night. Question is , Is it normal to leak fluid after removal, if so if there is anything should be done , and how long this may go on for?

davidg
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Date Joined Feb 2011
Total Posts : 4093
   Posted 5/16/2011 6:27 AM (GMT -6)   
a little yes. I'm sure they cleaned i well in hospital and showed you how to clean it and care for it. Mine oozed a little, not much. If it oozes a lot and/or smells foul you need to call your doctor. Even my other incisons, at least the one over belly button, oozed a little first 2-3 days. But it all heals quickly.

Glad you're home. Things are going to get easier for you by the hour now. You guys got through it, isn't it an experience?
40 years old - Diagnosed at 40
Robotic Surgery Mount Sinai with Dr. Samadi Jan, 2011
complete urinary control and good erections with and without meds
Prostate was small, 34 grams.
Final Gleason score 7 (3+4)
Less than 5% of slides involved tumor
Tumor measured 5 mm in greatest dimension and was located in the right lobe near the apex.
Tumor was confined to prostate.
The apical, basal, pseudocapsular and soft tissue resection margins were free of tumor.
Seminal vesicles were free of tumor.
Right pelvic node - benign fibroadiopse tissue. no lymph node is identified.
Left pelvic node - one small lymph node, negative for tumor (0/1)

AJCC stage: pT2 NO MX

MrGimpy
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Date Joined Jul 2009
Total Posts : 504
   Posted 5/16/2011 7:15 AM (GMT -6)   
Hi Klains,

Normally yes, for a few reasons , there has to be a place for excess fluid to escape from which is why they did not stitch closed the drain opening. also they inflated your husbands abdominal cavity with gas so that internal pressure is looking for an escape. I am sure there are more actual medical reasons but I recall that is what they told me

Everyone is different but I left the hospital less than 24 hrs after RP and the drain was removed just before i left and I had to change a bandage over it for the 1st week. I was very alarmed at first at how much much liquid was coming out plus it looked like an open hole. It closed on its own eventually

klains
Regular Member


Date Joined Nov 2010
Total Posts : 79
   Posted 5/16/2011 7:49 AM (GMT -6)   
thanks for to post, They actually did not discuss at the hospital on how to care for it, They just said it may leak a little. We have a visiting nurse comming today, I will have her check that, in the mean time she said to use a tampax pad. I told the nurse , would have not been so nervous if you know what to expect. I'v got to say the hospital staff on the weekend there, not to good. If every surgery again, I will seriously re-think having it scheduled on a friday. On the up side.. There was definately no traffic.

142
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Date Joined Jan 2010
Total Posts : 6898
   Posted 5/16/2011 8:30 AM (GMT -6)   
I suspect you are talking about the JP drain (Jackson-Pratt). It is intended to pull excess fluid from the surgery area.
 
They took mine out the day after surgery, although I was in the hospital a few more days. The surgeon was the one who pulled it - I thought it must have wrapped around me a couple of times. I had some leakage from all of the incisions for quite a while, the large one was the last to stop. I was told to not get them wet in the shower, and they gave me some large plastic bandages to put over them for the shower.
 
I guess every hospital has its cycles. I wound up being there over the weekend, and aside from it being much quieter (there were very few patients), I didn't notice any drop in quality of assistance. It made it easier for me to get out to walk, as I wasn't bumping into visitors with my catheter bag.

clocknut
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Date Joined Sep 2010
Total Posts : 2649
   Posted 5/16/2011 9:08 AM (GMT -6)   

Klains, my surgery was also on a Friday.  On Sunday morning, I had walked to the elevators about 300 feet from my room to meet my wife as she came up.  Suddenly, I thought my catheter had come out.  Fluid was running down my legs and puddling on the floor.  My wife, who's a nurse, came out of the elevator, saw what was going on, and rushed me into a men's room nearby.  She saw right away that fluid was leaking around the J-P drain and literally ran me back to the room, yelling at the nurse's station as we went by to get to the room and re-dress the drain.  It leaked from then on until I left on Monday morning, and for a while after we got home.  Beth, being a nurse, did a better job of dressing it than anybody at the hospital.

As for quality of care, on Sunday night, my surgeon had a look at the drain incision, and he and Beth re-dressed it.  She was opening and cutting dressings, and he was applying them.  Looked like a scene from "M.A.S.H.."  The hospital nurses were nowhere to be seen.

The doc removed it Monday morning, and yes, that's a strange sensation, but not painful.

Also, regarding quality of care, I was out in the hall walking at 5:30 a.m. Monday morning.  I returned to the the room and found a person in there who had just stripped my bed.  I asked what's up, and she said I had been discharged.  I said, "Well, I'm still here, and I need the bed."  So she made it back up, but I found out that she had thrown a way a lot of items, including a handmade card from my grandkids and a suture kit the doctor intended to use to remove the J-P drain.  She had also sent my CPAP mask to Inhalation Therapy and had tossed the breathing device that is used to exercise the lungs.

So, I agree that hospital care can leave something to be desired.  My R. N. wife also noticed that the nursing staff only entered the room at shift change, leaving the majority of "care" to the aides.  The nurses tend to be down at the nurse's station, doing data entry at the computer terminals.  But, as Beth says, what can they be charting when they haven't done anything?

After suffering two days with terrible gas pains, I found out the doctor had left a standing order for simethicone every six hours, which the nursing staff had ignored, in spite of my pleas for something to be done.

I'm sure we all have our "horror" stories.  Months later, they're sort of amusing, but not so funny at the time.

I hope you're adjusting to life back at home with the catheter and recovery from surgery.

 

 


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3637
   Posted 5/16/2011 9:46 AM (GMT -6)   
Back in the good old days, he would have been in the hospital for a few days and they would have monitored things like that..When lymph nodes are removed, there is always some leakage..In rare cases a condition known as a 'Lymphoctete" can develop, a fluid filled pocket or abscess that requires a return trip to the hospital to have a drain put in..Usually, they dry up by themselves...
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

dogbot
Regular Member


Date Joined Aug 2009
Total Posts : 147
   Posted 5/16/2011 9:56 AM (GMT -6)   
My drain was pulled about 20 hours after surgery after the doctor asked me if the bottle had been changed, I replied no, and I had had hardly any drainage , about 300ml at a guess. The sensation of the tube coming out was indeed very weird, not painfull.
I never had any problems with the incision sites, no weepage, no irritations. Probably just very lucky !!
 
All the best from England.

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 5/16/2011 10:08 AM (GMT -6)   
Wow. I had my surgery on aTuesday and was discharged on Wednesday.
 
My recovery was swift and uneventful (actually, the first bm was an event, the first walk, removing the catheter, etc. but you know what I mean).
 
Mel

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5687
   Posted 5/16/2011 10:19 AM (GMT -6)   
I had mine in for 4 weeks with instructions when it reduced output to xxx, cant remember, to come in and have it removed or have my wife remove it. Well it never got to that point, my surgeon replaced it with, a thinner drain with same instructions for removal. It got to that level within 48 hours, was a weekend, wife cut the knot, slipped it right out with her eyes shut. She's not a nurse, but is a saint, earned that status being married to me for 30 some years. I had 27 nodes removed all clear and did in fact develop 2 golf ball size lymphoceles, 2 mos post/op which pressed on bladder causing some discomfort. Local uro said he could drain them, but felt they would self resolve, which they did within a mos.
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

GTOdave
Regular Member


Date Joined Oct 2010
Total Posts : 175
   Posted 5/16/2011 10:59 AM (GMT -6)   
Klains. most RARP guys will have a little bit of seepage from the incision sites. I had a little yellow fluid from 2 spots. My surgeon looked and said if it was normal. Sensing my concern, he said that if it were urine seeping, I'd already be violently ill and not capable of lucid conversation.

And yes, the removal of the J-P tube was a very odd sensation.
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.
PSA 7/08: 2.2; 7/09: 2.9; 7/10: 4.1; 11/10: 3.5

First post-op PSA <.00! 7 weeks after

DaVinci surgery at Yale 3/4/11. Dr. John Coleberg THE BEST!!!

45 gram gland weight
Gl 3+3
PT2C
margins clear
no metastasis
5% of gland adenocarcinoma

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/16/2011 11:11 AM (GMT -6)   
My slowest healing incision was the one where the drain tube came out. It came out the next morning after the surgery. Leaked a little and healed up fine.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 5/16/2011 4:02 PM (GMT -6)   
The Dr looked like he has starting a lawn mower when he removed my drain, he stood over me and pulled on it with both hands, it seemed really long, maybe 18 inches but time may have exaggerated my recall of the length

I just checked and the only visible scar I have at 25 mo Post Op is the longer incision above the navel and the drain hole. I did use a great scar cream that helped out tremendously

davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 5/16/2011 4:08 PM (GMT -6)   
klains said...
thanks for to post, They actually did not discuss at the hospital on how to care for it, They just said it may leak a little. We have a visiting nurse comming today, I will have her check that, in the mean time she said to use a tampax pad. I told the nurse , would have not been so nervous if you know what to expect. I'v got to say the hospital staff on the weekend there, not to good. If every surgery again, I will seriously re-think having it scheduled on a friday. On the up side.. There was definately no traffic.


That's a shame. The nurses and doc at the hospital should have spent time with you going over everything including what you need to do over the next few days. Nobody here is a doc but many of us went through the same exact process so shoot away with questions. When they take the catheter out in 5-7 days they will inspect the wounds for you. I'm sure they'll be good by then.

lowandslow
Regular Member


Date Joined Jan 2011
Total Posts : 122
   Posted 5/16/2011 4:12 PM (GMT -6)   
I didn't even get to have a j-p drain, but I am NOT going back to get one!
Age 48
PSA 4.1 No symptoms
Diagnosis 1/12/11
RRP 3/14/11
Gleason 7 (3+4)
T2c
Margins clear
Seminal Vesicles clear
Lymph nodes clear
Prostate 69.5 grams
Organ confined
9% involvement

maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 784
   Posted 5/17/2011 1:28 AM (GMT -6)   
I had a drain, it was a tube that came out of my abdomen, and was attatched to a plastic bottle which was under pressure, left the hospital, and was glad to go home, my wife told me to go sit down while she maid dinner so I sat in my recliner and felt real good, the bottle was on the floor, and when my wife called me for dinner, got up not noticing the tube was caught in the chair, and pulled the drain out of the bottle..and nearly out of me!..yuck Back to the hospital where they fixed me up.

Mal.
age 67 PSA 5.8 DRE firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept 07 Totally dry
PSA 23rd Oct.0.5
Started SRT on 5th Dec.
Finished 24 Feb 08
PSA from 30th April 08, until now range- 0.5 to 0.7

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2211
   Posted 5/17/2011 3:43 AM (GMT -6)   
Yes
I had a drain after RP.
It made sleeping very uncomfortable on the first night after the op when I was in hospital.
The next morning the surgeon took a look at what had come out, (both colour and quantity) and it was removed about 24 hours after surgery started. I had a little oozing that day, and then the hole just healed up.

I had more oozing from the large incision by my vavel and that has ended up as quite an ugly red (keloid) scar.

Alf
Age dx 48
Apr 09 PSA 8.6
DRE neg
Biop 2/12 pos
Gleason 3+3
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
Nov 09 PSA 0.1
Mar 10 PSA 0.4 sent to RT
13 Apr CT
RT 66Gy ends 11 Jun 10
Tired + weird BMs
Sep 10 PSA <0.1
Jan 11 PSA <0.1
Apr 11 PSA <0.1
Erection OK

klains
Regular Member


Date Joined Nov 2010
Total Posts : 79
   Posted 5/17/2011 6:33 AM (GMT -6)   
The nurse came and told him to use a tapax pad for the hole. She said we do not need to put any antiseptic or anything on it. I asked if we could put a sterile piece of gauze and then the pad, she did but sid it was not needed. I was thinking of sterilization and a sterile gauze would be better directly on the hole. We did not recieve any info on cleansing. She said when he showers to let the water just run off. Im thinking it should be treated with maybe a neosprin spray and then the gauze /pad after. Just in case shampoo or something sits in it. May be Im wrong. The nurse and I had different opnions on sterilzation. She even said the purell and antibacterial wipes were a waste, " you can just make friction in your hands and it naturally sanitizes them" Again we kinda differ in opions on the sterile methods,  How has anyone else treated this opening? Change the tapax pad twice yesturday . Normal? One day after removal

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5687
   Posted 5/17/2011 9:39 AM (GMT -6)   
Mine be came infected at the opening 5 days postop, antibiotics cleared it. The tube kept coming out , when walking. Put it make in taped the tube together and went on. I t put out a lot for month. Mine was different in that I had lotsa nodes dissected.
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6898
   Posted 5/17/2011 10:46 AM (GMT -6)   
I was told not the get the incisions wet - and was given the waterproof bandages to use it the shower.
 
They don't want you to rub / scrub the incisions until they are pretty well healed. And yes, then, water run over, not pointed at, and patted dry, not rubbed. The sutures or glue they use should fall off on their own, no helping it along.
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