This website is about prostate surgery. Of course you may be here even if you’re not having surgery for your prostate cancer but another treatment such as chemotherapy, radiotherapy, hormonal therapy etc. You will probably experience some of the post treatment problems described below. The difference is that you don’t have to get over the surgery itself.
If you’re having surgery you’ll have surgical wounds. If you’re having conventional surgery you’ll have a wound about 15 cm across your lower abdomen. This will make it difficult and painful for you to move, get out of bed or chairs etc and you’ll probably need to take pain killers for four or five weeks. The wounds usually heal in about six weeks and you can then start driving, getting back to work and going about your business normally.
This is me two weeks after keyhole surgery
If you’re having keyhole surgery you should have very little pain after about the first week or 10 days. The wounds will heal within three to four weeks and you’ll be fine to go back to work. However, because the internal surgical wounds won’t have healed and so you’ll be vulnerable internally, you can’t drive for the first four to six weeks.
What the doctors tell you
Whichever type of surgery you have, you’ll suffer from urinary incontinence and erectile dysfunction for a while. How long is ‘a while’? Well the answer is different for everybody and it varies hugely depending on the extent of the surgery, whether you’re having additional treatment which may include hormonal, chemotherapy, radiotherapy, and of course how fit and/or how overweight you are to start with.
This is all true, but how long is ‘a while’ on average? “Ah well, everybody’s different so it’s impossible to say” is the standard response.
What is important is to keep up the pelvic floor exercises as much as possible and “if you don’t use it you lose it” so keep “it” stimulated and active even if nothing seems to be happening.
Whichever type of surgery you have going to the gym or any heavy lifting are simply out of the question. Indeed they’re impossible for the first ten days to two weeks while you’re wearing a catheter and urine collection bag.
However it’s important to keep exercising but only very gently at first. A short walk up to the end of the block and back, then maybe around the block, then maybe for a few blocks, slowly increasing with time as your strength returns. When your medical team advises that you can start going back to the gym or doing other exercise – usually after about four weeks – only do very light exercise for the first few weeks and slowly increase how much you do as your strength and stamina increase.
Crucially you need to keep drinking water and more water and more water to keep the flow going and ensure that bacteria don’t get a chance to settle into your urinary tract and start an infection. It’s well known that cranberry and pomegranate juice seem to prevent these bacteria succeeding in settling themselves and growing, so for a change have a glass of these juices every now and again.
What the doctors don’t tell you
Yes, it’s true that everyone is different. We all heal at different rates. We all have to put up with some post-operative problems such as having a catheter for a couple of weeks after surgery, incontinence and erectile dysfunction. And yes it is true that the surgical wounds heal in a few weeks.
But that’s not the end of the story. It’s only the beginning of this story! There’s a lot more to the healing process than the superficial healing of the wounds. Before I had my surgery someone said to me it can take two years or more to recover! Of course that had to be nonsense I thought! As I came through the operation I realised that healing was not going to take three to four weeks. As I researched the subject I started to realise that this was going to take a lot longer.
Recovery after surgery
The first 48 hours
In some situations surgeons insist on nothing to eat for 24 hours. After surgery your mouth will be parched and dry with a most unpleasant taste. It’s well worth taking some sugar free peppermints with you into hospital to help take the taste away until you’re allowed to eat.
In the first 48 hours while you’re feeling uncomfortable, bloated, sore and miserable, one of the most comforting things is a large electric heating pad. You can simply place it over the areas that are uncomfortable or sore and let the warming, relaxing heat seep into your wounded body. (It’s might be wise to have an extension cord handy just in case the cable is too short to reach the hospital socket.) A hot water bottle will do, but it’s a bit small and someone has to be around to keep refilling it, so it isn’t ideal.
You’ll have a urinary catheter in place for up to two weeks after your surgery. Walking around with a tube sticking out of your penis connected to a bag of urine is most unpleasant and not easy. Sleeping connected to a bag is also not exactly restful because the chances of getting entangled with the pipework and knocking over the bag while turning over or moving while asleep are very real worries. Most importantly catheters and their bags are often not set up correctly which results in significant pain.
The weight of the bag and tubing must never ever be borne directly from your penis/bladder region. The tube should never be taut as it emerges from your penis. It should always have some slack in it with the rest of the contraption strapped securely to your thigh. Always make sure it’s strapped above your knee. The tube mustn’t drag down because of the weight of the urine bag. This will put tension on the tube as it leaves your penis. If there’s any tension, pulling or dragging of the tube as it emerges from your body it will be painful. So if you’re feeling any pain and/or tension from the weight of the bag it might be set up incorrectly. Ask someone to check it.
Once you get rid of the catheter you need to carry on drinking as much water as possible to keep the flow going and prevent the possibility of infection. You also need to continue doing your pelvic floor exercises as frequently as you can. But please be aware that at this stage you have absolutely no control whatsoever over your bodily functions. What’s even worse is that you won’t be aware of what’s going on. So for at least the first few days after the catheter comes out, keep checking regularly to see what’s happening even if you don’t feel any urge to visit the bathroom.
The erectile dysfunction
You’ll experience erectile dysfunction no matter what you do, although getting an erection will probably be one of the last things on your mind. Erectile dysfunction is discussed in detail here.
Please be aware that in these early stages of healing you’ll regularly be overcome by feelings of exhaustion, periods of being completely unable to concentrate and the need simply to lie down and go to sleep. Your body has been traumatised and goes into a state of shock. It needs time to recover. You may also have periods of dizziness or unsteadiness on your feet. So listen to your body and if it says “sleep” then simply do what it tells you.
The Return to Work
Although the doctors will tell you that you’ll be fine for work after three to four weeks this is in most cases very optimistic! If you have a sedentary occupation where you don’t have to move around much you may be fit for part-time work/light duties by about four to six weeks. But if your work demands standing for long periods of time, walking about or other physical activity, it’s unlikely that you will be able to work at full capacity for about three months.
This doesn’t mean to say that you can’t work, but your concentration span may vary from only half an hour to a couple of hours and standing or walking around for long periods may just not be possible. The ideal situation is if you can go back to work part-time initially, let’s say mornings only, do what’s necessary at your workplace and perhaps take work home if this is feasible. Also periods of exhaustion, sleepiness and/or light-headedness can occur intermittently without warning. So always make sure there’s a comfortable chair (or of course if you’re at home your bed) close at hand to use when this happens.