Recovery after Robotic Prostatectomy

Posted by oskarpr @oskarpr, Sep 1 5:51pm

Just an update on my PCa Journey:
Finally got the Robotic prostatectomy surgery last Wednesday:
Today: Day 4
Main issue was constipation, able to passed gas, felt pain on the surgery ports area around the stomach, when tried to push.
took pain medication,(oxycodon) plus 2 stool softener pills, and that did the trick.
No bloody stools or diarrhea.
Now taking Miralax, to avoid this issue next time.
Scheduled for catheter removal on Tuesday.
Already got my supplies off: bed padding, depends, and male pads.

Questions:
Did anyone with same procedure able to squeeze penis a bit? Like when you finished urinating.
Any recommendation right after catheter removal?
Any comments or suggestions appreciated
Good Health to All!

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

I'm 70, had bilateral NS RALP late 06/2024. I'm about 9 weeks out from surgery. I don't understand your question about "squeezing penis like after urinating" since you still have the catheter in, so I'll just tell you about my experience after surgery. Catheter removal at 7 days was totally painless and easy. I took a Depends with me and put it on after catheter removal, but ended up being continent. However, things feel different so it's easy to have an accident. For example, my urine flow rate is like I'm 30 years younger so when I step up to a urinal I need to be ready because the flow starts immediately; no pause nor slow start like before surgery when I still had my enlarged prostate. Also, even though I'm continent, I've had a few minor accidents at odd times. For example, when I was allowed to resume working out at the gym after 6 weeks (no bicycling for 3 months), I started slowly and everything was fine. But after a couple more weeks I was getting back into heavier weights. Then the first time I "strained" lifting weights I had a minor urine release which totally surprised me. Ditto the first time I ate something that gave me gas and I tried to pass wind I also had a minor urine release. Minor surprises I probably should have expected, but I'm still adjusting to my new normal. No big deal since I'm retired, but if I was still working I'd probably have worn Depends or pads for at least a month or two until I was confident I'd figured things out a bit more. I do still have a large bed pad under the sheet "just in case", but I haven't had any issue while sleeping. I don't know if they've helped, but I did start kegals about a month before surgery and resumed them some time after the catheter came out (I don't remember exactly when). While I had the catheter and immediately after it's removal my penis tip was sore. Also, my testicals were a bit swollen after surgery. But both of those issues have gotten better as time passed. At this point, I'm feeling pretty normal except for sexual function. From what I've read, sexual function recovery will probably take a while. I started trying to have sex about a month after the catheter came out. Although I'm getting a response it's pretty marginal for intercourse. But it does seem to be slowly getting better, so I'm optimistic. Before surgery I was already using Viagra, so I've resumed using it. I have an appointment with the surgeon coming up soon and I do plan to tell him where I'm at with sexual function recovery and ask about getting a consult from whichever of his colleagues has experience with sexual function rehabilitation after surgery. I just want to baseline where I'm at and make sure I don't neglect getting any appropriate help to aid my sexual recovery. About the only other thing I should probably mention is that I read both the surgical report and the prostate biopsy when they showed up on the portal. I was pleased that the surgical report listed no complications. My prostate pathology report found clean margins (good) and it reported both Cribiform and IDC present (not good). So I'll be particularly diligent about tracking my PSA going forward. Long story short, every week has been better than the last since the catheter came out. Sexual function is still a work in progress, but other than that my life has returned to normal. Best wishes on your recovery!

REPLY

Hey, You got thru it - congrats! Be sure you put a little vaseline where the catheter enters the penis - sometimes a little blood or discharge can cause it to adhere.
Also, I urinated in the DRs office after catheter removal - a few tiny clots came out but nothing major. On the way home I said to my wife, who was driving, “Gee, I really have to pee but I can hold it”. At least I thought I could…I pissed all over my seat, sat in soaking wet pants all the way home. It was a huge wake-up call showing me that things were gonna be a bit different going forward.
Just might want to wear a full Depends on the way home….just sayin’!

REPLY

Professional PT guidance for properly performing Kegel exercises very helpful to me.
I was able to squeeze in 1 session before surgery and a few post op.
I was instructed to NOT do Kegels with catheter in place.
Also followed "cleaning catheter" instructions from Dr and online video while it was in place.
Best wishes.

REPLY

I was told to wait a few days after catheter removal to start kegals, if that’s what you’re referring to with the squeezing thing. Penis tip was a little sore, so had to start slow.

REPLY

My RARP was 9 weeks ago and was non-nerve sparing. Pathology showed Gleason 9 with cribriform and IDC. I was completely incontinent after the catheter was removed, which was totally painless and in fact, it blew out once the balloon was deflated! My incontinence after 2 weeks improved at night, but continued unabated during the day. I did kegals but did not see much improvement. At 6 weeks I found an exceptional pelvic floor PT's who is helping me greatly! I wear a depends at night and basically stay dry. During the day I can now control urination 50% or so. I got tired of changing depends every 2-3 hours so I bought a penis clamp. I use it about 75% of the day and it helps a lot. I'm now hopeful I can regain control the majority of the time within the next couple of months. I'm pretty sure I will need to wear some type of absorbant pad for a long time. Regarding impotence, because my surgery was non-nerve sparing, I will never be able to get an errection without shots or implants. My mayo surgeon says we will deal with that issue but for now he says he wants to focus on the cancer which he says will reoccur. Good luck on your journey!

REPLY

I had the same surgery. Exercise your Kegel muscles.

REPLY

@oskarpr -- Just a general comment about this site I just figured out and I thought I'd share it with you as you might find it useful. I went out to the main listing for prostate cancer and searched for "sexual function recovery after ralp". I got 8 hits on this site under prostate cancer and several of them were really excellent. Just thought I'd mention it as there's quite a bit of relevant recent historical information in various threads you might find interesting or useful. The search function can help you find them.

REPLY
@retireditguy

I'm 70, had bilateral NS RALP late 06/2024. I'm about 9 weeks out from surgery. I don't understand your question about "squeezing penis like after urinating" since you still have the catheter in, so I'll just tell you about my experience after surgery. Catheter removal at 7 days was totally painless and easy. I took a Depends with me and put it on after catheter removal, but ended up being continent. However, things feel different so it's easy to have an accident. For example, my urine flow rate is like I'm 30 years younger so when I step up to a urinal I need to be ready because the flow starts immediately; no pause nor slow start like before surgery when I still had my enlarged prostate. Also, even though I'm continent, I've had a few minor accidents at odd times. For example, when I was allowed to resume working out at the gym after 6 weeks (no bicycling for 3 months), I started slowly and everything was fine. But after a couple more weeks I was getting back into heavier weights. Then the first time I "strained" lifting weights I had a minor urine release which totally surprised me. Ditto the first time I ate something that gave me gas and I tried to pass wind I also had a minor urine release. Minor surprises I probably should have expected, but I'm still adjusting to my new normal. No big deal since I'm retired, but if I was still working I'd probably have worn Depends or pads for at least a month or two until I was confident I'd figured things out a bit more. I do still have a large bed pad under the sheet "just in case", but I haven't had any issue while sleeping. I don't know if they've helped, but I did start kegals about a month before surgery and resumed them some time after the catheter came out (I don't remember exactly when). While I had the catheter and immediately after it's removal my penis tip was sore. Also, my testicals were a bit swollen after surgery. But both of those issues have gotten better as time passed. At this point, I'm feeling pretty normal except for sexual function. From what I've read, sexual function recovery will probably take a while. I started trying to have sex about a month after the catheter came out. Although I'm getting a response it's pretty marginal for intercourse. But it does seem to be slowly getting better, so I'm optimistic. Before surgery I was already using Viagra, so I've resumed using it. I have an appointment with the surgeon coming up soon and I do plan to tell him where I'm at with sexual function recovery and ask about getting a consult from whichever of his colleagues has experience with sexual function rehabilitation after surgery. I just want to baseline where I'm at and make sure I don't neglect getting any appropriate help to aid my sexual recovery. About the only other thing I should probably mention is that I read both the surgical report and the prostate biopsy when they showed up on the portal. I was pleased that the surgical report listed no complications. My prostate pathology report found clean margins (good) and it reported both Cribiform and IDC present (not good). So I'll be particularly diligent about tracking my PSA going forward. Long story short, every week has been better than the last since the catheter came out. Sexual function is still a work in progress, but other than that my life has returned to normal. Best wishes on your recovery!

Jump to this post

Thanks for your input!
When I mentioned squeezing of penis is the contraction made by the penis like signal of no more urine, kind of like a kegel exercise contraction, but instead of feeling it in the perineal are you feel it in your penis.

REPLY

Another point of view, incontinence after prostatectomy varies from person to person. I had no problems with incontinence at all after the catheter was removed.

3 1/2 years later I had to have radiation when my PSA started rising. Still no problems with incontinence until about six years later when it started to become an issue.

Can’t hurt to be careful after the catheter is removed, but your results can vary.

REPLY
@heavyphil

Hey, You got thru it - congrats! Be sure you put a little vaseline where the catheter enters the penis - sometimes a little blood or discharge can cause it to adhere.
Also, I urinated in the DRs office after catheter removal - a few tiny clots came out but nothing major. On the way home I said to my wife, who was driving, “Gee, I really have to pee but I can hold it”. At least I thought I could…I pissed all over my seat, sat in soaking wet pants all the way home. It was a huge wake-up call showing me that things were gonna be a bit different going forward.
Just might want to wear a full Depends on the way home….just sayin’!

Jump to this post

Thanks for the encouragement note. I already have my first box of depends and pads ready,plan to keep some on my car, backpack and office.
Blessings

REPLY
Please sign in or register to post a reply.