Post radical prostatectomy (RP) Challenges

Posted by matthew61 @matthew61, Nov 11, 2023

Hello all, thanks for any input.
I had my RP 11 days ago. Had fairly severe bruising on my left side that seems to be diminishing. Initially it was thought that is was caused by my semi-violent wake-up from anesthesia. Doc gave me Bactrim antibiotic to diminish possibility of infection. Looks, like I am out of the woods on that, but nasty side effects, loss of appetite, constipation and insomnia. On day 7 went in for a systogram and ever since then I have had more/intermittent pain at Catheter site and abdominal area. Urine is flowing well, but is still pretty red. Slight leakage from catheter/penis when doing bowel movement. The results from Systogram was described as “significant leakage” from interior site. So was not able to have catheter removed. Scheduled for fluoroscopy imaging for this Monday. Is this too soon to repair significant leakage? Last night had significant leg cramping. It has been a challenge. Anyone else have a similar experience? I hope not. Thank you

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I definitely had one of these "semi-violent wake-up from anesthesia" although not sure how "semi" it was. Was being transferred from the DaVinci table to a gurney to be wheeled out when I woke up in severe pain, they knocked me back out pretty quick and I woke up later in recovery.

I had a loss of appetite, constipation and insomnia, I kind of assumed it was because of how long I went without food prior to the operation, it was a full 24 hours as it turned out. I also had a lot of pain internally that I believe was my digestive system "restarting" if you will. By 11 days though, that diminished dramatically with the exception of some insomnia.

"Slight leakage from catheter/penis when doing bowel movement" got that t-shirt as well. It was kind of unnerving for sure, but the doc's crew responded right away with a "that's normal but if it get's any worse let us know". They were big on the "don't push" that's kind of tough though. I just minimized as best as I could.

As far as the Systogram results, I don't have any experience on that as I didn't have any leakage from the interior site that I was aware of, I'll just add a Best of Luck to you!

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I had my RP in November, 2022. I had several of your symptoms for the first week. My medical team told me constipation is likely and to use an over the counter medicine if constipation continued for three days - I used "milk of magnesia" and it took care of constipation. The leakage around catheter/penis during bowel movements (especially when need to push), did occur for me - It was quite uncomfortable, but significantly improved after constipation addressed and obviously completely gone after you "break up with Cathy" (awesome joke my nurse told me during catheter removal). My doctor had me keep the catheter in for 7 days, do did not have a cystoscopy - Thinking this is done if they want to remove catheter in 3-4 days and red colored blood is a side effect post cystoscopy procedure (2nd hand info, no direct knowledge with having a cystoscopy)??

Sorry to hear you have leakage at urethra reconnection point.

Good luck and praying all goes well for you with your challenging recovery.

Jim

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My surgery was a mixed bag. 90min late start as case ahead of me went long. Brief memory of operating room. Woke up 5hrs later well sedated no pain. Surgery had been paused for frozen section pathology of lymph nodes then restarted. People appeared in recovery room with instructions of how/when to take drugs, manage catheter etc. each admonished “do not strain” gas gave feeling of impending bowel function but actually took til day 4 to normalize. Took some stuff to soften stools. Went back to surgeon in a wk but got his nurse instead. She removed 30or 40cc water from catheter then without warning tipped it out. To my surprise no pain.Their notes sad catheter removed in normal manner. No infection of any kind . A bit of blood in urine 3-4days.Pubic numbness at first gradually diminishing.

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@billfarm

My surgery was a mixed bag. 90min late start as case ahead of me went long. Brief memory of operating room. Woke up 5hrs later well sedated no pain. Surgery had been paused for frozen section pathology of lymph nodes then restarted. People appeared in recovery room with instructions of how/when to take drugs, manage catheter etc. each admonished “do not strain” gas gave feeling of impending bowel function but actually took til day 4 to normalize. Took some stuff to soften stools. Went back to surgeon in a wk but got his nurse instead. She removed 30or 40cc water from catheter then without warning tipped it out. To my surprise no pain.Their notes sad catheter removed in normal manner. No infection of any kind . A bit of blood in urine 3-4days.Pubic numbness at first gradually diminishing.

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Bad typing should have said ripped it out.

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@billfarm

My surgery was a mixed bag. 90min late start as case ahead of me went long. Brief memory of operating room. Woke up 5hrs later well sedated no pain. Surgery had been paused for frozen section pathology of lymph nodes then restarted. People appeared in recovery room with instructions of how/when to take drugs, manage catheter etc. each admonished “do not strain” gas gave feeling of impending bowel function but actually took til day 4 to normalize. Took some stuff to soften stools. Went back to surgeon in a wk but got his nurse instead. She removed 30or 40cc water from catheter then without warning tipped it out. To my surprise no pain.Their notes sad catheter removed in normal manner. No infection of any kind . A bit of blood in urine 3-4days.Pubic numbness at first gradually diminishing.

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Thanks how are you doing now?

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@hammer101

I had my RP in November, 2022. I had several of your symptoms for the first week. My medical team told me constipation is likely and to use an over the counter medicine if constipation continued for three days - I used "milk of magnesia" and it took care of constipation. The leakage around catheter/penis during bowel movements (especially when need to push), did occur for me - It was quite uncomfortable, but significantly improved after constipation addressed and obviously completely gone after you "break up with Cathy" (awesome joke my nurse told me during catheter removal). My doctor had me keep the catheter in for 7 days, do did not have a cystoscopy - Thinking this is done if they want to remove catheter in 3-4 days and red colored blood is a side effect post cystoscopy procedure (2nd hand info, no direct knowledge with having a cystoscopy)??

Sorry to hear you have leakage at urethra reconnection point.

Good luck and praying all goes well for you with your challenging recovery.

Jim

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Thanks, how are you doing now a year later?

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I had radical surgery in 2018. I have not had an erection after surgery and have noted a reduction in size to my penis but not testicles. As a result l am unable to pee standing and have to sit. Even then it is causing me stress as l urinate over the testes. I am able to have a dry organism by using a finger to brush the head pf the penis. I would like to have an orioctomy to make my situation more healthy. I live in Malaysia and am 72 years of age

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@matthew61

Thanks how are you doing now?

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11 months post surgery had recurrence psa1.83 then 2.33 8wks post surgery. They got around to telling me that lymph node involvement 6 of 35 positive made me stage 4. Got on zytiga/orgovyx /prednisone in march immediately drove psa to undectable til now 11/8 test. Pet scan showed residual tumor in feb 23 mri in October shows nothing. Team of drs seem obsessed with immediate radiation treatments. Puzzling to me how do you precisely aim radiation at something you can t find. Also what about cells traveling elsewhere in my system. Kinda in timeout while I try to solve these riddles. Doing my work daily with some level of fatigue but called stable by drs while i ponder .

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@web265

I definitely had one of these "semi-violent wake-up from anesthesia" although not sure how "semi" it was. Was being transferred from the DaVinci table to a gurney to be wheeled out when I woke up in severe pain, they knocked me back out pretty quick and I woke up later in recovery.

I had a loss of appetite, constipation and insomnia, I kind of assumed it was because of how long I went without food prior to the operation, it was a full 24 hours as it turned out. I also had a lot of pain internally that I believe was my digestive system "restarting" if you will. By 11 days though, that diminished dramatically with the exception of some insomnia.

"Slight leakage from catheter/penis when doing bowel movement" got that t-shirt as well. It was kind of unnerving for sure, but the doc's crew responded right away with a "that's normal but if it get's any worse let us know". They were big on the "don't push" that's kind of tough though. I just minimized as best as I could.

As far as the Systogram results, I don't have any experience on that as I didn't have any leakage from the interior site that I was aware of, I'll just add a Best of Luck to you!

Jump to this post

Sorry about the experience in the operating room.

The leakage around the penis during a bowel movement happened to me and I was told this is normal and not to push. Hence miralax and ducolax. Worked well and now two weeks ago normal bowel movements.

I learned with my appetite to eat small meals and slowly increase fiber.

Good lucky with your recovery.

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Based on a lot of comments I feel pretty fortunate. I had my RP last Tuesday. When I started to wake up the pain was excruciating. With pain meds it subsided quickly. I had an overnight in the hospital that went well. My bed felt like cardboard so they gave me a recliner which was wonderful. They woke me up every hour to check my vitals and every two hours to get up and walk. They had to slow me down. Since then, the pain have been minimal, using only Tylenol for pain. My urine was so what red at first, then darker brown, light brown and normal. They told me much of the color was due to elimination of IV fluids. The day after I had a slight sexual tingling, and a little stronger on Friday. Insomnia has been the toughest hurdle. I’ve had slight drainage, first blood and then a little urine, at the tip of the penis. They told me it is normal. Has gotten less everyday. Only discomfort now is a tickle in my penis and some discomfort in my perenium area. I’m back on a full diet but eat small and slow amounts until my intestines return to normal. As far as constipation, the first few days it was terrible. Milk of Magnesia did not help. When I felt close to a bowel movement and avoiding pushing, I actually did quick short kegels, and than a couple where I “held it”. It really worked. The catheter comes out Thursday, and I’m hoping for a favorable pathology report.
I hope this wasn’t too long. Health and happiness to all in our fraternity.

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