Aftercare

Recovery
If you’ve had a general anaesthetic or an opioid pain medication, you may feel different for 2 or 3 days with more fatigue or difficulties with your memory. You shouldn’t drive or drink alcohol if this happens. Also avoid making big and important decisions.

Incontinence
For the first few weeks after your catheter is removed, you can expect some leakage of urine. You may need to wear an incontinence pad. A continence advisor can help you reduce the impact of incontinence.

Scrotal swelling
Your scrotum may be swollen for up to a week after surgery. Wearing supportive briefs or an athletic support can improve your comfort. When you’re resting, elevate your scrotum on a rolled towel.

Bladder spasms
Cramping pains called bladder spasms can occur due to the catheter irritating the inside of your bladder. They may feel like an urge to urinate, pain in the tip of the penis, or brief pelvic or rectal pressure. The bladder spasms can cause urine or blood to squirt out around the catheter. If bladder spasms become a problem, call your doctor. They can prescribe or recommend medication to reduce the spasms. Some medications for bladder spasms need to be stopped 24 hours before your catheter is removed.

Bowel problems
Your normal bowel movements may not resume for 3–5 days after surgery. Avoid straining when you have a bowel movement. If you’re troubled by constipation, a stool softener may help. Increasing the amount of fibre in your diet and drinking plenty of fluids is also helpful.

Going back to work and normal activities
If you’ve had keyhole surgery, recovery time can be as short as 2 weeks. For open surgery, your recovery time can be between 6 and 8 weeks. Increase your activity gradually. Try to get up and walk every hour during the day. Don’t lift anything heavier than a brick or take part in strenuous activity for at least 4–6 weeks.

Sexual activity
You can have sex 4–6 weeks after your surgery but it could take up to 1 year before you get a proper erection. Your doctor can prescribe medication to help with erection problems. If you still have problems, there are vacuum devices and implants available.

Wound care
Always wash your hands before and after touching the area near your incision site. You can shower after the second day unless your urologist tells you not to. Don’t soak in a bathtub until your stitches, closure strips or staples are removed.

If you’ve been told by your urologist to change your wound dressing at home, follow their instructions. If you’ve had open surgery, a small amount of drainage from your incision is normal. Your discharge letter, as well as a conversation with your urologist should explain when and where your stitches or staples should be removed.

Catheter care
If you’ve come home with a catheter in place, follow the nurse’s instructions for catheter care.

Scar healing
Your scars will heal in about 4–6 weeks. They’ll become softer and continue to fade over the next year.

Coping strategies
Prostate surgery can be stressful and have lingering emotional effects. Mood changes and anxiety are understandable as you come to terms with your ‘new normal’. Your GP can help with medication and, if necessary, refer you for psychological counselling.

Support from the Prostate Cancer Foundation
The Prostate Cancer Foundation of Australia promotes research into prostate cancer and provides support materials as well as access to support groups. They also have an active online community. The Foundation produces a series of publications for patients and carers, which you can download or read online.

They also have specific advice for gay and bisexual men who are diagnosed with prostate cancer.

Follow-up
Your GP can remove any stitches or staples for you. Your urologist will tell you how soon to have them removed. You’ll need to make a follow-up appointment with your urologist, probably after 6 weeks, to check on your results.

If you’ve been treated for cancer, your urologist will want to see you again at 3, 6 and 12 months after surgery. They’ll order a follow-up PSA test at each visit. After radical prostate surgery, your PSA results usually show an undetectable level of PSA. If your PSA is increased, you may need further treatments.

Watching out for problems
Call your urologist immediately if you have:

• racing heart, shortness of breath or chest pain
• fever or chills
• nausea, vomiting or severe abdominal bloating
• severe pain
• pain in your thigh, calf or groin
• swelling or redness in your leg
• redness or discharge from your incisions
• problems urinating or having a bowel movement
• a blocked catheter
• signs of a urinary tract infection, such as ‘burning’ when urinating.