Post op advice

Ensure you have easy food available, depends n what he fancies

 start laxity/movicol when discharged, I was constipated due to pain relief/ anastetic, you don’t want anything stronger as that can cause strain

bowl for bag at night, plus I put mine in a carrier bag for ease of carrying, I’d get breakfast then return to bed for a while

enjoy not getting up at night

loose trousers for bag, training bottoms and outdoor adventure trousers, like the ones you can unzip legs

briefs for trial without catheter

he won’t be able to walk far but I found it important to go for a short walk/ shuffle each day, 500 yards probably 1km max

drinking plenty, flask of tea and large bottle of water save constantly getting up. Measure what you drink to ensure you have at least 2 litres a day, 

try and go out somewhere, my mate took me to kfc obviously not far

car journeys can be uncomfortable so lean car back back

comfy chair, cushions, wooden chairs pinched on catheter

stairs will be fine  but slow

good luck and I hope the op is successful 

Hi, my husband had a radical prostatectomy last Wednesday. It was radical as there was no nerve saving done, wider margins and all the lymph nodes.

If he hasn't already started them, start doing pelvic floor exercises as these can be key to getting good continence back. If overweight, try to lose some and start walking.

Addenbrooks make them walk a mile the day after surgery before sending them home and expect them to keep it up everyday and gradually build up to 2 miles. Hubby had a problem after surgery and he stayed an extra day, but we have been out walking each day, but half a mile is all he can do in one go, but they don't expect you to do it in one go. They also ensure that you can manage stairs.

As for not getting up in the night, he is still getting up twice a night, but to open his bowels as the laxitives are working well.

His appetite isn't great and he can't tolerate sweet things and I have found that little and often is suiting him. If your partner isn't a water drinker, start getting him to up his water intake, as he should be aiming on drinking between 2 to 3 litres a day.

If I can help with any other questions, ask away.

Sans

Thank you very much for your help. Op is at the end of this month & I will let you know how it goes. Saw your post about some of the comments people have made - Our best one so far was '"Isn't that something really old men get" from a work colleague!

Indeed, or

Hope they caught it nice and early

I hoped so to but you don't know and need to take things day by day otherwise it would be too much. You need to be positive and deal with today

Another one as a younger sufferer are the more intimate issues. I see you are very supportive of your partner so I believe you have a good grounding moving forward.  This has brought my wife and I closer together which has been positive as in long term relationships we can start taking each other for granted and niggling at each other.  I have truly seen how much she cares and is affected

There are a number if new normals. Rather than looking back at old normals

This site is helpful, but at times I found I needed to spend time away from it and enjoy what is around instead of cancer taking over

Best regards to you and your husband

Hi,  I can give you a few extra  pointers, please excuse the bullet point format.

The catheter

Make sure the catheter tube itself is well supported e.g. in his underpants.  Some men tape the tube to the thigh.

This will prevent the balloon which is holding the tube in the bladder from pulling on the bladder neck, particularly on where the surgeon has joined the urethra to the bladder neck.

Also make sure the tube doesn't get kinked or trapped, especially in bed as this could stop the urine flow and cause too much pressure inside the bladder.

It's important to keep the tube and the penis clean where the tube enters the penis, the best way to do this is to have a shower every day.  If there are any secretions around it, gently remove them.  Don't use soap.

Be careful when changing bags, e.g. from night bags to day bags and vice versa.  Do not put the open end of the catheter tube down and make sure nothing gets into it, this can be a source of infection.

Do NOT do Kegel exercise while the catheter is still in.

Keep an eye on the colour of the urine, particularly if it appears cloudy or pink.

Never strain on the toilet, this can place pressure on the bladder and force urine to go round the catheter tube instead of through it.  This can cause irritation to the urethra.

Have some incontinence pads ready for when the catheter is removed.  If he can't get a prescription for these, Boots sell some good quality ones at a reasonable price.

Mobility

Your partner must keep mobile, there is a risk otherwise, after surgery, of getting a deep vein thrombosis.  Obviously don't over do it.

No strenuous activity for at least six weeks.

Wounds and bruising

There shouldn't be any problem with the wounds.  He can have showers.  Just watch for signs of redness, swelling or heat round the wounds and if they hurt.  They shouldn't hurt.

His scrotum is probably very bruised, he should keep his testicles supported (supportive underpants).  His penis may also be bruised.  The bruising is worrying, but normal.  It should settle in a week or two.

Catheter removal

Two things can happen when the catheter is removed.  It may be difficult to wee at first and if he doesn't manage it at all in 12 hours then he should seek medical attention.  Contact his GP or dial 111 out of hours.

The other thing is he may have little or no control  at first.  This may just be dribbling or leaking but hopefully not great amounts.

This can be helped by

• Doing Kegel exercises as often as possible.
• Deliberately trying to  wee every hour during waking, for a couple of days
• Then slowly stretching the time between deliberately weeing.
• When weeing, it's best not just to wee normally but to start, stop and start again, several times.  This will strengthen the sphincters.

Don't expect continence to return for sometime. It varies considerably. It could be weeks or months. Progress can be judged in two ways.  One is the number pads he has to use each day.    The other is that at first he will notice that he stays dry at night (lying down), then drier when sitting, then finally when standing. This is simply a matter of gravity!  Beyond that there may still be some "stress incontinence", i.e. when pressure is placed on the bladder, e.g. when coughing or crouching.

Erectile dysfunction (ED)

This  may not be of concern to him generally or, not on his mind just at this time. If it is of concern, then it must be considered NOW.

Several factors can affect recovery.

• How good function was before.
• Whether he had both nerves spared, only one or neither.  Relative chances of recovery are 30%, 15% and 5% respectively.
• What rehabilitation is done
• And when it’s started.

 Erectile rehabilitation increases the chances of recovery.

 This usually starts with taking a “PDE5 inhibitor”. Sildenafil (Viagra) or Tadalafil (Cialis). He can get this from his GP under free prescription, no matter his age. It should be taken regularly not just on demand.

To further increase the chances of recovery, he should start taking this immediately after the catheter is removed. This is recommended by Cancer Research UK/Prostate Cancer UK. This is why I mention it now.

He should also consider using a medical vacuum pump. Again, he can get one on prescription, (they are expensive). His GP will have to refer him to an ED clinic.

The rationale for both these measures is to preserve the blood supply to the penis and prevent atrophy of erectile tissue. The longer a man goes without any erection the greater these two will occur and chances of recovery will be significantly reduced.

I hope this helps.

Thank you Uroboros for all this very helpful nformation.

Def get something in for yourself. New pair of slippers, bubblebath, night out with the girls arranged? Box set binge etc...whatever helps you. Hubby found that shuffling about each day helped, as did laxido or its equivalent. We had a headrest which was great for propping him up in bed when he felt like a rest. We led in bed for two days processing it all and doing all the medical bits. Get support for yourself. Here is great, some Facebook groups are good, some hospitals have support groups as well. Badicslky the tips you've been given are what I'd advise but treat yourself to something.. You've been through hell too. Xxxx

We are now two weeks post op & pleasantly surprised by how well everything is going at the moment.

Consultant has advised that the tumour was confined to the capsule, lymph nodes & all nerves were conserved. We won't be able to completely relax until we see the Consultant again in January though, when he will have the full Oncology report.

As far as recovery goes, he is doing amazingly - there were no problems with the catheter, which was removed 4 days ago & apart from a couple of minor stress incontinence incidents when bending suddenly, and another when trying to lift a box (which he shouldn't have been doing anyway!) Completely dry & sleeping through night. The supply of pads we purchased pre op will at current rate of use last about 3 years!

We have been on a couple of short walks together with the dog & last night a meal out with friends. We are now going to enjoy Christmas & hope for more good news in January.

Thank you all again for the advice xx

That's really great.  I'm glad things are going so well.

Wonderful news. Have a great Christmas & New Year and I hope all goes well in January.