There are actions that you can take prior to surgery to improve your recovery time and decrease your risk of complications. Most men find their recovery is less complicated if they are in good physical condition, not overweight, and don't smoke. If you are not an active person, beginning an exercise program such as walking for thirty minutes daily. This can greatly improve the recovery process.
Kegels are pelvic muscle exercises that have proven beneficial in reducing incontinence following radical prostatectomy. They should be started prior to the surgery, and continue after the catheter has been removed.
To locate the correct pelvic muscle, imagine you are trying to hold back from having a bowel movement. Squeeze the muscles, hold for 5-10 seconds, and relax. Repeat this 10 times four times a day. Don't forget to breathe, and keep your stomach and buttock muscles relaxed. If you are not sure you are contracting the correct muscles, touch the opening at the rectum. If you feel the opening contract at the same time you tighten the muscle, you are doing the exercise correctly.
Before undergoing surgery you may be required to attend a pre-admission session at your hospital. At this time you will meet your anaesthetist, to discuss your medical history, including any allergies you may have and any prescription or non-prescription drugs that you are taking.
A nurse coordinator will provide you with general information concerning your hospital stay, perform any additional exams (such as blood tests) that may be required, and answer any questions that you have. The hospital staff will also explain the admissions procedure to you, including any food and drink restrictions that may apply before your surgery.
You may be given the opportunity to make a blood donation before surgery, so that in the event that you should need a transfusion during or following surgery, your own blood will be used. This is known as an "autologous donation".
Your doctor may request that you not eat anything the day before surgery and not drink anything after midnight. You may also be required to take a laxative the evening before surgery and use an enema the morning of surgery to assure that your bowel is clear.
Your hospital stay will depend on how quickly you recover from surgery (the average stay is about 5 days).
When you awake, you’ll find that a tube called a Foley Catheter has been inserted through your penis to drain urine from your bladder. This will be removed within 1 to 3 weeks of your return home. As a result of having a catheter in your bladder, you may experience discomfort from contractions, as the bladder wall is irritated by this tube. It is common to feel a false sense of bladder fullness, and urge to urinate. This sensation is normal, and medications are available to relieve these symptoms in both a pill and suppository form.
The average recovery period following surgery is 4 - 6 weeks. During this time you should refrain from any heavy lifting or straining, but be sure to remain as active as possible. This speeds up the recovery process.
Within 5 - 6 weeks after surgery, your PSA should fall to undetectable levels. Depending on the amount and location of the tumour you can expect to have your PSA tested every 3 to 6 months during the first year after surgery. After the first year you’ll have your PSA tested every 6 to 12 months.
Once the catheter is removed you may find that you are incontinent (loss of bladder control). This will improve over time. Most men are fully recovered at 3 to 6 months after surgery. Exercises known as Kegels can be performed to decrease the length of time the incontinence persists. Approximately 10% of men may have stress incontinence (i.e. sneezing, coughing) that persists, and 5% may be totally incontinent. These men may desire a second operation to implant an "artificial" sphincter. This is not usually decided until one year following surgery.
Impotence (loss of sexual function) is another common side effect associated with surgical removal of the prostate. The rate at which your sexual function will improve is relative to your sexual function before surgery, age, general health and whether or not the nerves have been spared during surgery. A time period of 1 year is recommended for complete recovery, however as both the prostate and the seminal vesicles are removed, orgasm will be without a fluid ejaculation, or dry. Various treatments for impotence are available, and may be discussed with your doctor if necessary.