What To Expect
Before the operation
You will be admitted on the day of your operation and will undergo any necessary pre-operative (e.g. blood and ECG) tests. You will be seen by an anaesthetist and a member of the surgical team before the operation to answer any remaining questions.
The operation
The method of operating will have already been discussed – this will entail key-hole (laparoscopic) surgery with the aid of the da Vinci robotic system. However small the holes it is performed through, radical prostatectomy is still a major and complex operation. It takes 2-3 hours to perform it robotically through six small incisions.
Following the operation
When you wake from the anaesthetic you will have a catheter (a tube that drains urine from the bladder into a bag) in the penis, a drain in your abdomen and two drips in the arm. You should expect some discomfort but this should be easily controllable using the painkilling drugs you will be offered. Patients are allowed to drink freely on the first day following surgery and to eat by the next day. Most patients are ready for discharge with their catheter in after 1-2 days and are re-admitted on the 7-10th day for catheter removal. Constipation is common after any major operation and should gradually settle.
Continence
Most patients are not continent immediately. This is because the valve (sphincter) which normally keeps you dry is bruised and swollen after the operation and therefore does not work well. The number of pads you need to use will reduce with time. Performing pelvic floor exercises before and after the operation will hasten this process. Most patients achieve full dryness before 6 months after the operation but some take up to 12-18 months. It is difficult not to be a bit despondent when you leak urine but remember that for 95% it is temporary. If you are one of the unlucky 5% remember that there are smaller operations that can be performed to stop the leakage of urine.
Sex
Do not be afraid to experiment with erections and sex at any time after the operation, but remember that it can take up to 2 years for erections to return and that intercourse is much easier with adequate lubrication (e.g. KY jelly). You should also be aware that you do not need an erection to climax. Climax following radical prostatectomy is dry i.e. no fluid is produced but still pleasurable. Remember also that if erections do not return that all men can be made potent again somehow.
