What to Expect During Prostate Surgery Recovery

Recovery after prostate surgery can take up to four to six weeks after a short hospital stay. Most people need to manage basic needs like taking care of the wound, and symptoms like pain and constipation. They also can expect urinary incontinence and other side effects.

Prostate removal recovery also involves following up with your surgeon to monitor for complications. They can evaluate your healing and the success of your prostate cancer or benign prostatic hyperplasia (enlarged prostate) treatment.

This article discusses the steps in returning to a daily routine after prostate surgery while ensuring a smooth and safe recovery process.

What to Expect After Prostate Surgery

The recovery timeline begins in the hospital after your prostate surgery is completed and moves through your stages of healing and follow-up visits.

At Hospital

Most people can expect to stay overnight following a prostate surgery. You will begin walking around soon after surgery while observed by your healthcare providers. They'll also monitor signs of your early recovery, such as urinary output (your body's ability to produce urine, or pee).

During surgery, a Foley catheter to drain urine will be placed. It will typically remain in place for seven to 10 days at home. You may notice small amounts of blood in the urine.

First Couple of Days at Home

The first few days of recovery after prostate surgery typically involve low levels of activity. There are steps you can take to manage pain and return to basic activities, like meals and showering. Generally, you will:

• Experience pain. Your healthcare provider likely will give you pain medication and additional advice about pain relief. Motrin (ibuprofen) and Tylenol (acetaminophen) are commonly used.
• Eat small, frequent meals to minimize bloating and constipation. Avoid high-fiber foods for the first few days or so after surgery.
• Increase the walking activity that typically starts before you leave the hospital. Some experts recommend walking every hour, and even getting out of the car and walking if you have a long ride home from your procedure.
• Take showers rather than baths. Avoid swimming or going into a hot tub, typically for around four weeks.

One to Two Weeks After Surgery

Here's what to expect as your recovery progresses:

• Urinary catheter: Some people may still have a urinary catheter in place for up to 14 days. Talk to your surgical team about when the Foley catheter can be removed. Continue watching for bladder spasms or blood in your urine.
• Constipation: It's normal to experience constipation for up to one week after prostate surgery. Your surgeon will recommend stool softeners. Drinking water, and eating more fruits and vegetables, may help.
• Scrotum swelling: You may notice some swelling of your scrotum for a week or two after surgery. This swelling can be reduced by elevating your scrotum on a rolled-up washcloth when sitting or lying down. Your surgeon will also advise you to wear snug underwear.

One Month

At one month after prostate surgery, you:

• Can return to bathing, swimming, or going into a hot tub provided your healthcare provider has cleared you for the activity and no complications occur
• Can begin having sex again, although this may depend on the type of surgery you've had.

Three to Six Months

As your recovery progresses, you may be able to return to heavy lifting and other activities.

• Lifting: Avoid heavy lifting for up to six weeks after surgery. This means anything that weighs more than a gallon of milk.
• Urinating: Keep in mind that after a catheter is removed, most patients experience some dribbling or loss of urine. Normal bladder control often returns within a few months, but it can continue for a year or more.
• Erectile dysfunction: Patients may also experience erectile dysfunction after surgery, especially after surgery for prostate cancer. This is because the nerves that control erections may be injured and take a long time to heal after surgery (up to two years).

The recovery timeline for this depends on a number of factors, including:

• Advanced age
• Size of the prostate
• Underlying health conditions including diabetes and high blood pressure
• Smoking
• Drinking
• Low testosterone levels before the surgery

To improve blood flow to your penis and enhance your ability to have an erection, your healthcare provider may prescribe a vacuum pump or start you on Viagra (sildenafil).

Surgery Follow-up

You can expect to see your surgeon within the following time periods after prostate surgery:

• One to two weeks after surgery
• One to two months after surgery
• Three to six months thereafter

During these appointments, your surgeon will evaluate how well you are healing and monitor for complications like bleeding, infection, urinary incontinence, and erectile dysfunction.

You may also undergo prostate-specific antigen (PSA) blood tests at these appointments, as PSA level is related to how fast prostate cancer grows in those diagnosed.

Side Effects of Prostate Surgery

Recovery from prostate surgery can bring some quality of life concerns, including short-term urinary issues and sexual problems. Being aware of these possibilities and knowing what can you can do to better cope with them can help you both physically and mentally.

Incontinence

For most males, even a small amount of urine leakage can be distressing. And while most will experience some form of incontinence following surgery, it's a condition that tends to improve. Medications and surgical procedures can boost the odds of success in controlling leaks.

Your urologist may recommend a few helpful strategies, such as:

• Urinating frequently, even before the urge is felt
• Routinely urinating before going to bed at night
• Using the restroom as soon as the urge strikes
• Performing Kegel exercises to strengthen pelvic floor muscles

Erectile Dysfunction

Though penile sensation and orgasm may be maintained—even if the nerves are damaged—erectile dysfunction can be frustrating to deal with and negatively impact quality of life.

The same can be said of a decrease in libido, which can occur not from the actual surgery itself, but from post-surgical fatigue or cancer.

Seeking out reassurance or care from your urologist, having a strong support system, and even undergoing counseling with a psychologist or therapist can be helpful in sorting through any post-operative sexual problems you may be experiencing.

Open communication with your partner is also key to maintaining a sexual relationship. Intercourse is not the only way to experience sexual pleasure. Intimacy can be maintained, but it may require more effort than in the past.

Nerve Damage

Nerve damage is common with prostate surgeries, despite the development of nerve-sparing techniques. The nerve damage can lead to urinary incontinence issues.

Infertility

The vessels that produce semen are typically removed along with the prostate gland, which means that males become infertile. Talk with your healthcare provider about whether your condition and the type of procedure will lead to infertility.

Wound Care

Depending on the type of prostate surgery you have, one or more incisions in the skin may be made. To help prevent wound infection, your surgeon will advise you to clean your incision site(s) with mild soap when showering and use a clean towel to gently pat skin dry.

It's important to call your surgeon immediately if you develop any symptoms or signs of an infection, such as:

• Fever or chills
• Redness or swelling around the incision site
• Fluid draining from the incision site

How Long Can You Live Without a Prostate?

The removal of a prostate gland does not, in and of itself, affect life expectancy. However, older people tend to have a higher risk of side effects like urinary continence and erectile dysfunction.

Keep in mind that while prostate surgery can extend your lifespan, it may be discouraged for people age 75 and older. That's because prostate issues become so common with age and the benefits of surgery may not outweigh the risks in people with less than 10 years of life expectancy.

Longer life expectancies are changing how healthcare providers view this issue. It's also possible that, with surgery for an enlarged prostate, other procedures will be needed in the future.

Summary

Prostate surgery can be an essential treatment for prostate cancer or an enlarged prostate. It can help to know what to expect, and your healthcare team will provide guidance on what to expect during recovery.

The specifics will depend on the type of surgery you've had, as well as your diagnosis and other factors. Most people can expect recovery to progress in stages across four to six weeks. Side effects, including urination problems and erectile dysfunction, are common.