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Radical prostatectomy - Recovery

Alternative Names

Prostatectomy - radical; Radical retropubic prostatectomy; Radical perineal prostatectomy; Laparoscopic radical prostatectomy; LRP; Robotic-assisted laparoscopic prostatectomy; RALP; Pelvic lymphadenectomy

Before the Procedure:

You will have many visits with your doctor and tests before your surgery:

Complete physical exam
Visits with your doctor to make sure medical problems, such as diabetes, high blood pressure, and heart or lung problems, are being treated well

If you smoke, you should stop several weeks before the surgery. Your doctor or nurse can help.

Always tell your doctor or nurse what drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.

During the weeks before your surgery:

You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamin E, clopidogrel (Plavix), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
Ask your doctor which drugs you should still take on the day of your surgery.
On the day before your surgery, drink only clear fluids.
Sometimes, you may take a special laxative the day before your surgery. This will clean the contents out of your colon.

On the day of your surgery:

Do not eat or drink anything after midnight the night before your surgery.
Take the drugs your doctor told you to take with a small sip of water.
Your doctor or nurse will tell you when to arrive at the hospital.

Prepare your home for when you come home after the surgery.

After the Procedure:

You may stay in the hospital for about 1 to 4 days. After laparoscopic or robotic surgery, you may go home the day after surgery.

You may need to stay in bed until the morning after surgery. Afterwards, you will be encouraged to move around as much as possible.

Your nurse will help you change positions in bed, show you exercises to keep blood flowing, and recommend coughing or deep breathing to prevent pneumonia. You should do these every 3 to 4 hours. You may need to use a breathing device to keep your lungs clear. You may also:

Wear special stockings on your legs to prevent blood clots
Receive pain medicine in your veins or take pain pills
Feel spasms in your bladder
Return from surgery with a Foley catheter in your bladder. Some men will have a suprapubic catheter in their belly wall to help drain the bladder.

Reviewed last on: 2/4/2011
Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Su L, Smith JA. Laparoscopic and robotic-assisted laparoscopic radical prostatectomy and pelvic lymphadenectomy. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 99.

Walsh PC, Partin AW. Anatomic radical retropubic prostatectomy. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 97.

Hartke DM, Resnick MI. Radical perineal prostatectomy. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 98.

Wilt TJ, MacDonald R, et al. Systematic review: comparative effectiveness and harms of treatments for clinically localized prostate cancer. Ann Intern Med. 2008;148:435-448.

Walsh PC, DeWeese TL, et al. Clinical practice: localized prostate cancer. N Engl J Med. 2007;357:2696-2705.

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