Need Help on Catheters & Post surgery Recovery

Travelingman

I'm scheduled for robotic surgery on Monday Oct. 26th to remove my prostate. I would appreciate any ideas that worked for you guys in making catheter management easier as well as all other recovery tips. As an example, how do I prevent irritation where the catheter exits my penis? In addition, the surgeon says a nurse will visit me at home during my recovery? Will the nurse help me with maintaining my catheter & what is needed to take care of it? Are there any tips for preventing infection & is this even a real concern? I'm intersted in anything that will help me recover faster during the "catheter period" & especially afterwards. Thanks in advance!
_________________
PSA 18, Gleason 3+3+6, Age 58, Rising PSA since 1999, Biopsy 5% of one core
Robotic surgery 10/26/09 T2B Tumor 30% of prostate involving left & right lobes NOMX Gleason 3+4=7 Urethral Resection margins & resection surface clean Seminal vessicles clean

Sephie · Regular Joined: 24 Apr 2008 Posts: 31

Traveling, you will likely be sent home from the hospital on antibiotics. Our surgeon also told us to apply bacitracine or some other antibiotic ointment to the tip of the penis where the catheter exited. This keeps the area lubricated while providing protection against bacteria.

There's really no maintenance to the catheter. Before you leave the hospital, you should be given all the supplies you'll need. For instance, a leg bag which is smaller than the larger, overnight bag. The leg bag straps around your upper leg and allows you to pull pants on over it and go outside. This bag does not hold as much as the larger bag so don't go too far! But, you can empty the bag once it's full, and the nurse will show you how to do this.

You should be given instructions to take home with you about things to look for. Blood in the urine is nothing to worry about but you'll be told to look out for a fever.

My husband had robotic surgery in March 2008 and was lucky in that he had no pain at all. He was given a pain prescription but never needed it.

Staples are used to close the incisions - our surgeon encouraged taking the bandages off before showering and gently washing the area with warm water and soap (but not letting any direct shower pressure on the incisions). You can buy large bandages to keep the sutures covered during the day or your nurse may give you some.

I hope you do well with surgery, and that the pathology report brings you great news!

JohnRH · Regular Joined: 23 Aug 2009 Posts: 39 Location: Denver

I am 21 days out of DaVinci robotic prostate removal. I had the catheter removed at 10 days post surgery. I had no problems with it. My instructions were to wash the area around the tip of the penis twice a day and apply petroleum jelly. I had no chafing or infection. There was no pain with it. I had a thigh strap that I wore very high, right at the crotch, to keep the catheter loose at the penis. If that slips or gets tugged then there will be pain, I only had one minor reminder of that. The catheter removal was painless. The P.A. just pulled it out in a slow steady motion. The bags work well. I was amazed at how much urine the body produces. I sat and slept in a LayZboy recliner the first 3 or 4 nights for comfort. I would use the big urine bag overnight and carry around the house during the day initially. Overnight I produced a lot of urine and needed the big bag. What with that physics thing about water levels and all that the bags need to be below the level of the penis. I found it worked well, whether in a chair or bed, to hang the big bag just 10 or so inches off the floor, perhaps on an end table low drawer or a sturdy low box that wouldn't tip over when the bag got heavy. Emptying or switching bags was easy. You get adept fairly quickly. The leg bag works well but fills more quickly. You just put your foot up on the toilet and empty it via the bottom spout, being careful not to drip on your foot. I had 2 or 3 bright red blood clots appear in the bags during the 10 days, which is normal. I also had slight blood pinkness in the urine after initially longer walks. This is normal also. Take your time, take it slow and easy, lift little if anything initially. You probably won't feel like leaving the house much the first 3-5 days anyway, other than walking. I was doing short drives within a week (only took meds at home for 1 or 2 days). I'm off the bags now, and after peeing non-stop for 10 days I'm working on control now. What a surprise. It's coming along with slight improvements daily. I use pads that stick to your underwear. SNUG briefs are working best for me with the pads. Practice those Kegel urinary sphincter exercises, that's what it's all about. Since post-catheter I haven't had any big accidents, just lots of spits and dribbles, which are becoming fewer as I go along. Sitting and reclining is not a problem, it's getting to standing and then standing and moving around. When you stand you want to "Kegel" as you do. The disconcerting thing is that the spits and dribbles tend to sneak up on you unannounced. This too shall pass. The pads are cheap and VERY absorbent, so I don't worry about using alot of them. Still I've only needed about 4 a day to start and I was down to 2 a day yesterday. I'm sure each persons experience is different. You'll do fine.
_________________
DX 07/2009 with Gleason 4+3, PSA 4.1, age 63 1/2.
DaVinci RRP 09/2009; Gleason 3+4; Stage pT2c, NX, MX; neg surgical margins, neg for extraprostatic extension, neg for seminal vesicle invasion; est. tumor involvement 10% of prostate

Travelingman

[quote="JohnRH"]I am 21 days out of DaVinci robotic prostate removal. I had the catheter removed at 10 days post surgery. I had no problems with it. My instructions were to wash the area around the tip of the penis twice a day and apply petroleum jelly. I had no chafing or infection. There was no pain with it. I had a thigh strap that I wore very high, right at the crotch, to keep the catheter loose at the penis. If that slips or gets tugged then there will be pain, I only had one minor reminder of that. The catheter removal was painless. The P.A. just pulled it out in a slow steady motion. The bags work well. I was amazed at how much urine the body produces. I sat and slept in a LayZboy recliner the first 3 or 4 nights for comfort. I would use the big urine bag overnight and carry around the house during the day initially. Overnight I produced a lot of urine and needed the big bag. What with that physics thing about water levels and all that the bags need to be below the level of the penis. I found it worked well, whether in a chair or bed, to hang the big bag just 10 or so inches off the floor, perhaps on an end table low drawer or a sturdy low box that wouldn't tip over when the bag got heavy. Emptying or switching bags was easy. You get adept fairly quickly. The leg bag works well but fills more quickly. You just put your foot up on the toilet and empty it via the bottom spout, being careful not to drip on your foot. I had 2 or 3 bright red blood clots appear in the bags during the 10 days, which is normal. I also had slight blood pinkness in the urine after initially longer walks. This is normal also. Take your time, take it slow and easy, lift little if anything initially. You probably won't feel like leaving the house much the first 3-5 days anyway, other than walking. I was doing short drives within a week (only took meds at home for 1 or 2 days). I'm off the bags now, and after peeing non-stop for 10 days I'm working on control now. What a surprise. It's coming along with slight improvements daily. I use pads that stick to your underwear. SNUG briefs are working best for me with the pads. Practice those Kegel urinary sphincter exercises, that's what it's all about. Since post-catheter I haven't had any big accidents, just lots of spits and dribbles, which are becoming fewer as I go along. Sitting and reclining is not a problem, it's getting to standing and then standing and moving around. When you stand you want to "Kegel" as you do. The disconcerting thing is that the spits and dribbles tend to sneak up on you unannounced. This too shall pass. The pads are cheap and VERY absorbent, so I don't worry about using alot of them. Still I've only needed about 4 a day to start and I was down to 2 a day yesterday. I'm sure each persons experience is different. You'll do fine.[/quote]
JohnRH, I'm 4 days postop now & reviewing your posts on the catheter & post catheter. I wonder why some doctors go for 7 days, some 10 & some even longer! As far as the day your catheter was removed,did you just use the pads in your underwear? I don't know really know what SNUGS are. Are they like rubber underwear or are they disposable underwear or what? How long do I need the snugs & is their wetness in the groin area that has to be addressed? Thanks for any help you or others can give!
_________________
PSA 18, Gleason 3+3+6, Age 58, Rising PSA since 1999, Biopsy 5% of one core
Robotic surgery 10/26/09 T2B Tumor 30% of prostate involving left & right lobes NOMX Gleason 3+4=7 Urethral Resection margins & resection surface clean Seminal vessicles clean

JohnRH · Regular Joined: 23 Aug 2009 Posts: 39 Location: Denver

Congrats on your surgery. I don't know why the different lengths of time for post-op catheter removal. My appointment was made even prior to surgery. Surgeons' option and experience I presume.

SNUG is not a brand but the fit, as in comfortably tight so the pad is held close to the body. I see how that was misleading the way I wrote it. Though I normally wear boxer briefs they were a little too large for comfort so I purchased some regular briefs on the smallish, but not too small, side. The continence pads have a sticky strip on the outside that makes them stick to the underwear so they stay in place. The pads are disposable (in the trash, not the toilet!). I coulda shoulda bought pads in advance of catheter removal but didn't, so they had some baby diapers at the doc's that they cut up for my trip home. I bought pads on the way home. They fit close to the body with the briefs and are no bigger than a heavily padded jock cup. They are not noticeable under regular trousers or even jeans.

You should be able to find men's pads practically anywhere (big-box store, drug store, even grocery). I bought mine at WalMart. They're usually one-size fits all and in packages of 40-50+. You'll need -em.

Per wetness, the pads are VERY absorbant. Initially you will dribble alot and feel wetness, but my pads still never leaked into my underwear or pants. When they are getting well used you will also smell the urine. Change them as often as makes you feel comfortable. They're cheap and there is no gain to feeling wet or smelly for a long time. Wash your groin area with a washcloth as necessary for quick cleanup.

I presume we will wear the pads until we are continent and confident we won't have accidents. That can be 3 to 6 to 12 months or more. Walsh's book said at Johns Hopkins that 79% of men were continent after 3 months, 88% after 6 months, and 98% after 12 months. Every single person will obviously be different. I am 4+ wks post-op and 3+ wks post catheter removal and in my opinion I am progressing VERY satisfactorily. I am generally using 1 or 2 pads per 24 hour period now.

If you are a coffee addict like I am, REDUCE YOUR CAFFEINE INTAKE NOW! I cut back to 50% decaf before surgery and I'm up to 75-80% decaf now. It makes a BIG difference in the amount of peeing you do.

Reducing general liquid volume intake when you are post-catheter will help also, but they may want you to drink liquids until that time. Caffeine has a bigger effect on me than general liquid anyway.

If you have further questions don't hesitate to ask.
_________________
DX 07/2009 with Gleason 4+3, PSA 4.1, age 63 1/2.
DaVinci RRP 09/2009; Gleason 3+4; Stage pT2c, NX, MX; neg surgical margins, neg for extraprostatic extension, neg for seminal vesicle invasion; est. tumor involvement 10% of prostate

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