Discharge from hospital following Robotic Prostatectomy

Medications

When you leave the hospital, you will be given a prescription for several different medications. This prescription will be dispensed before you leave hospital and the nurses will go over the instructions with you.

Coloxyl: One tablet (100 mg) three times a day – this is a stool softener that you will take for 30 days after the operation. It is important not to become constipated or strain while moving your bowels immediately after the surgery.
Celebrex: One tablet (100 mg) twice a day for 5 days – this is an anti-inflammatory medication that is very useful for pain relief after the operation (if you have a history of heart disease this should not be taken).
Panadol: 2 tablets as required each 4-6 hours - will be used for pain relief when you leave hospital.
Trimethoprim: One tablet daily for 14 days – this medication is to be started when you leave hospital and is to be continued for a week after the catheter is removed. It is to prevent a urinary tract infection occurring around the time the catheter is removed.

Regular medications

You can restart your regular medications once you start eating and drinking after the operation. However, if you are taking warfarin, other blood thinners or medications that predispose you to bleeding, such as antiinflammatory medications or aspirin, you will need to discuss this with Dr Swindle prior to recommencing them. These must be ceased whilst in hospital.

If you were taking anticoagulant medications Dr Swindle will advise you when to recommence them. You are able to read more about medications to consider pre and post operatively, in the Prostate Cancer section of our website.

Catheter

When you leave the hospital (either the day after surgery or the following day), you will still have the urinary catheter in place. This can be uncomfortable but is generally well tolerated.

Prior to discharge, you will be educated by the nursing staff on the ward how to care for the catheter and the leg bag when you are home. Jan in Dr Swindle’s office will make arrangements for the catheter to be removed 7 days after the operations. Occasionally the catheter may be left in for longer but this is rare. The catheter, which is held in place by a water-filled balloon on its tip, is left in for 7 days after the operation, allowing the anastomosis, or union between the bladder and the urethra, time to heal completely.

You can wear a urinary leg bag during the day - it allows you to move around more easily but it must be emptied every 3 hours or when needed as it gets full. This stays on the whole time your catheter is in. It should be fixed in place with a strap around the upper thigh to prevent it pulling down on the bladder and penis.

The catheter and its balloon can rest on the bladder wall and irritate the bladder resulting in bladder spasms. These present as mild to severe pain or cramping in the lower abdomen and the sudden need to urinate. These are infrequent however if they occur you should contact Dr Swindle immediately. The pain can be relieved by appropriate medications.

When you get into bed, be sure that the leg bag tap is ON and the night bag tap is OFF. You will need to arrange the tubing so that it does not pull on the leg bag or kink.

Some leakage of urine or blood-stained fluid around the catheter is not unusual. It is also not unusual to notice a pink or red tinge to the urine after you have been walking or after you have had a bowel movement. Avoid being alarmed simply increase your fluid intake until the urine becomes clear again.

Summary of Catheter Care;

It is very important to always wash your hands before and after emptying your catheter to avoid discomfort or infection. To disconnect the overnight bag, turn the leg bag tap to OFF, pull the night bag off the end of the leg bag and empty into toilet. You will be shown how to work the tap on the bag before you leave hospital.

Always keep the drainage bag below the level of the bladder
Use soapy water to wash the area around the catheter at least twice a day as debris and mucous will collect at the tip of the penis
Even when showering, keep the bag attached to the catheter at all times. You should also keep your catheter strapped to your thigh for comfort as this prevents it pulling in the bladder.
Keep the drainage bags free of kinks and loops
Drink at least 8 glasses or water a day to keep urine a clear, pale yellow colour

Occasionally when the bag is emptied, an airlock may form - caused by all the air emptying out of the drainage system. This can cause urine to stop draining, but is easily fixed. If the sides of the bag look sucked hard together and no urine has drained, just allow a small amount of air back into the system after emptying your bag by pulling the front and back of the bag slightly apart while the tap is open.

Changing your collection bag is only required if you have your catheter in for longer than usual - ask if you are not sure. Ensure that your hands are washed before and after this procedure. Prepare the new bag ready to be connected but without the tip of the bag tube touching anything. Empty the collection bag.

Carefully, without pulling on the catheter, disconnect the catheter end from the bag drainage tube. Connect new bag to catheter. DO NOT TOUCH THE OPEN END OF THE CATHETER OR NEW DRAINAGE TUBE TIP. Hold the tube at the base of where it would connect to the catheter to push it firmly into place.