After a robotic prostatectomy, there will be 6 small incisions where the robotic instruments were placed. The small incisions will be covered by waterproof dressings. Bruising around these incisions and the abdomen is not uncommon and should not alarm you. This will resolve over time.
The sutures that hold the incision together are under the skin and do not need to be removed as they will dissolve. Occasionally the wound sites may ooze blood stained fluid. If this occurs the dressings can be removed and the wounds washed in the shower. The wounds can then be dried with a clean pad or towel and a clean dressing reapplied.
You may also shower with these waterproof dressings and they can eventually be removed 3 days after the procedure. Once the dressings are removed, the wounds need to be kept clean by showering. Do not take a bath for 1 week after the procedure.
It takes 4-6 weeks for the incisions to heal completely, so you should avoid heavy lifting (over 10kg) or straining during that time. Daily exercises such as walking, climbing stairs, or swimming (do not start for 1 week after the operation), will help you recover faster, but wait 4-6 weeks before beginning heavy exercise such as jogging, weight lifting, or golf with a full swing.
Your perineum (the area between the scrotum and anus) may be tender for several weeks or months, so avoid sitting on anything hard or pointed like a bicycle seat, and do not ride a motorcycle or a horse until the tenderness is gone.
Some men feel fullness or tenderness in the rectum, as though they have to have a bowel movement. The prostate gland lies just above the rectum, so this sensation is to be expected and usually will go away with time. It is normal to experience tenderness and swelling of the testicles after the surgery and for the penis to be retracted and shortened for a time after the surgery.
You may return home in a car or airplane, but you should not drive as long as you have any pain or you are taking pain medications stronger than Tylenol, Aspirin, Advil, Vioxx, or Celebrex.
Avoid sitting with your feet on the floor for more than 15 minutes at a time. Get up and walk, stretch your legs, or keep your feet propped on a stool as much as possible. If you return home by airplane, walk in the cabin area every half hour. Avoid standing still for more than a few minutes at a time.
Sitting and standing still, slow the circulation in your legs and predispose you to a blood clot. Notify your doctor or contact our office immediately if you notice swelling in your feet or ankles or tenderness in your calves or thighs or if you become short of breath or cough up blood. These symptoms may signify a deep vein thrombosis or pulmonary embolus (blood clot in the lungs).
Generally, you can return to work about 1-6 weeks after the operation. If your work requires heavy physical activity, you may need a longer period of recovery until all the soreness disappears from the incision and the urinary control is satisfactory.
You should be comfortable with desk or office work within 1-3 weeks - once the catheter is out and you feel confident with the urinary pads. After your return home, do not plan any long trips for 6 weeks after the operation to avoid prolonged sitting.
Bowels and intestinal function
After the operation, you can have ice chips and water as soon as you are fully awake, progressing to a liquid diet that evening or the next morning. You can try solid food 24-36 hours after the operation, when your intestinal activity begins to recover.
Most people do not pass flatus (intestinal gas) for 1-2 days and do not have a bowel movement for 4-5 days. It is common to have abdominal bloating after the procedure but this should resolve once your bowels return to normal function.
When you return home, you may resume your normal diet. It is important to avoid constipation by taking a stool softener, such as Coloxyl, three times a day for 30 days after the procedure and by drinking plenty of fluids.
Your bowels may be loose initially when they first start to work after the operation. Increasing the fibre and water intake in your diet should help to keep stools soft.
Metamucil is an excellent natural stool softener as well. Use a gentle laxative, such as Agarol 30mls at bedtime, if you begin to feel constipated.
A major operation can predispose you to heartburn and indigestion from excess stomach acid. Let Dr Swindle know before the operation if you have a tendency to these problems and do not hesitate to take medications to control heartburn should it occur after the operation.