Recovering from prostate cancer surgery takes time and effort.
Some men may feel quite fine after a radical prostatectomy or surgery to remove the prostate gland because of cancer, said Associate Professor Edmund Chiong, president of the Singapore Urological Association and senior consultant, Department of Urology, National University Hospital.
But they should refrain from lifting heavy objects and strenuous exercise as the "internal wounds" usually take longer to heal.
He discusses what one can expect about a week after undergoing radical prostatectomy.
•Urinary incontinence: A week to 10 days after surgery, your doctor may remove your urethral catheter. Most men will experience temporary difficulties with urinary control after the removal of the catheter.
This will result in the involuntary leakage of urine, which is less of a problem when you are lying down or sleeping. It usually takes several months for this to improve. In the meantime, use adult urinary absorbent pads.
Kegel exercises, which help to strengthen the pelvic floor muscles, can be done immediately after the catheter has been removed.
These exercises should be done throughout the day. It will take time and effort to strengthen the external sphincter muscle, which becomes the only mechanism for urinary control after such surgery.
•Sexual function: Erectile dysfunction (difficulty achieving erections) and erections not lasting as long or being less firm than before, may occur.
Erections are initiated when the nerves running very closely beside the prostate gland are stimulated. One or both of these nerves may not always be fully spared or spared at all during surgery, due to a variety of factors, such as when the cancer is located close to these nerves.
If some part or parts of the nerves are spared, there may be a chance of recovering the erections, but the recovery may be slow, as nerves generally heal very slowly (ranging from six months to several years on average).
There are several methods of penile rehabilitation, including oral or injectable medications and vacuum erection devices. If these methods are ultimately unsuccessful, a prosthesis can be implanted surgically to restore sexual function.
Generally, sexual activity can be resumed when the urinary catheter has been removed, the wounds are healed and when one feels ready.
The ability to have an orgasm should not be affected by the surgery, but with an orgasm, there will not be an emission of semen because the prostate and seminal vesicles have been removed.
•Returning to work: Refrain from doing vigorous activity or heavy lifting (about 4kg or more) for at least six to eight weeks after surgery, to give the inner wounds time to heal.
Your occupation and the rate of your recovery will determine when you can return to work.
For most non-physically demanding jobs, patients return to work in two to three weeks on average.
•This is the last of a two-part series on what to expect when recovering from prostate cancer surgery.