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What to expect after prostate cancer surgery

Start walking soon so that bowel function can return to normal

Prostate cancer is the third most common cancer among men in Singapore.

A common treatment is radical prostatectomy, which involves removing the entire prostate gland and some of the tissues around it.

The risks include urinary incontinence and erectile dysfunction.

Associate Professor Edmund Chiong, president of the Singapore Urological Association and senior consultant at National University Hospital's Department of Urology, tells Mind&Body what patients can expect when they return home after undergoing prostate cancer surgery.

He will be chairing several sessions on prostate cancer at the 14th Urological Association of Asia Congress 2016 from July 20 to 24.

Gradually increase the amount of walking done each day. Avoid sitting still in one position for too long to reduce the risk of deep vein thrombosis.

Urethral catheter

Patients will be discharged from hospital with a catheter in place. This drains urine from the bladder and needs to be kept in place - typically seven to 10 days - until the newly sutured connection between the bladder and the urethra heals.

Do not remove it on your own. If the catheter falls out, notify your urologist at once.  A non-urologist is generally not allowed to replace it, as it may compromise or destroy the newly-formed connection between the bladder and the urethra.

Keep the urethral opening clean, so as to reduce the risk of infection from the catheter. This area can be washed with soap and water once or twice a day. Or place a small amount of lubricant or anaesthetic ointment around the urethral opening to reduce any discomfort.

Bladder spasms

Some patients may experience cramping, some pressure or a sense of urinary urgency when the urinary catheter is in place.

These spasms are the natural response of a healing bladder and can cause urine or blood to squirt out of the penis during bowel movement. Your doctor may prescribe medications to help relieve the discomfort.

Scrotal swelling

This may occur soon after surgery and may last for a few days to a few weeks. You can wear supportive briefs and elevate your scrotum on a rolled towel when lying down.

Lower limb swelling

Some may experience lower leg or ankle swelling, especially if pelvic lymph nodes were removed during the surgery. This may last for a few days to a few weeks. Elevating your legs while sitting or lying down usually helps.

Daily activity

The benefits of walking soon after surgery - as early as one to two days after surgery - include the early return of bowel function and reduced risk of blood clots developing in the lower limb veins (deep vein thrombosis).

Gradually increase the amount of walking done each day. Avoid sitting still in one position for too long to reduce the risk of deep vein thrombosis.

You can take a shower but avoid submerging yourself in the water, such as taking a bath or swimming, until your wounds have healed completely and the urethral catheter has been removed.

Diet

It is not uncommon to experience some abdominal distension, constipation or bloating after surgery, which, along with your appetite, would usually gradually recover in the first week after surgery.

Meanwhile, keep yourself well- hydrated and eat small meals throughout the day. Do not force yourself to eat if you feel full or uncomfortable.

Avoid carbonated beverages or too much gas-producing foods in the initial week after surgery.

Oral stool softeners can be used as needed to relieve constipation.

Joyce Teo

•This is the first of a two-part series on what to expect when recovering from prostate cancer surgery. We will look at what to expect after the removal of the urethral catheter next.

A version of this article appeared in the print edition of The Straits Times on July 19, 2016, with the headline 'What to expect after prostate cancer surgery'. Print Edition | Subscribe