Charleston Area Medical Center has been performing robotic prostatectomies since 2006. We completed our 1,500th robotic da Vinci case in August 2012. Currently there are three da Vinci robotic consoles at CAMC Memorial Hospital and a dedicated training console at CAMC General Hospital.
About the procedure
da Vinci robotic prostatectomy is a minimally-invasive approach to removing the prostate. By removing the prostate completely the full extent of the prostate pathology will be known.
Immediately following the procedure
You will be admitted to CAMC Memorial Hospital following the procedure where you will stay overnight. After the procedure you will have a Foley catheter, which you will go home with and have for 5-7 days.
After the procedure
THE FIRST WEEK
- Monitor your temperature and report to your nurse or surgeon anything higher than 100.5 degrees.
- You will have 6 small incisions. They will have surgical glue holding them together, which wears off in 3 to 4 weeks. You may experience a small amount draining from the incision, which is normal.
- Incisions are covered with a dressing. You may remove that after your first shower. Only an antibiotic ointment like Polysporin should be applied to the incision.
- It is not uncommon to bruise around the incision site. It can even develop 1 to 5 days after surgery. The bruises will go away.
The Foley Catheter
- You may experience some discomfort where the Foley catheter inserts, and you may find it helpful to put a small amount of Vaseline on the tip of the penis and the catheter tubing several times daily.
- You may experience a small amount of urine leakage around the catheter. This is not unusual. You may want to put and absorbent pad (such as Depends, Attends) in your underwear to soak up any leakage.
- Urinary incontinence is the inability to prevent urine from leaking. It may be a surgical side effect because the sphincter muscle beneath the bladder is weakened from the surgery. Most men regain continence within 1 to 3 months. If you have had an enlarged prostate or previous urinary control issues, it can take longer. Kegel exercises strengthen the pelvic floor muscles.
- You may see some blood in the urine. In that case, you should drink more fluids to help flush out any clots.
- It typically takes 5 to 7 days for the urethra and bladder to heal, at which point the catheter can be removed. This will be discussed with your urologist at your first follow-up appointment.
Swelling of the Scrotum, Testicles or Penis
- To help reduce swelling of the scrotum, you should roll up a small towel or washcloth and elevate it when you are sitting or lying down. Also, wear snug-fitting underwear to give support (even while you have the catheter). Call to report new swelling or bruising of your scrotum or penis.
- You may experience some pain in the perineal area, which is between your rectum and scrotum. You may also have some testicular discomfort for several weeks. This should go away. Call the nurse if the medication is not alleviating the pain.
- Begin drinking clear liquids. Avoid soft drinks or carbonated beverages until after you begin passing gas.
- Once you begin passing gas, you may return to your regular diet. It may be desirable to eat several smaller meals daily rather than three large meals. You should avoid eating foods that increase gas.
- It is common to take 2 to 4 days for a bowel movement to occur after surgery. You will receive a prescription for stool softener when you leave the hospital, which you should fill and begin taking right away. Do not use any Fleet enemas. You may experience pain with bowel movements. If so, it may help to place your feet on a small stool while having a bowel movement. You may also find relief using Anusol or Preparation H. Increasing fiber and water will help. Avoid pushing or bearing down when you do have a bowel movement. If you are constipated for more than 4 days call the nurse.
- After activity or a bowel movement, you may have bloody drainage around the catheter or in your urine. While this may cause you alarm, it is not uncommon. Usually this drainage will lessen after you rest for a short period of time.
- Do not lift more than three pounds for a week after surgery. Do not lift more than 15 pounds for six weeks. This is especially critical when you still have the catheter.
- Begin walking as soon as you feel able. You can walk and do as much stair climbing as you can tolerate. Begin slowly and increase to your pre-surgery activity level.
- Avoid sitting in one position for more than 45 minutes.
- Do not drive until one week after surgery or after the Foley catheter is removed.
- Refrain from sexual intercourse until one month after surgery.
Showers and Baths
- You can resume showering 24 hours after surgery.
Medications after Surgery
- You may resume your daily medications (with the exception of blood thinners) upon discharge unless otherwise instructed.
- Blood thinning medicines should NOT be resumed until after the Foley catheter is removed and should be discussed with your doctor first.
- You will need to take: stool softener, a complete course of an antibiotic, and pain medication, as needed.
THE SECOND WEEK
- You return to see your surgeon 4 to 7 days after surgery.
- If your job is primarily sedentary (sitting at a desk), you may return to work in 1 to 2 weeks. If your job is physically demanding, you would typically be cleared to return to work in 6 weeks.
- You may begin to attempt sexual intercourse.
- Do not lift more than 15 pounds for two more weeks.
- You may begin to take baths or go into hot tubs.
- You must have a PSA test every three months for the first year.
- After 1 year, these checkups will be every 6 months, then annually.
Physicians performing this procedure:
Samuel Deem, DO
James P. Tierney, DO