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Old 11-07-2010, 12:50 PM   #1
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A Note on Robotic Prostatectomy; Post-Op

I think there should be a class or a primer for people who consider or have decided to undergo robotic prostatectomy. There are many things I wish I knew.

First, I did not know that Kegel exercise for a month or two before will help continence after surgery.

Second, I would be nice if there is an animated video for Kegel exercise. I am still not sure that what I am doing is the right exercise.

Third, when I walk with catheter, I was worried that it will come off. I later learned that there is a balloon in the bladder preventing the Foley catheter from coming off. Both Dr. Kegel and Dr. Foley should get high praises.

Fourth, my wife and I learned how to take care of the overnight and leg bag to collect the urine from a video. I think it is very important to keep the catheter and the bags super clean to prevent infection.

I learned to empty the leg bag before I took a nap. The leg bag holds about 30+ cc and we don't want it to get full.

I also learned to make sure that there was no tension on the tube from the belt on the thigh to the penis. We want to position the belt holding the tube to the thigh just right especially when we walk.

At the hospital after I took a walk for the first time, I felt a burning sensation.
The nurse applied Xylocaine 2% jelly on my penis. It gave me relief right away. She knew the right remedy.

Fifth, I wore the catheter for 8 days. I learned beforehand how the cath would be removed and it reduced my anxiety. The nurse deflated the ballon by a needle to the Y shape in the tube. My nurse practitioner was skilled. He told me to inhale and exhale twice. He would remove the cath during my second exhale. When the thing came out what I felt was close to an orgasm.

Sixth, I did not know that during the period I had the cath, my bladder did not have to work. He pumped 200cc of water into my bladder. He wanted to see whether I could urinate after the cath was removed. My bladder was not ready. He told me to drink 3-4 cups of water. He would not let me go home if my urine does not come out in a stream. He said, "For some people we have to put the catheter back". Hearing that I drank more water. After about ten minutes I was able to urinate. I came back to give him the report. He said, "You are good to go".

Seventh, I prepared both underwear pamper type and guard (pad) type to the
appointment. I had a long drive home with my wife. I chose to wear the underwear type and put the pad in my jacket. I was able to drive long distance 8 days post-op. I don't think I can do that if I go with open prostatectomy.

Eight, incontinence is not a minor thing. The urethra was severed. The bladder came down to where the prostate was. The urologist reattached the urethra to the bladder. The chance for leakage is high. I hope time and Dr. Kegel are on my side. I am now 20 days post op. I need at least two pads a day. I try to go to pee about every 90 minutes. If I wait until I have to go I can make a mess.

Ninth, I had to cut down on coffee and alcohol. I cannot drink more than one beer in the evening. I would get up too many times at night.

Tenth, even though the surgery removes the prostate gland, lymph nodes and seminal vesicles, most of the consequences are about I&I (incontinence and impotence) or about the penis. I wish I can find a video that would address issues of the penis post-op from shorter penis to whatever.

Before I decided to go with RRP, I talked to four oncologists, four urologists and one pathologist. I also talked to Pca survivors who went through HIFU, Brachytherapy, RRP and traditional open surgery. I read until I dreamt of Dr. Walsh talking to Dr. Catalona about nerve sparing. My final decision: I want to have the specimen out to the lab for the complete pathology findings. All other treatments cannot do that.

Good luck to us all, whatever we choose.

 
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Old 11-21-2010, 05:35 PM   #2
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Re: A Note on Robotic Prostatectomy; Post-Op

Quote:
Originally Posted by Netirati View Post
I think there should be a class or a primer for people who consider or have decided to undergo robotic prostatectomy. There are many things I wish I knew.

First, I did not know that Kegel exercise for a month or two before will help continence after surgery.

Second, I would be nice if there is an animated video for Kegel exercise. I am still not sure that what I am doing is the right exercise.

Third, when I walk with catheter, I was worried that it will come off. I later learned that there is a balloon in the bladder preventing the Foley catheter from coming off. Both Dr. Kegel and Dr. Foley should get high praises.

Fourth, my wife and I learned how to take care of the overnight and leg bag to collect the urine from a video. I think it is very important to keep the catheter and the bags super clean to prevent infection.

I learned to empty the leg bag before I took a nap. The leg bag holds about 30+ cc and we don't want it to get full.

I also learned to make sure that there was no tension on the tube from the belt on the thigh to the penis. We want to position the belt holding the tube to the thigh just right especially when we walk.

At the hospital after I took a walk for the first time, I felt a burning sensation.
The nurse applied Xylocaine 2% jelly on my penis. It gave me relief right away. She knew the right remedy.

Fifth, I wore the catheter for 8 days. I learned beforehand how the cath would be removed and it reduced my anxiety. The nurse deflated the ballon by a needle to the Y shape in the tube. My nurse practitioner was skilled. He told me to inhale and exhale twice. He would remove the cath during my second exhale. When the thing came out what I felt was close to an orgasm.

Sixth, I did not know that during the period I had the cath, my bladder did not have to work. He pumped 200cc of water into my bladder. He wanted to see whether I could urinate after the cath was removed. My bladder was not ready. He told me to drink 3-4 cups of water. He would not let me go home if my urine does not come out in a stream. He said, "For some people we have to put the catheter back". Hearing that I drank more water. After about ten minutes I was able to urinate. I came back to give him the report. He said, "You are good to go".

Seventh, I prepared both underwear pamper type and guard (pad) type to the
appointment. I had a long drive home with my wife. I chose to wear the underwear type and put the pad in my jacket. I was able to drive long distance 8 days post-op. I don't think I can do that if I go with open prostatectomy.

Eight, incontinence is not a minor thing. The urethra was severed. The bladder came down to where the prostate was. The urologist reattached the urethra to the bladder. The chance for leakage is high. I hope time and Dr. Kegel are on my side. I am now 20 days post op. I need at least two pads a day. I try to go to pee about every 90 minutes. If I wait until I have to go I can make a mess.

Ninth, I had to cut down on coffee and alcohol. I cannot drink more than one beer in the evening. I would get up too many times at night.

Tenth, even though the surgery removes the prostate gland, lymph nodes and seminal vesicles, most of the consequences are about I&I (incontinence and impotence) or about the penis. I wish I can find a video that would address issues of the penis post-op from shorter penis to whatever.

Before I decided to go with RRP, I talked to four oncologists, four urologists and one pathologist. I also talked to Pca survivors who went through HIFU, Brachytherapy, RRP and traditional open surgery. I read until I dreamt of Dr. Walsh talking to Dr. Catalona about nerve sparing. My final decision: I want to have the specimen out to the lab for the complete pathology findings. All other treatments cannot do that.

Good luck to us all, whatever we choose.
-----------------
I learned that I might have overdone Kagel exercise. Overdoing it will cause muscle fatigue and worsen incontinence. Dr. Catalona also cautioned against too much Kagel. I am now trying to adhere to the schedule given by my urologist. Hope it will work. Incontinence will impair quality of life even if you stay home all day.

 
Old 11-27-2010, 07:49 PM   #3
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myfavfellow HB User
Re: A Note on Robotic Prostatectomy; Post-Op

Thank you so much for your information. I am the daughter of THE most wonderful daddy who is having surgery in January. I am going to call him tomorrow and tell him to start his Kegal exercises. It is so hard to know what to do, what choice to make when faced with Prostate cancer. I am a nurse and I feel responsible to help my dad make the best and most educated decision. I am not sure that we have done that but are scheduled for surgery on Jan 7 for the DaVinci prostatectomy. I have researched quite a bit via this most wonderful of boards, Patrick Walsh's book and internet research. And of course, talking with my dad's urologist and any other urologist I can corner at work.
But I still feel SOO unprepared. What am I "allowing" my dad to get into? He mostly cares, actually only cares, about incontinence. He feels like it is an outcome that he could not live with . So that is what worries me alot. BUt mostly...will they get it all and cure him and give him the most optimal outcome possible so can live a full, joyous life. He is a very young 69 and is at this time building a summer home in NOrth Carolina for us Floridians to enjoy.
It is nice to hear from those who have been through it. Thank you

 
Old 12-02-2010, 01:30 PM   #4
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Join Date: Sep 2009
Location: Chicago
Posts: 47
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Re: A Note on Robotic Prostatectomy; Post-Op

I have not posted to the board in some time, but wanted to provide a little information on kegels. I found a great explanation on how to do them on this board shortly after having my own RP. I had surgery in Sept 09. Here is the link: http://www.healthboards.com/boards/showthread.php?t=725021&highlight=kegel

You will also find a number of very good postings about post-surgery recovery if you look back between Sept 09 and Nov 09.

I would like to add one comment about your issues on Robotic surgery. After reading your 10 issues I wanted to go and sit down with your surgeon and explain that their job is more than "fixing the problem". Unfortunately there are a lot of doctors today that do not take the time to explain the procedures, what to do before and what to do after. In addition, many do not offer an explanation of the options. As for your ten items - my guess is most all of them apply to the open procedure as well as any general surgery where there is post op healing to be done (clearly Prostate is a specialized area - let's not fool ourselves - which is why the surgeon should have taken the time to explain).

I did not find this forum until after my surgery; however, many of the posts are prior to surgery and many are from spouses. This is a great place to ask for advice and get some good options/answers. I found this was a place where the answers contained good information/options and were not the type where people just went off and complained.

PC is a very difficult surgery and every person has a different recovery curve. I also found that the two surgeons I interviewed had radically different pre and post-operative procedures (kegels, rate of sexual activity, drugs, exersize, etc.). It is also extremely personal dealing with incontinence and sexual function. For many of people the recovery is measured in years instead of weeks and months. You will also find that you are not alone in your concerns.

I hope you find this helpful and will continue to ask and get good advice from the members of the community.

 
Old 12-26-2010, 06:03 PM   #5
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Join Date: Dec 2010
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teachersue HB User
Re: A Note on Robotic Prostatectomy; Post-Op

Thank you for starting this thread, and for all of the very helpful information provided. My husband is going to have the robotic surgery in three weeks, and his personality is to accept what is, and to not fight things that are beyond his control. So after having decided on his preferred form of treatment, he's pretty much just waiting to have the next part happen. He's done no real digging for info beyond our appointments with two urologists, when we were told some info and we asked some questions.

I, on the other hand, am more of a gathering-information person. So I'm kind of on my own in this. I found this thread to be very practical, informative, and helpful. Thank you so much.

 
Old 12-27-2010, 06:58 AM   #6
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Join Date: Jul 2010
Posts: 31
Netirati HB User
Re: A Note on Robotic Prostatectomy; Post-Op

I am now seeing a physical therapist who specializes in lower pelvic floor. I have had two sessions with her and I feel that she is putting me on the right track for Kegel exercise. I am trying to be patient hoping that Kegel is my remedy, not other more drastic solutions. I&I are double jeopardy. Together they are very heavy on my mind. I would not wish them on anyone.

 
Old 12-28-2010, 06:25 AM   #7
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mrmike2009 HB User
Re: A Note on Robotic Prostatectomy; Post-Op

I think the key is to realize that everyone that goes through this is different. I went back and found a couple of references that might help. First - take a look at this thread:

http://www.healthboards.com/boards/showthread.php?t=725021

I think it is different than the one I sent you earlier. It has a good link to a set of statistics that reflect the very different recovery times and how long it actually takes to get "pad free" and that is just one of the "I's". The other "I" (in your I&I) has a different set of statistics. Your doctor or PA should be able to work with you to help out.

I also clipped the explanation on doing kegels as I thought it was excellent - it was from KCON.

Imagine trying to stop yourself from passing wind. To do this, you would squeeze the muscle around the anus. Try squeezing that muscle as if you really did have wind. You should be able to feel the muscle move. You should be aware of the skin around the anus tightening and the anus being pulled up and away from whatever you are sitting on. Do not move the buttocks and thighs. Do not hold your breath - breathe normally. Do not tighten your abdominal or buttock muscles - keep them relaxed. Later, you can check whether you are contracting the correct muscles by touching [I skipped this part] the opening at the rectum as you are tightening the muscle - you should feel the opening of the rectum contract at the same time.


Best of luck to you and let us know how you are doing. I have found the contributors to this forum to be very helpful so do not hesitate to write.

 
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