Prostate Surgery: Recovery

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Recovery after prostate surgery has several elements, from basic needs like taking care of your wound and managing issues like constipation to more involved ones, like coping with possible post-surgical effects like erectile dysfunction.

It also involves following up with your surgeon as advised to monitor for complications and proper healing, as well as evaluate the success of your treatment for prostate cancer or benign prostatic hyperplasia (enlarged prostate).

The hospital stay for most prostate surgeries is around one to two days, and recovery at home is around four to six weeks. Easing back into your daily routine after prostate surgery and taking the necessary steps to monitor your health are key to ensuring a smooth and safe recovery process.

Man sitting in a hospital bed speaking to a nurse

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Surgery Follow-up

You can expect to see your surgeon within the following time periods after prostate surgery:

  • One to two weeks after surgery
  • One month after surgery
  • Three to six months thereafter

During these appointments, your surgeon will evaluate how well you are healing and monitor for complications like bleeding, infection, urinary incontinence, and erectile dysfunction. 

You may also undergo prostate-specific antigen (PSA) blood tests at these appointments.

Recovery Timeline

As you recover in the hospital and then at home, you can expect the following:

  • Urinary catheter: During surgery, a Foley catheter to drain urine will be placed. It will be removed within one to fourteen days. While the catheter is in place, you may experience bladder spasms or notice some blood in your urine.
  • Constipation: It's normal to experience constipation for up to one week after prostate surgery. Your surgeon will recommend stool softeners and possibly Milk of Magnesia (magnesium hydroxide).
  • Scrotum swelling: You may notice some swelling of your scrotum for a week or two after surgery. This swelling can be reduced by elevating your scrotum on a rolled-up washcloth when sitting or lying down. Your surgeon will also advise you to wear snug underwear.
  • Eating: To minimize bloating and constipation, eat small, frequent meals and avoid high-fiber foods for the first few days or so after surgery.
  • Driving: Avoid driving until one to two weeks after surgery (when your catheter is removed and you are off all pain medications).
  • Showering: You can shower after surgery but avoid bathing, swimming, or going into a hot tub for around four weeks.
  • Activity: You will begin walking around soon after surgery and then slowly build up your activity level at home. Avoid heavy lifting for up to six weeks after surgery and sexual intercourse for up to four weeks.

Keep in mind that after a catheter is removed, most patients experience some dribbling or loss of urine. Normal bladder control for most returns within a few months. Only in rare instances do patients develop permanent urinary incontinence. 

Patients may also experience erectile dysfunction after surgery, especially after surgery for prostate cancer. This is because the nerves that control erections may be injured and take a long time to heal after surgery (up to two years).

The recovery timeline for this depends on a number of factors, including:

  • Your age
  • Preoperative erectile dysfunction
  • Preservation of the neurovascular bundle (one of two tiny collections of blood vessels and nerves adjacent to the prostate gland) during surgery
  • Surgeon performance

To improve blood flow to your penis and enhance your ability to have an erection, your doctor may start you on Viagra (sildenafil).

Coping With Recovery

Recovery from prostate surgery can bring some quality of life concerns, including short-term urinary issues and sexual problems. Being aware of these possibilities and knowing what can you can do to better cope with them can help you both physically and mentally.

Incontinence

For most men, even a small amount of urine leakage can be distressing. And while most will experience some form of incontinence following surgery, it's a condition that tends to improve considerably after the first month.

If faced with incontinence following prostate surgery, your urologist may recommend a few helpful strategies, such as:

  • Urinating frequently, even before the urge is felt
  • Routinely urinating before going to bed at night
  • Using the restroom as soon as the urge strikes
  • Performing Kegel exercises to strengthen pelvic floor muscles

Sex

Though penile sensation and orgasm are maintained—even if the nerves are damaged—erectile dysfunction can be frustrating to deal with and negatively impact quality of life.

The same can be said of a decrease in libido, which can occur not from the actual surgery itself, but from post-surgical fatigue or cancer.

Seeking out reassurance or care from your urologist, having a strong support system, and even undergoing counseling with a psychologist or therapist can be helpful in sorting through any post-operative sexual problems you may be experiencing.

Open communication with your partner is also key to maintaining a sexual relationship. Intercourse is not the only way to experience sexual pleasure. Intimacy can be maintained, but it may require more effort than in the past.

Wound Care

Depending on the type of prostate surgery you have, one or more incisions in the skin may be made. To help prevent wound infection, your surgeon will advise you to clean your incision site(s) with mild soap when showering and use a clean towel to gently pat skin dry.

It's important to call your surgeon immediately if you develop any symptoms or signs of an infection, such as:

  • Fever or chills
  • Redness or swelling around the incision site
  • Fluid draining from the incision site

When to Seek Medical Attention

Be sure to also call your surgeon right away if any of the following occur:

  • Blood clots in your urine or increased blood in your urine
  • No urine output for two to three hours
  • Your urinary catheter falls out (do not attempt to put it back in)
  • Scrotal or penile pain 
  • Inability to have a bowel movement for one week

A Word From Verywell

Undergoing prostate surgery may be essential for treating prostate cancer or an enlarged prostate that is causing serious problems like refractory (treatment-resistant) urinary retention issues or recurrent urinary tract infections.

While a necessary surgery, it's normal to be worried over the potential sexual and urinary side effects that may occur from removal of the prostate gland. Be sure to share your concerns with your urologist, and do not hesitate to ask them about their surgical experience and your individual expected outcome.

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Article Sources
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