Prostate Surgery: How to Prepare

Before having prostate surgery, there area few things you will have to do to prepare. Depending on the type of prostate surgery you are having, you might be instructed to adjust some of your medications and/or food and drink beginning the night before your procedure. You may also need special preparation, including a process to empty your bowels the day before your surgery.

If you are staying overnight in the hospital after surgery, you should be prepared with any assistive devices you use (such as a walker) and if you are going home on the same day of surgery, someone should be able to drive you home and assist you at home.

Location

A prostatectomy is the most common type of prostate surgery. Most of the time, this surgery is done to treat localized prostate cancer—that is, to remove a cancerous tumor that is located in the prostate gland and has not spread to other parts of the body.

Radical prostatectomy is the removal of the entire prostate gland, and simple prostatectomy is the removal of a portion of the prostate gland.

Prostatectomy is usually done with general anesthesia in an operating room at a hospital or outpatient surgery center.

A radical prostatectomy usually requires at least an overnight stay in the hospital after the procedure.

In some cases, a minimally invasive partial prostate resection is done under local anesthesia in a medical office. With a minimally invasive procedure, you can usually go home the same day of your surgery.

Your doctor will discuss the different surgical options with you as you decide together on the best approach for you, based on your condition and expectations.

Types of Prostatectomy

Before the day of your surgery, your doctor will do some tests to see how much of your prostate gland needs to be removed. How you prepare will depend a lot on how much of the prostate gland needs to be removed and what technique your doctor plans to use.

Surgical techniques for prostatectomy include:

  • Robot-assisted radical prostatectomy: This is a minimally invasive technique used for the removal of the entire prostate gland. Your surgeon will use robotic tools inserted through a few small incisions to do your surgery. This technique usually has a quicker recovery and is more likely to spare nerve sensation and sexual function than more invasive techniques. With this method, you should expect to be in the hospital for about 24 hours after surgery.
  • Open radical prostatectomy: With this approach, the entire prostate gland is removed using a traditional, open technique. Your doctor will make an incision in your lower abdomen between the pubic bone and navel, or in the perineum between the scrotum and anus. Your doctor will separate the prostate gland from its surrounding tissue, blood vessels, and nerves. Your incision will be closed with sutures, and you should expect to be in the hospital for one to two days after your surgery.
  • Simple prostatectomy: During this procedure, a portion of the prostate gland is removed with a cystoscope, which is a long, flexible device. The cystoscope is inserted through the penis and into the prostate area. The cystoscope allows the surgeon to visualize the surgical area with a small camera and is equipped with tools to remove the affected part of the prostate gland. You may be able to go home the same day after this procedure.

What to Wear

When you arrive at the hospital or outpatient center for your prostatectomy, you will be asked to change into a hospital gown.

Be sure to remove any piercings, jewelry, glasses, hearing aids, or other metal objects at home, before you arrive for your surgery appointment. You will want to bring comfortable, loose clothing to wear home after your surgery.

Food and Drink

Before your surgery, your doctor will give you specific preparation instructions.

For surgery that will be done with general anesthesia, you will be instructed not to eat or drink anything after midnight the night before your procedure.

If your doctor wants you to take any medications on the day of your surgery, you should do so with very small sips of water to minimize the amount of fluid in your body.

Medications

Your doctor will review all of your regular medications and supplements with you before the day of your surgery. Be sure to discuss any over-the-counter medications or supplements you take with your doctor too. Medications like ibuprofen and certain herbal supplements can affect blood pressure or increase your risk of bleeding.

Some of your medications, like blood thinners, might be stopped for a few days before your procedure to prevent complications. Others, such as diabetes or heart medications, are important to continue.

In some cases, your doctor may also prescribe a laxative solution to clear your bowels before your procedure. This can include oral laxatives or an enema. Your doctor will give you specific instructions if this preparation is required.

What to Bring

Items to bring with you on the day of the procedure, include:

  • Photo ID
  • Medical insurance card
  • A current medication list
  • A list of your allergies
  • Information about any prior complications you have had with surgery or anesthesia
  • Hearing aids, if you have them
  • Glasses
  • Loose, comfortable clothing to wear home

You will need to arrange to have someone drive you home when you are discharged from the hospital on the day of surgery, or several days afterward.

Pre-Op Lifestyle Changes

You will be asked to quit smoking and refrain from using alcohol or other drugs before your surgery. These substances can delay your post-operative healing.

How you prepare for your prostate surgery depends a lot on how much of the prostate gland your doctor needs to remove. A resection, in which only a portion of the gland is removed, can be minimally invasive, and you can go home the same day with little preparation. A radical prostatectomy, in which the entire prostate gland is removed, takes more planning and usually involves a hospital stay. Make sure you discuss the technique that will be used with your doctor and find out the best way you can prepare to help ensure a successful recovery.

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Article Sources
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  1. Johns Hopkins Medicine. Radical Prostatectomy.

  2. University of Wisconsin. Frequently Asked Questions About Robotic Prostatectomy.

  3. American Cancer Society. Surgery for Prostate Cancer. Updated August 1, 2019.

  4. Mayo Clinic. Prostatectomy. (Sept. 1, 2020.)

  5. National Institutes of Health. Prostate Resection. (April 2, 2019.)