Robotic Assisted Laparoscopic Prostatectomy FAQ P2

Patient Information Part 2

 13 How long does the operation take?

Between 2 to 3 hours. It is done under general anaesthetic, and you will wake up in the recovery bay before being transferred back to the ward.

 14 Will I be in pain?

Robotic surgery is less painful than open surgery. Before you wake up the anaesthetist give you pain relief and we use local anaesthetic (numbing solution) in the wounds and bladder. If you feel you have pain then please inform the nursing staff so they can give you pain relief.

A lot of patients wake up with the sensation of a full bladder or can get periodical bladder spasms, this is because of the catheter and the surgery around the bladder, and not because the bladder is full. It usually settles but if not can be helped with medication.

 15 How long will I be in hospital?

1 day. The majority of patients (95%) are discharged the day after the operation. Along with the catheter, you will wake up with a drain tube which is removed prior to discharge. You will also be taught how to administer a small injection which you will need to self administer for 4 weeks.

 16 Will I have help once discharged?

Yes. Before leaving hospital you will be given instructions on how to manage with the catheter and manage dressings.

Absorbable stitches are used so no stitches need to be removed.

You will be given pain killers to take as and when you need them, tablets to stop gastritis to be taken for the first week and medication to prevent constipation. For men whom erectile function is important a medication will be offered, and this should be started once the catheter is removed.

If needed the Community Nurse is available, (contact details are available via your GP). The Community Continence Team are available and you will have planned contact or appointments with them. The ward can be called if there are any problems. Please see below for useful contact numbers

 17 Are there any restrictions once I go home?

Initially exercise should be gentle but gradually built up on a daily basis as symptoms allow. Don’t confine yourself to bed. You should take a full and balanced high fibre diet and maintain a good fluid intake especially in the first week.

Occasional alcohol consumption is permitted but should be restricted in the first week after the operation.

Energy levels can vary from day to day following this surgery.

 18 How long will I need a catheter for?

The catheter is a very important part of your recovery. It protects the join between your bladder and your urethra (water pipe) in the early stages of the healing process. We like to leave the catheter for a short as time as possible, between 7 – 10 days after the operation. Removal of the catheter is very straight forward and only takes a matter of seconds however it is done in the Urology department. You will be given a date for catheter removal before you are discharged from hospital.

Once the catheter is removed please continue doing your pelvic floor exercises regularly.

Remember most patients have some degree of leakage initially once the catheter is removed and you may need to use pads for a period of time. This is where the Community Continence Team will assist you.

 19 When do I get the results of the prostate?

This takes our pathologists about 2 weeks to process and examine the prostate. If you wish to receive your results before your 6 week follow up please contact your Prostate Specialist Nurse. The results can be given to you by telephone.

 20 Will I need any other forms of treatment?

Most patients don’t need any other forms of treatment. Some patients with more advanced disease may be offered radiotherapy after the surgery, either immediately or later if there is a rise in the PSA, others may be given a long course of hormones. This will be discussed with you by your surgeon. Further appointments with the Oncologists may be needed in this situation.

 21 What follow up will I receive?

After the initial pathology results, you will be seen by the surgeon at 6 weeks after the surgery, then at 3 monthly intervals with a check PSA. If all is well then time between appointments can be lengthened. You may also have appointments with the physiotherapist’s if there is an issue with recovery of continence or in the Erectile Dysfunction clinic if restoration of the erections is important to you.

 22 When can I drive?

This varies between patients. You will only be fit to drive if you can do an emergency stop without it causing pain. Please wait a minimum of one week.

 23 When can I return to work?

Again this is variable. You can return to work when you feel able. Some patients are back to work after 1 week, others take 3-4 weeks. It is important only to do light duties initially and no heavy lifting for 4 weeks. We have found that patients after robotic surgery return to work quicker, on average at 3 weeks compared to 11 weeks after open surgery.

 24 When can I fly?

Short haul 2 weeks. Long haul 4 weeks.

These are just minimum recommendations and again if you have any concerns please delay your travel. You must also check with your carrier and travel insurance company.

 25 What do we do to improve our service?

We are constantly trying to improve the high quality care we provide. We continually audit and assess our results. We will ask you to fill out questionnaires on your continence, erectile dysfunction and overall quality of life. We would like you to fill these out before the operation and at all your follow up appointments. We also want to you to record the first day you manage without pads and when you return to work. Please let us know these dates at follow up or by email. All this information is handled anonymously, and is collected on all patients. Please feel free to add any other comments whether good or bad. All these comments will be taken seriously and will be used to improve the system further.

If you have any compliments or comments you would like to share with us please send in writing to: Clinical Quality & Patient Safety Manager at Kent and Canterbury Hospital

 26 Where can I get further information about the operation?