Prostate Surgery

miss81, BSN, RN · Sep 10, 2009

I have taken care of A LOT of ppl that have had the surgery and my dad also had the surgery last month! I know how you feel, he's only 57. Prostate Ca is generally a younger mans disease.

Make sure your dad know his options for pain control (PCA, Epidural, narcotics or Toradol etc.) My dad and I discussed this and he decided on the PCA because he likes to be able to have control and the PCA was a good choice as he is "smart" (ok, for lack of a better word) enough to understand how to use a PCA and because he could still have pain meds for breakthrough if needed.

Make sure you dad is given instructions on kegel exercises. Even though the doctor will attempt to to spare the nerve, apart from ensuring longevity of the ejaculated sperm, the prostate gland also closes the urethra during sexual intercourse. This prevents urination when the male ejaculates. For that reason you father must build the pelvic muscles.Kegel workouts can provide men with stronger erections. Research published in 2005 issue of BJU International, have shown that pelvic floor exercises could help restore erectile function in men with erectile disfunction. Be sure that he is aware and he may lose his ability to ever have an erection again, despite the attempt to spare the nerve. It is also possible that strengthening the pelvic floor may allow some men to achieve a form of orgasm without ejaculation. In men, this exercise lifts up the testicles, also strengthening the cremaster muscle, as well as the anal sphincter, as the orifice is the main area contracted when a Kegel is done. This is because the pubococcygeus muscle begins around the orifice and runs up to the urinary sphincter. My dad had these exercises down pat before the catheter was out and had bladder control (most of the time) a week after the foley was removed. He'll need to know how to change from a leg bag for daytime and lg. foley bag for night time and ensuring good hygiene practices while doing this.

Make sure he knows that he may see blood in the catheter bag and that he needs to get up ASAP after surgery to ensure he doesn't end up with Pneumonia. Teach him about deep breathing and cough, while splinting his incision (if he has one).

Tell him to ask his doctor about when he can drive after the surgery. Most pt's here a allowed after the stitches are removed. Kind of a rule of thumb!

Hummm...can't really think of anything else right now... but feel free to ask questions.

southernbeegirl, BSN, RN · Sep 10, 2009

oh wow, thank you so much for all the information!!

i allready have a stash of leg bags/drainage bags and cath supplies stored up.

he's a good patient. his hand got whacked off at work a couple years ago and he did everything the surgeon and i told him to do so i'm very optimistic about his recovery.

i talked to him about the possibilities of not being able to have an erection/orgasm.

cancer is about the only prevalent disease in our family. in one year we nursed both his dad and my mom's dad with cancer until they both died. it was extremely traumatic for the whole family. so when they told dad his options he wanted it "out of him". (trying not to cry here...) he told me "i dont care what it takes, beegirl, just make them get it out of me".

i hadnt thought to ask him about what he's decided on for pain control. even when his hand got whacked off i couldnt hardly get him to take a percocet to save my life! i'll have a talk with him about it on monday. thank you so much!

about the blood in his cath. (i was laying in bed thinking about this last night). should i irrigate his cath if he has quite a bit of blood or just leave it alone?

i'm an geriatric ortho nurse so if you break your hip, i'm your girl but in this situation, i'm on new ground. i know there are things i wont think of so i cant thank you enough!

so for the first week your dad was incontinent often? what did he use...a brief, a pad?

i know my dad and he thinks when the foley is out he is going back to work. he's lucky about work tho. he works with almost all men. he is the second man to have prostate cancer. when he was diagnosed, every one of the guys went in for their PSA test.

about the catheter bag changes (this is probably a dumb question but at work whenever we change a bag we use a new sterile one). so how can i teach him to clean the leg bag out at night? this is new for me too so i'm not sure how to clean them. and do you keep the ends sterile until used again?

again, thank you so much for all the info!

southernbeegirl, BSN, RN · Sep 10, 2009

Has this ever happened to anyone else?....

if it is about a patient, i have all the answers. but now that it's MY dad...i feel like i dont know what to do.

:crying2:

miss81, BSN, RN · Sep 10, 2009

By the time your dad is d/c'd from the hospital the drainage in his foley bag will probably only be blood tinged. He may need gentle irrigation (which needs a doc's order for this type of surgery) while in the hospital, but he should be good at home.

As for the changing of the leg bags. While at home we don't really say that the end of the tube on bag needs to be sterile. At home we say clean technique. My dad would drain the bag and did rinse it with sterile water a few times, but he would clean the tip with alcohol swabs and put the cap back on the tip. He had a few bags that he used (he had the catheter in for 10 or 14 days, can't remember exactly). Ensure to remind him to wash his hands well before handling the catheter.

My father used a male incontinence pad that he purchased at the local drug store. I also made sure to have colace ordered and also on hand at home as the narcotics and the nature of the surgery WILL cause some constipation. Also, may patients mention the itching of the scar. I explain to them that this is a sign of healing (if no s/s of infection) and I suggest Benedryl cream. My dad used it faithfully. He had a lot of itching after the first week or two after the dressing came off.

You guys will get through this! Sounds like he has a great support system! My father used to grumble, " I have a daughter that's a nurse, a son-in-law that is a nurse and a wife that THINKS she's a nurse..." haha

BTW, I know nothing about ortho so I may have question for YOU some day!

Take Care and I'll be thinking about you and your dad!

southernbeegirl, BSN, RN · Sep 10, 2009

i just talked to my parents. daddy has some pus and blood coming from his meatus. he is going to the surgeon tomorrow. if they have to postpone the surgery, i think he just might have a nervous breakdown .

southernbeegirl, BSN, RN · Sep 10, 2009

By the time your dad is d/c'd from the hospital the drainage in his foley bag will probably only be blood tinged. He may need gentle irrigation (which needs a doc's order for this type of surgery) while in the hospital, but he should be good at home.
As for the changing of the leg bags. While at home we don't really say that the end of the tube on bag needs to be sterile. At home we say clean technique. My dad would drain the bag and did rinse it with sterile water a few times, but he would clean the tip with alcohol swabs and put the cap back on the tip. He had a few bags that he used (he had the catheter in for 10 or 14 days, can't remember exactly). Ensure to remind him to wash his hands well before handling the catheter.
My father used a male incontinence pad that he purchased at the local drug store. I also made sure to have colace ordered and also on hand at home as the narcotics and the nature of the surgery WILL cause some constipation. Also, may patients mention the itching of the scar. I explain to them that this is a sign of healing (if no s/s of infection) and I suggest Benedryl cream. My dad used it faithfully. He had a lot of itching after the first week or two after the dressing came off.
You guys will get through this! Sounds like he has a great support system! My father used to grumble, " I have a daughter that's a nurse, a son-in-law that is a nurse and a wife that THINKS she's a nurse..." haha
BTW, I know nothing about ortho so I may have question for YOU some day!
Take Care and I'll be thinking about you and your dad!

thank you so much!!!

WalkieTalkie, RN · Sep 10, 2009

My dad had this surgery a couple of years ago. He also had a cath for a couple of weeks. He did have some problems with incontinence after the cath came out, so he wore pads for awhile. He no longer has incontinence... not sure about the other aspect, but I've not heard any complaints!