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Living with Prostate Cancer SURGERY REMOVING DISEASED TISSUE If cancer seems to be confined inside your prostate, you and your doctors may have decided that you'll have a radical, or total, prostatectomy. This is surgery to remove the prostate and all the cancer. Your healthcare team will help you prepare for surgery. Be sure to ask any questions you have about the procedure. Before Surgery You may have routine lab tests. Also, you'll meet with an anesthesiologist. He or she will discuss the anesthesia (medications to block pain) that you'll receive to keep you comfortable or asleep during surgery. You'll be told not to eat or drink anything after midnight the night before your surgery. Also, you may be told to use an enema or laxative. During Surgery The surgery usually takes 2 to 5 hours. Your urologist may make an incision in your abdomen (retropubic approach) or between your legs (perineal approach). Some of your lymph nodes may be checked to find out if cancer has spread into the nodes around your prostate. If cancer hasn't spread, your prostate, the portion of the urethra it surrounds, and your seminal vesicles will be removed. If cancer has spread beyond the prostate, your doctor may decide not to remove the prostate. Controlling Urine Flow Before surgery, part of your urethra passes through the prostate. During surgery, this part of the urethra is removed. Then your bladder is reattached to the rest of the urethra. A catheter is inserted to drain urine while you heal. A balloon inflated inside your bladder holds the catheter in place. Your urologist will tell you when the catheter can be removed. Risks and Complications Your urologist will discuss any risks and complications of surgery with you, including: Infection Pneumonia Excessive bleeding Erectile dysfunction Incontinence Difficulty urinating Bowel perforation Blood clots After Surgery In the Hospital You'll wake up in the recovery room and later be taken to your hospital room. Urine will drain from your bladder through the catheter into a sterile bag. You may feel a strong urge to urinate. Also, your urine may be bloody or cloudy for a while. You may be asked to drink plenty of liquids to help flush out your bladder. If any stitches need to be removed, this may happen when you're in the hospital or in 1 to 2 weeks when you next visit your urologist. Based on the surgical approach used and how fast you heal, you may return home in 2 to 6 days. At Home It may take you from a few weeks to several months to control your bladder. Pain can be controlled with medications. Ask your urologist what activities you can and cannot do. Eat a balanced diet to help prevent constipation.       Call Your Doctor If: You have fever or chills. The incision is draining or increasingly painful or red. Urine isn't draining from the catheter, or you can't urinate after the catheter has been removed.

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