Drains, exiting the abdomen (or perineum, in the radical perineal approach), will be left in place for about three to five days, and the Foley catheter, inserted in the penis and anchored by a tiny balloon in the bladder during surgery, will remain in place for two or three weeks. The main reason for the catheter is that it allows the anastomosis, the reconstructed urinary tract, a chance to heal. The drains are there to evacuate any urine that might leak from the anastomosis as it’s healing; they stay in place until nothing more flows through them. It is critical that the Foley catheter stay in place. If it is inadvertently pulled out or removed too soon after surgery, this can be disastrous, and may lead to permanent incontinence. Your catheter should be securely taped to your thigh, and you should examine its mooring often. The catheter may take some getting used to, but remember—it’s only temporary, and its presence is helping the body heal. While you’re at home, keep the catheter connected to a large drainage bag most of the time, and use the leg bag only if you plan to go out of the house. The reason many doctors suggest this is that the leg bag doesn’t hold as much urine, and if the bag becomes full and the patient doesn’t realize what’s happening, the urine can “back up” into him because it has no place else to go.

You’ll be dealing with the catheter mostly at home; the economic trend these days is for patients to leave the hospital as soon as possible after any procedure, and prostate surgery is no exception. Fortunately, radical prostatectomy patients are actually able to go home and generally be more active sooner than ever before, and this is due largely to a new pain medication called ketorolac. As it turns out, one factor that kept men in the hospital was their inability to eat or to keep down oral painkillers after surgery. We always blamed this on the operation, but now we know what really happened—it was the pain medications they received after surgery that made them nauseated. Ketorolac belongs to a group of drugs called nonsteroidal anti-inflammatory agents (NSAIDs; these drugs include the over-the-counter painkillers Motrin or Nuprin). Patients on ketorolac usually are able to eat on the day after surgery— and for many men, this often is the first hurdle back toward normal life, even if it is bland hospital food!


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