Prostate cancer surgery, specifically radical prostatectomy, is a common treatment option that can result in challenges like urinary incontinence and erectile dysfunction. However, with proper care and rehabilitation strategies, these issues can be effectively managed to improve recovery and quality of life. This article explores essential postoperative care techniques and supports mechanisms aimed at optimising outcomes for patients undergoing this procedure.
Postoperative Care
Under general anesthesia, a urologist makes several small incisions (half an inch or less) in your lower abdomen and inserts a thin rod with a camera at the end of it (laparoscope) into one incision to see inside your body. They then remove the prostate gland and some surrounding tissue and connect the bladder to the urethra. They may also remove nearby lymph nodes if they think cancer has spread, and send them to the lab to check for cancer cells.
Your doctor often performs this surgery laparoscopically, which reduces your recovery time and discomfort. You will have a tube in your bladder to drain urine until you are ready to leave the hospital. Until you are able to have this tube removed, you will be given IV pain medications.
The main side effects of prostatectomy are incontinence and erectile dysfunction. These usually improve as healing occurs and patients resume normal physical activity, but the amount of improvement depends on how much of the nerve bundles that control erections were preserved during surgery. Erectile function can return over the course of two or three years.
Physical Therapy
After your prostate cancer surgery, a physical therapist can show you how to do pelvic floor exercises to help prevent incontinence. These are exercises similar to Kegels, which help you control your urine stream and strengthen the muscles that surround your bladder. You may also want to consider a prosthetic sphincter, which is a small device that holds your urethra closed except when you’re urinating.
Your doctor can remove only the prostate gland or the whole pelvic area to treat your cancer, depending on its grade. Its grade is based on how abnormal the tumor cells look under a microscope. The higher the grade, the more likely it is to spread.
During the surgery, you’re under general anesthesia. The surgeon makes one or more small incisions (half an inch or less) in your abdomen, inserts a thin rod with a camera at the end of it (laparoscope), and then uses other tools to remove the prostate. If necessary, they’ll also remove the lymph nodes that drain the prostate (pelvic lymph node dissection). This helps determine whether the prostate cancer has spread to these nodes.
Occupational Therapy
Millions of men are diagnosed with prostate cancer each year. The good news is that survival rates are improving and treatment options have advanced significantly in recent years. However, a diagnosis of prostate cancer can still have a devastating impact on quality of life. Many patients are left with incontinence and/or erectile dysfunction that can interfere with daily living.
Radical prostatectomy, or surgery to remove the prostate, is a common treatment option for patients with prostate cancer. During this procedure, a surgeon inserts a thin tube into the urethra through the penis and removes the tissue with an electric knife or laser. A catheter (thin, flexible tube) is placed to help urine drain until the prostate heals.
During this type of surgery, the surgeon may injure part of your intestine. This could cause diarrhea. If it becomes severe, you should contact your doctor.
Another possible side effect of a prostatectomy is lymphedema, a condition where fluid accumulates in the legs or genital area after removing the lymph nodes. This can be treated with physical therapy, but it may not go away completely.
Speech Therapy
Depending on the type of cancer and how aggressive it is, men are faced with a range of treatment options. Some choose deferred treatment (the watchful waiting and active surveillance programs). Others opt to have radiation therapy (external beam or brachytherapy with implanted seeds) while others may go through radical prostatectomy – removing the prostate gland, seminal vesicles, and any surrounding lymph nodes that appear potentially cancerous.
While many men will experience the side effects of this surgery, such as incontinence and erectile dysfunction, these usually last only a short time. However, some of these symptoms can bear a heavy burden on the mind and the patient’s emotions. That’s where a speech-language pathologist can help.
A speech-language pathologist is trained to help patients with a variety of conditions that affect communication and swallowing. These include speech impairments (such as childhood apraxia of speech, dysarthria, stuttering, and tongue-tie) and swallowing disorders (dysphagia). They also treat stroke patients to help them restore their ability to speak and swallow safely. Often, these services are covered in full or in part by Medicare for people over 65, by Medicaid for low-income people, or by private health insurance.
Counseling
Whether you have had radical prostatectomy or another type of treatment for prostate cancer, the symptoms can have an impact on your quality of life. Talking to someone who understands the emotional and physical effects of these side effects can help you cope better. You may experience a range of feelings and emotions, including shock, deep sadness, anxiety, and anger. Some days will be worse than others.
After surgery, you might need pain-relieving drugs. You will be given these through a tube placed into one of your veins, called a drip (intravenous infusion). Your nurses and physiotherapists encourage you to get out of bed as soon as you can to walk around the hospital. Walking helps to heal, improves blood flow, and reduces the risk of blood clots, pneumonia, and other complications.
After a prostatectomy, you will have a urinary catheter in place for a few days or longer, depending on the type of surgery you have had and how quickly your bladder heals. Your nurse will teach you how to use the urinary catheter and how to care for the incision site.
Navigating Recovery Successfully
Effective postoperative care and rehabilitation following radical prostatectomy are pivotal in managing common side effects such as urinary incontinence and erectile dysfunction. By emphasising physical therapy, occupational interventions, and emotional support, patients can enhance their recovery trajectory and regain their quality of life. Continued advancements in surgical techniques and comprehensive patient education are key to ensuring optimal outcomes and empowering individuals through their prostate cancer journey. For more detailed information on prostate cancer treatments and recovery, visit www.pereraurology.com.
