Pop! Goes the Prostate...

The process to remove an organ deeply embedded with many vital structures is intricate. In the old days, a broad incision is made and the prostate gland and surrounding tissues can be visualized and touched directly. I say old days, because a complication using robotic laparoscopic surgery could result in the backup of conducting an open procedure. What are the advantages? Obviously, it’s less invasive. Instead of a 5-inch incision, there are smaller incisions, I had six of them, with the longer near the belly button from which the prostate is pulled (that’s the pic on this post.) Recovery is about 1 1/2 -2 weeks faster (meaning returning to work) over 6 weeks in an open procedure. So what’s it been like? Really very minimal pain, though I have a high threshold. The pain I felt was on the ride home, 1 hour from San Francisco to San Jose, and I think bumps in the road caused my bladder to spasm. That I would call pain, but only lasting seconds, and twice at that. I am 3 days out, following recommendations for walking, 1/4 - 1/2 mile 3-4 times a day, and the discomfort I am feeling is the soreness at the incisions. An abdominal binder has been helpful, it’s used after a number of types of procedures in that area and has been shown to reduce pain, as the name implies, it prevents movement and controls swelling. I’m a massage therapist too, and I find it’s like a reassuring hug around the waist. One thing post-op that would be worth a study, is how gentle manual massage around a wound site decreases pain and supports healing, I found gentle pressure circles soothing against the soreness. I have only taken ibuprofen for “pain.” It has been ages, but when I did orthopedic foot surgery in the ’80s, and even with cutting and realigning bones and joints with pins and wires, I only ever prescribed ibuprofen at 800mg 3 times a day and mostly for its anti-inflammatory effects more than analgesia. My patients never complained of pain. The last part of the convalescing, as tissues start to deal with the cutting and cauterization, is dealing with the important healing of the connection urethra to the bladder as it runs through the prostate. It had to be cut and reattached around the Foley catheter that allows drainage. It’s been draining without problem and immediately post-op had blood which made it wine-colored, but by discharge, a day later was almost clear. I have to say it’s a bit strange to have your bladder “extended” this way, and it is amazing how much urine is produced when you see it like that. So the challenge with these tubes going into the body and fluids coming out is prevention of infection that can travel up towards the bladder. My schedule for catheter removal is 10 days.