Funding research and education to beat prostate disease
Post treatment
Your doctor and medical team will discuss any potential issues that you may encounter after treatment, so most of this information will not be new to you. It is important to raise any concerns or questions you have regarding catheterisation, regaining continence or your physical appearance with your doctor.
Living with a catheter
If you have a catheter inserted during your treatment, you may be required to look after it yourself. The hospital staff will show you how to do this.
Catheter cleaning
The catheter must be kept clean. Make sure you always wash your hands before touching any part of the catheter. Twice a day wash the area of the skin where the catheter enters your body with soap and water. Dry it thoroughly but do not apply talc. The catheter is held in place by a Velcro strap, which fits around the catheter and your leg. This prevents it being pulled.
The leg bag is securely attached to your leg and looks rather like a sock. The leg bag will fill with urine throughout the day; you will feel it getting heavier as it fills. Don’t let it get too full – open the tap over the toilet and drain the urine from the bag at regular intervals. Always wash your hands before and after doing this.
The night bag should be attached to the bottom of the leg bag and attached to a stand. You will be shown how to do this by a member of the hospital staff. In the morning, do not forget to close the tap before removing the night bag. After disposing of the urine, rinse the night bag with warm water so that it is ready to be used again the next night.
Unless there is a problem, only change your leg bag once a week. Rinse it out and put it in a sealed plastic bag with your household waste.
In some circumstances your doctor or district nurse may recommend that you use a tap on the end of your catheter rather than attaching a bag. This will allow you to empty your bladder (through the catheter) on a regular basis straight into the toilet. If you are finding the leg bag difficult or inconvenient it is worth asking if this is an option for you.
Leakage
Leakage can occur if the bladder muscles go into spasm. If you leak a little urine outside the catheter, check that the connection between the catheter and the leg bag is still good. Let your doctor or nurse know what has happened. If the bladder spasms are very troublesome, contact your doctor or nurse, who can usually help by adjusting the catheter. Alternatively, your doctor may prescribe a drug to reduce your bladder contractions, such as tolterodine or solifenacin.
If urine is not collecting in the bag, check that
- The bag is below the level of your bladder.
- There are no twists or kinks in the catheter.
- You have drunk sufficient fluids.
If 1-2 hours pass without any urine draining into the bag, contact your doctor or nurse. The catheter may have become blocked and will require attention.
Blood in the urine
Blood is commonly seen in the urine after radical prostatectomy. As you become more mobile, the catheter can irritate the bladder and lead to blood in the urine. You may also see blood in the urine when you open your bowels. This is normal. However, large clots or pieces of tissue passing down the catheter can block it, so contact your doctor or nurse for advice.
Infections
You should contact your doctor if you have any of the following symptoms as they may be due to infection:
- Cloudy urine.
- A burning sensation (cystitis).
- Strong-smelling urine.
- A high temperature.
- Shaking attacks.
Self-catheterisation
Occasionally, narrowing of the bladder neck occurs after radical prostatectomy. This can cause a reduction in the urinary flow and occasionally even complete retention of urine. This problem is treated by gently dilating the bladder neck under light sedation. Sometimes, this is followed by a period of self-catheterisation for a few weeks. This involves passing a small slippery tube through the narrowed area on a daily or less frequent basis.
Regaining continence
Depending on your treatment, you may experience a period of urinary incontinence. You will be supplied with incontinence pads to wear by your medical team and given advice on how to use them. Additional incontinence pads can be purchased from your local chemist.
Working on your pelvic floor muscles can help you to regain continence. To perform pelvic floor exercises, you need to be aware of your pelvic floor muscles. This can be accomplished in two stages.
- When passing urine, contract your muscles up and inwards to stop the flow. Then let go. You may not stop the flow completely; the important part of this stage is to recognise the muscles you are using to control urine flow.
- Tighten the muscles around your rectum as if you are trying to control an attack of diarrhoea.
Pelvic floor exercises
You should use all of these muscles at the same time when performing pelvic floor exercises.
- Contract your pelvic floor muscles and hold for a count of five.
Repeat five times and try and do this exercise once an hour each day. - Contract your pelvis floor muscles strongly and sharply, but don’t hold.
Repeat 20 times a day.
You will need to perform these pelvic floor muscles regularly for several weeks before you notice any improvement. To help you remember to do your exercises, try to schedule them with other daily tasks you perform regularly, e.g. sitting down with the daily crossword.
Physical appearance
After a radical prostatectomy, some men feel their penis appears shorter in length. Any shortening, and if there is a noticeable difference it is usually very slight, occurs because the newly sutured urethra has been shortened. This pulls the penis back into the body.
After a few months, the urethra will stretch to accommodate most of the change. There is little or no shortening visible on erection.
Support groups
The Bladder and Bowel Foundation offers information, advice and expertise about bladder and bowel problems no matter how small.
www.bladderandbowelfoundation.org
