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Instructions Following Removal of the Catheter After Prostatectomy

Call Your Doctor Immediately If:

  • If you develop severe pain in your lower abdomen when you are urinating or are unable to urinate. The catheter may need to be put back in.
    • 9:00 am to 5:00 om during the week: (646) 422-______________
    • After hours or on weekends, call (212) 639-2000. Ask for the fellow covering your doctor.

If you are unable to return to Memorial Sloan Kettering Cancer Center (MSKCC), you may have your local doctor or emergency room re-insert it. In this case, please inform the staff of your recent surgery. Also, notify your surgeon on the next business day.

Activity & Exercise

  • You may now decrease your daily liquid intake to what you normally drink. You should be drinking four to six 8-ounce of liquids every day.
    • Limit your fluids after 7:00 pm and empty your bladder before you go to bed. This might prevent your having to get up at night.
    • Please limit your alcohol and caffeinated beverage intake if you are experiencing a lot of urine leakage.
  • Start your Kegel exercises ______________________. Do not push to urinate after the catheter is removed. Do not strain to move your bowels.
  • You may resume sexual activity _____________________________.
  • You may start taking medicine to achieve an erection the night the catheter has been removed. The goal of penile rehabilitation is to improve recovery of your erectile function after surgery. It may also help preserve the erectile tissue.

Nightly Dose:

  • Take sildenafil (Viagra®) 25 mg or vardenafil (Levitra®) 10 mg every night. Or you can take tadalafil (Cialis®) 20 mg every other day.
    • You can break a sildenafil (Viagra®) 100 mg pill into four pieces or a vardenafil (Levitra®) 20 mg pill into 2pieces. Use a pill cutter. You can get it at your local drug store.

Challenge:

  • Over the next 4 to 6 weeks after the catheter has been removed you should try to take a full dose of sildenafil (Viagra®) (100 mg) or vardenafil (Levitra®) (20 mg) once a week on an empty stomach.
    • Try this on 3 separate occasions before you return to see your doctor.
    • Do not take the regular nightly dose of sildenafil (Viagra®) 25 mg dose or vardenafil (Levitra®) 10 mg on the night you attempt the challenge.
  • If you are taking tadalafil (Cialis®), you do not need to change your dose of 20 mg. This is the maximum dose, so you do not need a challenge.
  • Try to become sexually aroused through contact with a partner or self-stimulation.
  • Record your response.
  • Let your doctor know at your post-operative visit how you responded.
  • If you are not responding to this regimen, your doctor may ask you to see the sexual health team here at MSKCC.

Post-Surgery Information

  • If you have one or two episodes of blood in the urine two to three weeks after surgery, it is usually due to the scab on the internal incision coming off.
    • Try increasing your liquid intake. When you no longer see blood, decrease your liquids to what you normally drink.
    • Call your doctor if you see blood or blood clots in your urine for longer than one day.
  • Finish taking your antibiotics as prescribed.
  • Call the office on the tenth day after surgery for your pathology results.
  • Have your PSA drawn 6 weeks after surgery. This can be done at MSKCC or by someone closer to where you live. If you do not have it done here, please have the results faxed to our office at 212-988-_________.