This information explains what to do after your catheter is removed after prostate surgery.
What to do after your prostate surgery
Manage urinary problems
For 2 days after your catheter is removed, your bladder and urethra will be weak. Do not push or put effort into urinating. Let your urine pass on its own. Do not strain to have a bowel movement (poop).
Limit the amount you drink each day to 4 to 6 (8-ounce) glasses of liquid. This will help lessen urine leakage. If you’re leaking urine, limit how much alcohol and caffeine you drink.
Avoid drinking too much after Empty your bladder by urinating before you go to bed. This can help you avoid having to wake up to urinate during the night.
You might see blood or blood clots in your urine for several weeks after the catheter is removed. This happens because the incisions (surgical cuts) inside your body are healing, and the scabs are coming off. If you see blood in your urine, drink more liquids until you no longer see blood. If you still see blood in your urine 24 hours later, call your surgeon’s office.
Do Kegel exercises
Start doing Kegel (pelvic floor muscle) exercises 3 days after your catheter is removed. Talk with your healthcare provider about what exercises are safe for you. Read Pelvic Floor Muscle (Kegel) Exercises for Males (www.mskcc.org/pe/kegels_males) for more information.
Take your medications
Finish taking your antibiotics as prescribed.
Get your results
Your results will be ready about 10 days after your surgery. Call your doctor’s office to get your results.
Schedule prostate-specific antigen (PSA) blood tests
Have a PSA blood test done at the following times:
- 6 to 8 weeks after surgery
Appointment date: ____________________
- 3 to 6 months after surgery
Appointment date: ____________________
- 12 months after surgery
Appointment date: ____________________
Starting 12 months after your surgery, have a PSA blood test done every 6 months. Do this for 5 years following your surgery.
Starting 5 years after your surgery, have a PSA blood test done every 12 months. Do this for the rest of your life.
Your doctor might ask you to have PSA blood tests done more often. If they do, your nurse will give you more information.
Follow your medication plan for sexual activity
Talk with your healthcare provider about when it is safe to start sexual activity again after your procedure.
The night the catheter is removed, you can start taking medication to get an erection. You might need to take one of these medications every day for up to 1 year after your surgery. Talk with your surgeon about how long you’ll need to take these medications.
Your doctor or nurse will give you information about your medication plan. Keep following this plan until your see your surgeon during your post-operative (post-op) visit.
| Medication | Normal dose | Challenge dose |
|---|---|---|
| Sildenafil citrate (Viagra®) |
Take 25 mg 6 nights per week. To make the 25 mg dose, split a 100 mg pill into 4 pieces. Use a pill cutter from your local drug store. |
Take 100 mg 1 night per week. |
| Sildenafil citrate (generic) |
Take 1 (20 mg) pill 6 nights per week. |
Take 5 (20 mg) pills 1 night per week. This is a total of 100 mg. |
| Tadalafil (Cialis®) 20 mg pills |
Take 1 (20 mg) pill every other day. |
Do not take a challenge dose. A 20 mg dose of tadalafil (Cialis) is the highest dose you should take. |
| Tadalafil (Cialis) 5 mg pills |
Take 1 (5mg) pill 6 nights per week. |
Take 4 (5 mg) pills 1 night per week. This is a total of 20 mg. |
About the challenge dose
A challenge dose is the highest dose of medication. This is most likely the dose you will need to get an erection (get and stay hard for sex). When you take the challenge dose, take the medication on an empty stomach (without food). Take it about 2 hours before your evening meal.
The medication takes 30 to 60 minutes to start working. It will stay in your system for up to 8 hours. At any time during these 8 hours, try to become sexually aroused through contact with a partner or yourself. Write down what happened and tell your doctor during your next visit.
If you cannot get an erection after trying the challenge dose for 4 weeks, call your doctor’s office. Your doctor can refer you to our Sexual Medicine team.
When to call your surgeon’s office
Call your surgeon’s office right away if:
- You have severe (very bad) pain in your lower abdomen (belly) when you urinate (pee).
- You cannot urinate.
These things can mean that your catheter needs to be put back in. If you cannot come to MSK, go to your local urologist or emergency room to have the catheter put in. Tell them that you recently had prostate surgery. Tell your MSK doctor that you went to a local provider or emergency room on the next business day.
Call your surgeon’s office if you:
- Have burning at the tip of your penis that doesn’t go away after 3 days or gets worse.
- Have not been able to get an erection after trying the challenge dose for 4 weeks.
- See blood in your urine that does not go away 24 hours after drinking more liquids.
If you have any questions or concerns, talk with a member of your healthcare team. You can reach them Monday through Friday from to After , during the weekend, and on holidays, call 212-639-2000. Ask for the urology fellow on call.