HealingWell
Search Close Search
☰

Catheter removal after robotic surgery

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 5/21/2010 11:54 PM (GMT 0)
My surgery is still coming up but I did have a question.

My Uro/surgeon said during my consult that the catheter comes out in a week under normal circumstances.

How is it determined or tested that I have healed enough to have it removed or is it just assumed to be ready to come out unless I am having an obvious complication.

Also he said that my one week appointment to have it removed is with his nurse and he sees me two weeks after the surgery. Is this method similar to what others have experienced. I am sure that my Uro/surgeon would see me at the one week appt. if I am having complications but not if things are going smoothly.

Dan
Posted 5/22/2010 1:04 AM (GMT 0)
Dan,
Not sure what the procedure is called but they put me under a arc like machine and I think it was to make sure the bladder was full. Some of the old timers can answer your question better than I can. Hopefully it will be in no more than 10 days which appears to be the common time. keep us posted.
Michael
Posted 5/22/2010 1:11 AM (GMT 0)
Hi - the uro ordered a cystogram for me to have one week after surgery. In this procedure a fluorescent dye is squirted into the bladder (up the catheter) and they look for leaks where the urethra has been reconnected to the bladder. Unfortunately, I leaked, and the booby prize was to keep the catheter in for a second week. Catheter removal was by the nurse - I didn't see the doc again until 5 weeks after surgery.
Posted 5/22/2010 1:32 AM (GMT 0)
That is the essence of it. They pressure test it and look for leaks.

Also, if the surgeon has some trouble with the bladder neck reconstruction, he may just say two weeks to make sure it heals. My ureters came in the bladder very close to where they cut the bladder off. So I came out with 3 tubes. 2 to make sure the ureters stayed open, and the catheter. Two weeks ir was.

Yes the catheter is uncomfortable, but after having my walnut removed, the doctor tellling me it looked good in there, it was a minor thing.

Good luck !
Posted 5/22/2010 1:35 AM (GMT 0)
Thanks for the responses!

Dan
Posted 5/22/2010 1:41 AM (GMT 0)
Spoke to my uro about this a few weeks back.

The short of it is that getting the catheter out quickly makes you feel better and more advanced, but this isn't a sprint race - and in the marathon, a bit of patience goes a long way.

Or, it's a short term pain, but having the catheter in for a few more days can mean major quality of life improvement for the following years
Posted 5/22/2010 1:47 AM (GMT 0)
My experience was the same as some of the other posts. They shot die up me and took a picture to make sure I was healed. However, even with robotic surgery, my surgeon kept the catheter in 14 days. He believed the bladder needed time to heal and wouldn't take it out earlier. He actually took the catheter out instead of the nurse.
Posted 5/22/2010 1:48 AM (GMT 0)
I had my cath out after a week, and it was done by a nurse, as the doc was away that week, but he did call the next week to check on me.

I would have to guess that the time is based on average recovery. I did not have a pressure test or the like.

Post Edited (142) : 5/21/2010 7:54:15 PM (GMT-6)

Posted 5/22/2010 1:49 AM (GMT 0)
Dan, I meant to ask you where you are having surgery?
Posted 5/22/2010 2:04 AM (GMT 0)
My uro said to have my cath removed at day 10.  I did it myself at 6a.m. and never had a problem. Hero
Posted 5/22/2010 2:09 AM (GMT 0)
Usually what determines the length of time with the catheter is how well the bladder neck to urethra connection is done. Typically would be 7 days on the short side and 14 days on the long. They had a lot of difficulty with my surgery at that juncture, and my original catheter stayed in place for 30 days, and to make a long story short, it was 63 days after surgery before it was ultimately removed. Hopefully, your surgery will go well and your catheter time will be short.

David in SC
Posted 5/22/2010 2:22 AM (GMT 0)
Dan, I meant to ask you where you are having surgery?

Shawnee Mission Medical Center (in a suburb of Kansas City).
The surgeon is Dr. David Emmott.



My uro said to have my cath removed at day 10. I did it myself at 6a.m. and never had a problem.
You are a braver man than I!

Dan
Posted 5/22/2010 2:40 AM (GMT 0)
When my cath was removed, I wasn't even sure it had happened - the nurse did something and it was gone.

The only significant thing for me was that the nurse was hot, and I mentally, but not physically "responded", which confirmed to me that the nerves were really gone -
Posted 5/22/2010 3:19 AM (GMT 0)
Mine was 6 days after surgery done by the pa - quick with no tests of any kind
Posted 5/22/2010 3:42 AM (GMT 0)
A suggestion when you go to have it removed- be prepared with underwear and a large pad or adult undergarment like Depends.  I felt totally normal and went by my office on the way home.  Just after I got home there was a flood that I didn't feel coming and I was lucky that it didn't happen in the middle of my office.
Posted 5/22/2010 8:47 AM (GMT 0)
I think what gtmriviera said is important enough to reiterate!

The hospital, Doctors, nurses, were sort of unconcerned/unaware about the fact that I had to get off the Cystogram table and walk through the halls back to the dressing/recovery area while leaking iodine and urine. They also seemed unaware that I might need some sort of a pad or Depend to get me home- and I was not prepared. So take a waterproof pad for the car seat and some Depends. It took a few hours for me to get the hang of clamping down with my pelvic floor muscles.
Posted 5/22/2010 10:25 AM (GMT 0)
Yeah. My catheter came out after about a week. And I had a cystogram to check for leaks before they'd take it out. (I was given the appointment for it the day I left hospital after surgery.

What did it invovle.

On the lower end of the catheter is a Y junction one branch is the output and is connected to the leg bag. The other branch is for input.
The Cystogram thus involves lying on a thing like an Xray table while a liquid that is visible to Xrays is fed into your bladder via the input arm of the catheter to fill it. (about 150ml was needed in my case and it took about 5 minutes, they used gravity to get it in there by hanging the bottle about four feet above me, so it's not like they suddenly squirt a great load of stuff into you or anything, but there was a strange sensation of things cooling down)

The staff then went off to the lead-lined room and watched on screens as the machine moved round me to look at the bladder from different angles. There was also a screen near me that I could watch it all on too, and every few moments someone called out to ask if I was okay.
The expert thus waited and watched for about a minute to assess the join, and then gave me the all clear and sent me upstairs to see the uro to get it removed.

Had the thing been leaking, then I would have been asked to leave the catheter in situ and repeat the test by coming back after at either ten days after surgery or two weeks after, depending on how much leaking had been found.

I did not see the surgeon, as they work with a team of one surgeon plus two nurse practitioners. And it was thus the nurse practioner who removed the catheter.
I sat on the edge of the examination couch with my feet apart and he told me to take a breath and the thing was out before I had finished taking that breath: there must have been about 15cm in me but it felt like only 1cm moved. The liquid that had been put in me had made things inside me cold and I guess that helped.
It did then feel like I was going to flood the place, but he put a pad in my underpants for me straight away and I had a spare with me already for the journey home.

I then had to sit in the waiting area till I had been able to go to the WC and pee and then I could go home. So I guess I was done about 30 minutes later.

The actual problem that day was that it was the same day that I got my post-op pathology, which was an upgrade from what I had had before. (Gleason 7 instead of 6 and there was tumour in my seminal vesicles)

So make sure you get a cystogram.
Make sure you have suitable clothing and pads with you.
The removal of the catheter itself is a very swift thing.
If you're not sure about anything then ask.
If something hurts then say so.
If you want some help then ask for it (you may find it difficult to get off the machine for instance or to sit up)

If you think you are going to leak on the floor or wherever just say so. I often think I am going to pee during RT and have warned the staff. (There is a microphone and speaker system so we can communicate ) As yet it's been okay. And the nurses dealing with me all through various things over the last year were and are very reassuring about leaking or making a mess not being a problem. (After my biopsy the nurse actually washed everything for me while I lay there, and that was much messier than a bit of pee. She then offered to get me a coffee too!)

Anyway all the best with surgery.

Alfred
Posted 5/22/2010 4:31 PM (GMT 0)
The "underpad", an absorbent material on a water-resistant backing, is a must have in the car and around the house in the post-surgery days. You'll want them in car seats, chairs, etc. just in case. They come in a couple of sizes, about 24" x 30" and 30" x 36", usually packs of 10 or 20. If you have a Walgreen's, watch the sales - these are often a loss-leader.

I had severe bladder spasms with a lot of leakage around the catheter tube, so had to wear the diaper if I had to get out, or ever sit up for a long period of time. In that case you need the Depends "adjustable" - they split on the side and adjust with a velcro like fastener. That way you can put them on over the cath tube with less difficulty. So by default I had an extra with me the day they pulled the cath.
Once the cath is gone, if you need pants, the standard Depends Men's was my preference. Tena is also good, but expensive.

If you are in the States, go to the Depends web site - they offer a sample pack of pant & pad - one per household (I signed up good friends as caregivers and got an extra). Also Tena and Coloplast will send a sample pack. At Tena, you choose the product. Coloplast is more a drip collector which is for minimal leakage, so I suggest the "5420 Extra". They sent a 10 pack, but these are terribly expensive and hard to find.
Get the free samples - if you don't need them, you saved money. If you do, you will be better prepared.

Since I was in free-flow mode for months after the cath, I know all too much about pants & pads.

Post Edited (142) : 5/22/2010 11:53:54 AM (GMT-6)

Posted 5/22/2010 5:47 PM (GMT 0)
I just checked with a friend of mine who had his prostatectomy from the same surgeon I am going to have for my surgery. No crystogram before they removed it.

Dan
Posted 5/22/2010 7:56 PM (GMT 0)
I have already had 15 catheters removed, about to have my 16th removed on Monday. If it is a foley catheter, coming out your penis, the way my dr does it is best way. He has me stand up in front of him. The real trick is to have the dr or nurse to slowly extract the fluid from the balloon holding it in side you. Some help wants to just let it out with one quick action, that can create both pain and back pressure up the cath. Release the fluid slowly, and while standing, in most cases, the cath will just start sliding out on its own to the floor. The dr. does put a pad on the floor so that its not a slippery mess.
Posted 5/22/2010 11:31 PM (GMT 0)
Dan,

You still reading all this? It's informative to hear all the different experiences. Here's mine: First removal was after 7 days. No cystogram, they just figured it was enough time to heal. The nurse was a funny old lady. I had to pee in front of her to prove I was ready to go. But, clogged up and had to have another one put in. Second time, they did a cystogram first. And peed in front of a different nurse. Turned out better the second time.

DJ
Posted 5/25/2010 1:44 AM (GMT 0)

My doctor removed it for me but it is something hat a nurse can certainly do.  Word of advice, make sure you take pads with you and put it in immediately.  I started leaking profusely as soon as I stood up to dress.

I had urine leaking through the urethra as well as through the catherer tube during the 7 days.  I didn't notice until removal which means that for 7 days there was urine seeping under the tape holding the catherer in place.  When the tape was removed I was left with a very nasty fungal infection on my leg where the tape had been.  Make sure you keep the area clean even though the catherer is in place.  I was so afraid to mess with it that I wouldn't even look down.  Big mistake. I was miserable for 7 days after removal.

Good luck.

Posted 5/25/2010 2:05 AM (GMT 0)
Thanks guys for the info.

One week to go before the surgery. Wife is on edge but I am ready for it and ready to get on with my life without a prostate. I am hoping for the best but know things don't always turn out as planned and am prepared to deal with it if the post surgery isn't what we are hoping for.

The info in this group has been great and talking to my two friends (here in KC) who had the same surgery by the same surgeon have had a calming effect on me too.

Dan
✚ New Topic ✚ Reply