New member - husband recovering very slowly from RALP

I have found this a very helpful forum over the last few weeks since my husbands PCa Dx in Oct 2011.  Although grateful we do not have to pay for medical treatment in this country we really had to chase for a diagnosis and proper treatment.  Husband only just had RALP (on 11th Jan 2012) which in hindsight should probably have been done about 5 years ago had anyone actually diagnosed PCa back then.

Anyway, top surgeon (done over 1000 robotic prostatectomy ops) - right nerves spared.  Op did not go to plan as prostate had adhered to rectum - so rectal tear repaired with double layer closure.  Hospitalised for 2 weeks due to this, also fluid collection in pelvis due to urine leak.  In a lot of pain.  Catheter still in - cystogram last week showed healing is taking place.  Due for another cystogram in 2 days.  Still discomfort in abdomen and with catheter - now on antibiotics for urinary infection.   My big concerns are that my husband has had serious night sweats (not had before) since coming home (having to sleep on towels, and change of clothes in night), but has no temperature.  Sweating mostly around neck and chest.  Also weight loss after surgery was 9 lbs, and since coming home (2 weeks ago) has not put on weight but is eating well - has lost another 3 or 4 lbs. We follow a no dairy and no meat diet so a high calorie diet is a challenge.  My husband is very light build anyway (weight prior to surgery was 149lbs).  Local GP completely unhelpful and not possible to speak to surgeon or urologist until PSA test appt which is on 23rd Feb.  Anyone else experience a difficult RALP with rectal tear, and with night sweats, weight loss etc.  Concerned that maybe some spread to lymph nodes (none removed due to additional infection risk as well as rectal tear) - no enlarged nodes on contrast MRI.  Any advice on what we should do next, or just wait for post op PSA ? Also not sure how good the urologists are here at addressing any ED issues - when should I start asking them about this ?

I know I have posted a lot of information and a lot of questions but would appreciate any helpful advice ! Thanks.

You might ask the doctor about his pain meds. After a gallbladder operation I got a bad case of the sweats too with my wife adding towels and changing sheets a couple of times a day. Turned out it was the vicodin that I was intolerant to and the sweats were a symptom of that. As I got of the meds it went away.

Just one possibility. Others might have a better idea.

Thankyou all for your helpful and reassuring advice. At now 4 weeks with the catheter in my husband is longing for the day it will be removed. He finds it difficult to do anything much with the catheter in as it causes so much discomfort - he did try going for walks but this was a disaster as caused too much leakage from the catheter and pain around the bladder area. He has an appointment on Thursday to see if the catheter can be taken out. Not sure how he will manage if he has to have another few weeks with the catheter in !
Glad to hear that some of you have also had night sweats post op - maybe a reaction to prolonged anaesthetic ? My husband has not been on any pain meds for the last 2 weeks so can't blame it on that.

Just an update - husband went to hospital yesterday to have a cystogram.  Unfortunately still evidence of urine leak from urethra/bladder (less than last time, so it is healing slowly), so catheter in for another 2 weeks when another cystogram has been arranged to see if healed.  The Dr said that in 99% of cases it does heal - what happens to the other 1% ?  He has had the catheter in for 30 days now and not looking forward to at least another 14 days.  The nurse gave him some other leg straps to keep everything in place a bit more so that he can take some short walks.  Anyone have any ideas on how long before he may be able to start working again (he does quite a lot of walking in his job) - I think it will take him at least a couple of weeks once he has his catheter out to get to grips with the pads etc.  He will also have his post-op PSA blood test next week and then the results of this when he has his cystogram.  In the UK they tend not to do the ultra-sensitive PSA test as they would not do any more treatment unless the reading was more than 0.2.

Yes it appears to be. While in hospital the JP drain kept filling with urine - a CT scan showed a collection of fluid in the pelvic area (but not enough to drain). The drain actually fell out after a week and was replaced with a temporary drain. This was left on for a further 2 weeks, but did not really drain very much.
The problem with the catheter now is that apart from the continuing internal urine leak (which is improving) there is also quite a bit of leakage from around the end of the catheter which means my husband has to wear pads constantly to catch the drips ! At least he does not have so much other discomfort now from the catheter, only some occassional twinges.

Yep, I also leaked around the catheter, so I used a lot of pads and disposable briefs.
I am hesitant to mention that the longer the catheter remains, the more unpleasant it may be at removal time. Mine came out kicking and screaming,(well, I didn't kick or scream, but it seemed like a good idea) as there was a buildup of calcium and other crud on the end that doubled or tripled the diameter of the catheter. Ah, but the joy that came immediately afterward! The agony immediately subsided and I was free of the tether. I could actually sit comfortably in a hard chair.

All that being said, your husband's situation may differ and not be so unpleasant, but you will have to judge whether to reveal the content of this post to him or not.