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The prostate is a small gland about the size of a walnut which surrounds part of the urethra. The urethra is the tube that travels from the bladder and prostate to the penis and carries urine and semen. Cancer of the prostate results in the enlargement of the prostate which consequently causes the prostate to press on the urethra and block the normal flow of urine. Symptoms caused by prostate cancer include; difficulty passing urine, pain on passing urine, frequent urination, blood in the urine or semen and an increased risk of urinary tract infections.
There are two approaches to prostatectomy surgery including:
- Radical prostatectomy
- Laparoscopic prostatectomy
Radical prostatectomy
Radical prostatectomy is indicated if the cancer has not spread outside of the prostate and for younger males, with high grade tumours. The procedure is performed under general anaesthetic. The surgery is carried out by a specialist surgeon who makes a large incision into the abdomen or between the testicles and the back passage. The entire prostate is removed along with surrounding tissues with the aim of getting rid of the cancer. Once the malignant tissues have been removed, the area is checked and the wound is then closed.
Above: abdominal and pelvic stretch applied by a specialist physiotherapistLaparoscopic prostatectomy
Laparoscopic prostatectomy surgery has similar outcomes to radical prostatectomy surgery in that the prostate is removed along with surrounding tissue so as to eradicate the cancer. Laparoscopic prostatectomy surgery is performed using keyhole surgery (laparoscopic). Keyhole surgery involves a small incision being made to the abdomen. A narrow tube with an attached light and camera is inserted into the body so the surgeon can see the prostate clearly. Small instruments are also attached to the tube and the prostate gland is cut away along with surrounding tissues and removed through the incision in the abdomen. With laparoscopic prostatectomy surgery, there isn’t a big wound therefore there is a reduced risk of infection, a smaller scar and faster recovery post-surgery. Once the cancer has been removed, the small wound is the closed.
Special effort is made in both the procedures to spare any damage to the nerves located near the prostate to prevent any erection difficulties after the operation. However, in many cases damage to the nerves cannot be avoided.
Physiotherapy after prostatectomy surgery is essential to maximise the success of the surgery, prevent future problems and to aid in a full or near to full recovery.
Symptoms after prostatectomy surgery
During the initial period after you have undergone prostatectomy surgery, you will feel drowsy until the anaesthetic fully wears off. You will have a drip attached to your arm to replace bodily fluids which will be removed once you’re able to drink normally. You will be encouraged to drink as much fluid as possible. During your stay in hospital, you will initially require a catheter for 2-3 days after your surgery to drain urine from your bladder and to wash out your bladder with a sterile solution (bladder irrigation). The catheter will be removed once your urine begins to run clear and when you are urinating normally. After the surgery, you will experience some pain and discomfort around the wound which you will be given pain killers for. However, you will experience minimal pain if you underwent laparoscopic prostatectomy surgery. The length of time you stay in hospital will depend on your recovery. You will be discharged approximately four days after your prostatectomy surgery. You will be advised not to drive for up to four weeks after your surgery and full recovery may take eight or more weeks. You should avoid strenuous activities and heavy lifting after your prostatectomy.
After your prostatectomy, you may experience problems such as:
- Pain
- Urinary incontinence
- Bowel problems
- Weakness in and around your pelvic area
Physiotherapy after prostatectomy surgery
After your prostate surgery, you should begin physiotherapy during your hospital stay which will aim to get you out of bed as soon as possible and mobilising to avoid chest infections, blood clots and consequently a longer hospital stay. Once you have been discharged, Physio.co.uk will provide you with a personal rehabilitation programme which main goals focus on:
- Minimising pain
- Reducing urinary problems and incontinence
- Reducing bowel problems
- Improving muscle strength and endurance
- Improving cardiovascular fitness
- Re-establishing function and independence
- Pain modalities (to control pain)
- Strengthening exercises for the pelvic floor muscles
- Strengthening exercises for the abdominal muscles
- Bladder training to help the bladder return to normal function
- Biofeedback training to show you how well you are using your pelvic floor muscles
- Electrical stimulation to improve muscle function
- Instruction for home exercise programme to improve pelvic floor function
- Instructions on how to control pelvic floor and abdominal muscles during coughing, sneezing and laughing etc.
- Education on how to make lifestyle changes that may affect the bladder
- Controlled breathing and relaxation exercises
- Advice on comfortable positioning
- Hydrotherapy
Summary
Prostatectomy surgery is a procedure that is performed to remove all or part of the prostate so as to treat prostate cancer. Prostatectomy surgery is essential to significantly reduce symptoms that are associated with enlargement of the prostate and in the attempt to cure the cancer. Prostatectomy surgery can be performed using a large incision in the abdomen or between the testicles and the back passage (radical prostatectomy) or it can be performed using keyhole surgery (laparoscopic prostatectomy). Both procedures aim to remove the prostate and its surrounding tissues with the aim of getting rid of the cancer. Physiotherapy with Physio.co.uk is recommended after prostatectomy surgery to maximise the success of the surgery, to help you achieve a full or near to full recovery and to prevent the likelihood of future problems occurring. Physio.co.uk provides a personal physiotherapy programme that will get you back doing what it is you love the most whether it is your job, hobby or sport.
Call Physio.co.uk now on 0330 088 7800 for more information or to book an appointment. You can also use our online booking system to make an appointment online today!
