Prostate resection - minimally invasive - discharge
Laser prostatectomy - discharge; Transurethral needle ablation - discharge; TUNA - discharge; Transurethral incision - discharge; TUIP - discharge; Holmium laser enucleation of the prostate - discharge; HoLep - discharge; Interstitial laser coagulation - discharge; ILC - discharge; Photoselective vaporization of the prostate - discharge; PVP - discharge; Transurethral electrovaporization - discharge; TUVP - discharge; Transurethral microwave thermotherapy - discharge; TUMT - discharge; Water vapor therapy (Rezum); Urolift
Not every man will have to deal with age-related issues like balding or weight gain. Whether you have these problems really depends on your health, and luck. But one problem just about every man will have to face, if he lives long enough, is an enlarged prostate. Let's talk about an enlarged prostate, also known as benign prostatic hyperplasia, or BPH. The prostate gland is part of your reproductive system, and its job is to add fluid to the sperm before ejaculation. The prostate is pretty small when you're young, but as you get older it grows and grows. Keep in mind, this growth isn't cancerous. But by design, the prostate is wrapped around the urethra, the tube that carries urine from your bladder out of your body. So as the prostate grows, it can begin to squeeze or pinch the urethra which often can make it harder for men with an enlarged prostate to urinate. If you have an enlarged prostate, the first notice that you're having trouble urinating. Instead of having a strong even flow, the urine only dribbles out like a leaky faucet; drip, drip, dribble, drip. Because you're not emptying your bladder fully each time, you keep feeling the urge to use the bathroom, even in the middle of the night. To check your prostate, your doctor or urologist will check your prostate gland by inserting a lubricated, gloved finger and feeling for any growth. Other tests may check your urine flow, and how much urine is left in your bladder after you go, as well as look for signs of an infection or prostate cancer. How is an enlarged prostate treated? Treatment often depends on how you feel. If you're not having any symptoms, your doctor may suggest just watching it, that's called watchful waiting. If you've got bothersome symptoms, medications can reduce the size of the prostate gland, and relax your bladder and prostate so you don't constantly feel the urge to go. For more serious symptoms, surgery can remove the extra prostate tissue. To help relieve the symptoms of an enlarged prostate, watch how much fluid you drink, especially before bedtime, or before going out. Minimize alcohol and caffeine, as well as over-the-counter decongestants and antihistamines. They can make your symptoms worse. Double voiding can help. After you've emptied your bladder, wait a moment and try to go again without straining or pushing. Some people take herbs like saw palmetto for an enlarged prostate. Although there's some evidence that these herbs can relieve BPH symptoms, many studies haven't found a benefit. Talk to your doctor before taking any herbal remedy, because they can cause side effects. Prostate enlargement isn't usually serious, but it can have a serious impact on your way of life, especially when you're always going to the bathroom. Remember that BPH is treatable. Work with your doctor to find the treatment that works best for you. If you've been caring for your symptoms for 2 months and not finding any relief, or you're having more serious symptoms like you're not urinating at all, or you have a fever or pain in your back or abdomen, call your doctor as soon as possible.
Catheterization is accomplished by inserting a catheter (a hollow tube, often with and inflatable balloon tip) into the urinary bladder. This procedure is performed for urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time. Catheterization in males is slightly more difficult and uncomfortable than in females because of the longer urethra.
When You're in the Hospital
Your procedure was done in your health care provider's office or at an outpatient surgery clinic. You may have stayed in the hospital for a night.
What to Expect at Home
You can do most of your normal activities within a few weeks. You may go home with a urine catheter. Your urine may be bloody at first, but this will go away. You may have bladder pain or spasms for the first 1 to 2 weeks.
Self-care
Drink plenty of water to help flush fluids through your bladder (8 to 10 glasses a day). Avoid coffee, soft drinks, and alcohol. They can irritate your bladder and urethra, the tube that brings urine from your bladder out of your body.
Eat a normal, healthy diet with plenty of fiber. You may get constipation from pain medicines and being less active. You can use a stool softener or fiber supplement to help prevent this problem.
For the first few weeks after surgery, take only the medicines your provider has told you to take.
- You may need to take antibiotics to help prevent infection.
- Check with your surgeon before taking aspirin, ibuprofen (Aleve, Motrin), naproxen (Aleve, Naprosyn), acetaminophen (Tylenol), or any other drugs like these.
You may take showers. But avoid baths if you have a catheter. You can take baths once your catheter is removed. Make sure your provider clears you for baths to make sure your incisions are healing well.
You will need to make sure your catheter is working properly. You will also need to know how to empty and clean the tube and the area where it attaches to your body. This can prevent infection or skin irritation.
After your catheter is removed:
- You may have some urine leakage (incontinence). This should get better over time. You should have close-to-normal bladder control within a month.
- You will learn exercises that strengthen the muscles in your pelvis. These are called Kegel exercises. You can do these exercises any time you are sitting or lying down.
You will return to your normal routine over time. You should not do any strenuous activity, chores, or lifting (more than 5 pounds or more than 2 kilograms) for at least 1 week. You can return to work when you have recovered and are able to do most activities.
- Do not drive until you are no longer taking pain medicines and your doctor says it is OK. Do not drive while you have a catheter in place. Avoid long car rides until your catheter is removed.
- Avoid sexual activity for 3 to 4 weeks or until the catheter comes out.
When to Call the Doctor
Contact your provider if:
- It is hard to breathe
- You have a cough that does not go away
- You cannot drink or eat
- Your temperature is above 100.5°F (38°C)
- Your urine contains a thick, yellow, green, or milky drainage
- You have signs of infection (a burning sensation when you urinate, fever, or chills)
- Your urine stream is not as strong, or you cannot pass any urine at all
- You have pain, redness, or swelling in your legs
While you have a urinary catheter, call your provider if:
- You have pain near the catheter
- You are leaking urine
- You notice more blood in your urine
- Your catheter seems blocked
- You notice grit or stones in your urine
- Your urine smells bad, it is cloudy, or has a different color
References
Abrams P, Chapple C, Khoury S, Roehrborn C, de la Rosette J; International Consultation on New Developments in Prostate Cancer and Prostate Diseases. Evaluation and treatment of lower urinary tract symptoms in older men. J Urol. 2013;189(1 Suppl):S93-S101. PMID: 23234640
Benjamin TGR, Kreshover JE. Simple prostatectomy. In: Bishoff JT, Kavoussi LR, Kayoussi N, Bishoff T, eds. Atlas of Laparoscopic and Robotic Urologic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2023:chap 30.
Han M, Partin AW. Simple prostatectomy: open and robot assisted laparoscopic approaches. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 147.
Helo S, Welliver C, McVary KT. Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 146.
Version Info
Last reviewed on: 4/1/2023
Reviewed by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
