Understanding Cystoscopic Resection (TURP)
The operation you have experienced is a "scraping" operation. Bleeding was controlled with electrocautery which has produced a "scab" in the channel through which the urine passes (the urethra). About 1-2 weeks after the operation, pieces of the scab will fall off and come out with the urine. As this occurs, bleeding may be noted which is normal. You should not worry about this. Simply lie down and increase your fluid intake for a few hours. In most cases, the urine will clear. If bleeding occurs or persists for more than 12 hours or if clots appear impairing your stream, call your surgeon. Because of the potential for bleeding, aspirin (or Advil) should be avoided for the first 3 weeks after surgery.
You will be given a prescription for antibiotics to be taken for a few days after surgery. This is to help prevent infection. If you develop a fever over 101°, chills, or pain in the testicles, call your surgeon. Although not common, this may indicate infection that has developed beyond the control of the antibiotics that you have taken.
It will take 6 weeks from the date of surgery to fully recovery from your operation. This can be divided into two parts -- the first 2 weeks and the last 4 weeks. During the first 2 weeks from the date of your surgery, it is important to be "a person of leisure". You should avoid lifting and straining, which also means that you should avoid constipation. This can be done by any of 3 ways: 1) modify your diet, 2) use stool softeners which have been prescribed for you, and 3) use gentle laxatives such as Milk of Magnesia which can be purchased at your local drug store. Remember that the prostate is near the rectum, and therefore, it is important for you to be mindful of the way you sit. For example, sitting directly upright on a hard surface, such as an exercise bicycle seat, may cause bleeding. Reclining on a soft sea, or sitting on a "donut", is best. Walking (not jogging) is okay. You should avoid sexual activity during this time. Also, avoid driving an automobile. This is important, not because you are physically incapable of driving, but rather if you have an urge to urinate, it is important that you void and not let your bladder "stretch" too much, otherwise bleeding may occur. Therefore, it is OK for you to be a passenger in an automobile (or even to drive for very short distances).
During the second 3-5 week period of your recovery, you may begin regular activity, but only on a graduated basis. For example, you may feel well enough to return to work, but you may find it easier to begin on a half-day basis. It is common to become quite tired in the afternoon, and if such occurs, it is best to take a nap! If you are a golfer, you may begin to swing a golf club at this time. Sexual activity may be resumed during the second 3 week period, but only on a limited basis. Remember that the ejaculate may be directed back into the bladder (rather than out), producing a "dry" orgasm which is a normal consequence of the operation. This should not change the quality of sex. In general, your overall activity may be escalated to normal as you progress through this second time period, such that by 6-8 weeks following the date of surgery, you should be back to normal activity. Remember that your operation was a "scraping" operation and not all of the prostate was removed. Therefore, you should still be monitored for prostate cancer (assuming age and general medical conditions dictate such).
Within one week of discharge, call our office for your return office visit appointment which should already be scheduled.