Aftercare following da Vinci prostatectomy: what happens after prostate cancer surgery

After complete removal of the prostate due to prostate cancer, many patients ask themselves the same question on discharge: what happens now? Prof. Dr. med. Sven Lahme, urologist and medical director of the Goldstadt Private Clinic in Pforzheim, has been performing radical prostatectomy for several decades. On this page, he explains what matters after a robot-assisted da Vinci prostatectomy: physical rest, sport, the pelvic floor, follow-up rehabilitation and PSA checks.

From the procedure to discharge

If the prostate cancer has been confirmed by a tissue sample and is confined to the prostate, the Goldstadt Private Clinic today generally recommends robot-assisted da Vinci prostatectomy. The minimally invasive procedure requires an inpatient stay of about one week.

Usually on the fifth day after the operation, an X-ray examination is used to check whether the connection between the urinary bladder and the urethra is watertight. The bladder catheter is then removed, and discharge usually follows one day later.

Why da Vinci surgery makes aftercare easier

Robot-assisted surgery allows dissection that closely respects the anatomy. With appropriate experience on the part of the surgeon, the pelvic floor and sphincter can be precisely visualised and spared. The suture between the urinary bladder and the urethra is watertight, and there is only minor swelling in the surgical area.

With the open surgery that used to be common, on the other hand, haematomas and more severe swelling were hardly avoidable.

Rest and sport after prostate surgery

Everyday activities such as walking, driving and moving around at home are possible without restriction after discharge. Nevertheless, a certain degree of physical rest is recommended for one to two weeks.

When cycling, the saddle presses on the area where the fine suture between the bladder and the urethra is located. Prof. Lahme therefore advises refraining from cycling for about two to three months.

Is rehabilitation necessary after prostate cancer surgery?

In German it is often colloquially called a "Kur"; medically, it is referred to as follow-up rehabilitation. Its aim is to restore the function of the pelvic floor so that patients can hold their urine well again.

After open surgery, regular pelvic floor training actually made sense. Due to the restricted view of the junction, the pelvic floor was more frequently impaired. After a properly performed da Vinci operation, the situation is different: the pelvic floor muscles remain intact. In the opinion of the Goldstadt Private Clinic, follow-up rehabilitation is therefore usually unnecessary.

Coordination instead of training

What patients relearn after the operation is the coordination of the pelvic floor. Holding urine and urinating feel different, but the function itself is there. Depending on age, this adjustment is usually achieved very quickly. Above all, it takes time and patience.

Why too much pelvic floor exercise can be harmful

Those who want to speed up control through intensive pelvic floor exercises often achieve the opposite. Excessive training can increase swelling in the surgical area and thus trigger new complaints. The Goldstadt Private Clinic therefore advises against unnecessary pelvic floor training after da Vinci surgery.

Follow-up schedule and PSA value after prostatectomy

In the first few weeks after discharge, a weekly urological check-up is recommended. This checks whether the urinary bladder is emptying well and whether there are any abnormalities. This includes an ultrasound examination and a blood test to track the drop in the PSA value. After a few weeks, the PSA value is usually no longer detectable.

Oncological tumour follow-up then begins, on an outpatient basis with ultrasound and PSA checks:

The key facts in brief

• Follow-up rehabilitation is usually unnecessary after prostate cancer surgery with da Vinci.
• Unnecessary pelvic floor exercises should be avoided so as not to cause additional swelling.
• No sport for about one month, no cycling for two to three months.
• PSA checks initially weekly, then quarterly for two years, then every six months.

Consultation on prostate cancer surgery with da Vinci in Pforzheim

Patients with prostate cancer who are considering surgery or would like a second opinion can seek advice in the special consultation for robot-assisted da Vinci operations at the Goldstadt Private Clinic. There, Prof. Dr. Lahme and his team discuss the individual findings and the further procedure. Appointments can be made via the contact form or by telephone.

Make an appointment for the da Vinci special consultation

This page does not replace medical advice. The course after an operation varies from person to person.