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What can you not do after a catheter is removed?

For 2 days after your catheter is removed, your bladder and urethra will be weak. Don't push or put effort into urinating. Let your urine pass on its own. Don't strain to have a bowel movement.

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This information explains what to do after your catheter is removed after prostate surgery.

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Call Your Doctor Right Away If You:

Have severe pain in your lower abdomen (belly) when you’re urinating.

Aren’t able to urinate.

These things can mean that the catheter needs to be put back in.

Monday through Friday from to , call _______________.

After , during the weekend, and on holidays, call 212-639-2000 and ask for the urology fellow on call. If you can’t come to Memorial Sloan Kettering (MSK), you can go to your local urologist or emergency room to have the catheter put in. Tell them that you recently had prostate surgery. If you go to your local urologist or emergency room for any reason related to your prostate surgery, tell your MSK doctor on the next business day.

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General Information for After Your Surgery

Finish taking your antibiotics as prescribed.

Your pathology results will be ready 10 days after your surgery. Call your doctor’s office to get your results.

Drinking liquids

You can decrease your daily liquid intake to 4 to 6 (8-ounce) glasses of liquids every day. This will help decrease urine leakage. Avoid drinking too much after Empty your bladder before you go to bed. This can help you avoid having to get up to urinate at night.

Urinary problems

For 2 days after your catheter is removed, your bladder and urethra will be weak. Don’t push or put effort into urinating. Let your urine pass on its own. Don’t strain to have a bowel movement.

If you’re leaking urine, limit how much alcohol and caffeine you drink.

You might have burning at the tip of your penis for a few days after the catheter is removed. If the burning doesn’t go away after 3 days or gets worse, call your doctor’s office. You might see blood or blood clots in your urine for several weeks after the catheter is removed. This happens because the incisions (surgical cuts) inside your body are healing and the scabs are coming off. If you see blood in your urine, drink more liquids until you no longer see blood.

Prostate specific antigen (PSA) blood tests

Have a PSA blood test done at the following times: 6 to 8 weeks after surgery (date: ____________________) 3 to 6 months after surgery (date: ____________________) 12 months after surgery (date: ____________________) Starting 12 months after your surgery, have a PSA blood test done every 6 months. Do this until 5 years following your surgery. Starting 5 years after your surgery, have a PSA blood test done every 12 months. Do this for life. Your doctor might ask you to have PSA blood tests done more often. If they do, your nurse will give you more information.

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If you can, have your PSA blood test done at a MSK location. If you can’t have it done at a MSK location, you can go to a medical office closer to where you live. Have the results faxed to your MSK doctor’s office.

MSK doctor: ___________________________

Fax number: ___________________________

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Kegel (Pelvic Floor Muscle) Exercises

Start doing Kegel exercises _________________. For more information about Kegel exercises, read the resource Pelvic Floor Muscle (Kegel) Exercises for Males.

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Sexual Activity

You can start sexual activity again __________________.

The night the catheter is removed, you can start taking medication to achieve an erection. You might need to take one of these medications every day for up to 1 year after your surgery. Your doctor or nurse will give you information about your medication plan. Keep following this plan until your see your surgeon during your post-operative (post-op) visit. Your plan may be one of the following:

Medication Normal dose Challenge dose sildenafil citrate

(Viagra®) Take 25 mg 6 nights per week.

To make the 25 mg dose, split a 100 mg pill into 4 pieces. Use a pill cutter from your local drug store. Take 100 mg 1 night per week. sildenafil citrate (generic) Take 1 (20 mg) pill 6 nights per week. Take 5 (20 mg) pills 1 night per week. This is a total of 100 mg. tadalafil (Cialis®) 20 mg pills Take 1 (20 mg) pill every other day. Do not take a challenge dose. A 20 mg dose of tadalafil (Cialis) is the highest dose you should take. tadalafil (Cialis) 5 mg pills Take 1 (5mg) pill 6 nights per week. Take 4 (5 mg) pills 1 night per week. This is a total of 20 mg.

About the challenge dose

When you take the challenge dose, take the medication on an empty stomach. Take it about 2 hours before your evening meal. The medication takes 30 to 60 minutes to start working. It will last in your system for up to 8 hours. At any time during these 8 hours, try to become sexually aroused through contact with a partner or yourself. Write down what happened and tell your doctor during your next visit. If you haven’t had any response after trying the challenge dose for 4 weeks, call your doctor’s office. Your doctor can refer you to our Sexual Medicine team.

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