Welcome Charles, and congratulations on having caught this case in time
that it will not hurt you.  Some answers below.

Seems to be the individual doctor's SOP.  In my case it was in until the
second Wednesday after the surgery.  Suggest you not worry about the
catheter.  It doesn't hurt, and like a bandage over a bad cut, you need
it in order to heal.

Those were my instructions too.  Don't know why.  One less possibility
to have a mishap with that thing, I guess.

I have read about the epidural here, but nothing was ever said about it
to me.  And I had a standard RRP with a big incision.

A general anesthetic was use for the surgery.  I woke up with the
epidural.  I don't know when it was put in, but it was not removed for
two days.

The catheter is inconvenient--not impossible.  I was in the hospital six
days and the doctor removed it one week after I was discharged.

My doctor did not let me drive for 5 weeks.  The incision needs time to
heal.

Dick Winters

From: camcq@shaw.ca (Charles McQuarrie)
I was diagnosed with prostate cancer in October (PSA=7.5, T1c, Gleason
score of 3+4=7) and am scheduled for the removal of the offending little
bugger on January 28.
While I intend to telephone my urologist tomorrow with a couple of
questions I thought I would post them here to see what your experiences
have been.
========hi charles - i'll try to answer some of your questions.

First, how is the determination made to remove the catheter? There does
not seem to be any consistent length of time for this and, I must admit,
the catheter seems to be the thing that concerns me a lot.
---------> seems to be up to the surgeon.  my surgeon left the catheter
in for 22 days.  this is one of the longest times for men who have the
RP done.   others will remove them a lot sooner.

Second, I read here a while back where one individual was not permitted
to drive until the catheter was removed. Is this the norm?
----------> probably has to do with the fact that the person may be on a
pain killer that could affect their reaction time.  doctor doesn't want
the liability of patient getting into auto wreck and being sued just
because he said is ok to drive.  if you do it - that's a different
story.  

i drove the first day i got home.  had no problems and wife said i was
driving normal.

Third, it just dawned on me yesterday that at the consultation with the
urologist that my wife and I attended he mentioned an epidural. Surely
this in not the primary anaesthetic but is intended more for
post-operative pain management?
---------> don't have an answer for that one.

Fourth, since I have previously undergone three back operations is the
scar tissue that is there going to impede the installation of the
epidural?
---------> using my wife for a guide - since she has had 3 back
surgeries, i don't think that would be a problem.

hope this info helped.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc

Sorry to welcome you to the club nobody wants to join, Charles.

I'm sure you'll get some good ideas here!  Lots of support in this group!

Guess this is really up to the doctor.  I had a setback and wound up with
catheter for about 3 weeks... but that is not the norm.  Actually, the
catheter, itself, was not painful.... just aggravating having to carry that
bag everywhere!

Those were my instructions!  But... even without the cath... I would imagine
one would be expected to refrain from driving for a couple of weeks after
abdominal surgery... ??

Do you have a choice in the matter?  I know that some people had epidural...
then the doctor administered twilight sleep intravenously to help them rest
through the surgery.

Can't answer that one.  Your doc is aware of your previous surgeries, I
presume?
That would be a good question to pose to him!

Check out www.phoenix5.org if you haven't already done so!  Lots of good
info!

Take care... and keep us posted!
MikeH :)

Sounds a lot like my diagnosis.  After 4 1/2 years, I'm doing quite
well.  Hope the same for you.

This depends on the surgeon, who wants to be sure there won't be any
problems.  Some are more conservative than others.  It can range from a
little over a week to three weeks.  You just have to accept what your
surgeon does.  They all have their own protocols and they follow them.
It may seem like a long time, but even three weeks is not forever.

My doctor didn't want me to drive for something like a month.  I've
heard of others who had to wait six weeks, long after the catheter has
come out.  I think the concern is that in a sudden stop, if you jammed
on the brakes, you could rupture the sutures.

Many surgeons use epidural anesthesia for a radical prostatectomy as the
primary method.   It supposedly has some advantages over general
anesthesia.  Walsh, in Guide to Surviving Prostate Cancer, recommends
it.   Again,  you pretty much have to accept your doctor's advice about
this.  If you have any questions, ask your doctor.   You shouldn't worry
about being aware of what is going on during the surgery because the
drugs they give you pretty much preclude that.

I would suspect not, but talk to your doctor and if necessary get hold
of the anesthetist beforehand to discuss it.

Welcome, Charles (or do you prefer Charlie or Chuck?), to the club no one
asked to join.  You should ask your doc all the questions you can think of.
You should also ask those of us who have already been sliced and diced.  You
should read books (Dr. Patrick Walsh's Guede to Surviving Prostate Cancer is
one of the best).  Get as much information as you can before starting your
prep on the night of the 27th.  You'll be surprised how easy it all is when
you know what is coming.

Everyone here that had RP breathed a sigh of relief when the catheter was
extracted.  One, because it is just a major inconvenience while you have it
and, two, because we just don't believe it when people tell us it is a
no-pain process.  I understand docs wait one to two weeks, in general, and
in the U.S., and largely it is a doctor's personal decision.  I assume it's
the same in Canada, but understand it might be different in the UK and/or
AU.

It is the norm.  But, it might be more conincidental than one event being
dependent upon the other.

Epidural is the primary and immediate post operative anesthetic.  It is a
wonderful method.  I had absolutely no pain....  ever!  ... while on the
epidural.  And so little pain after, that I asked for them to stop the pain
meds in the hospital.  I went home with great meds that I never used.

I would say that is impossible for even an anesthesiologist to say until he
gets a look at your back.  The needle (which is also painless) goes in about
midway from your neck to you tail bone.  Is that where you are scarred?

Charles,

I was diagnosed in late October, and had my RRP in Houston on 12/1/04.

RE CATHETER REMOVAL:  It's a matter of how well your anastomosis (the new
joining point of your urethra to your bladder) is healed.  I was told by
my surgeon that in 60-70% of men, it can be removed at 1 week, and in 100%
of men at 2 weeks.  The determination is made (at least what I was told) by
a cystogram, basically just an X-Ray of the area after filling you a bit
with some clear contrast solution.  My cystogram at one week showed a
small leak.  So I went home, bummed, knowing it had to stay another week.
It's due for removal in 2 days.

RE EPIDURAL: In my pre-op interview, it was given as an option for
excellent post-op pain control, and not as part of the anesthesia.  I was
told I could decide right up to the moment I walked in the day of surgery.
On that day, I told the anesthesiologist that's what I wanted, and I
distinctly remember him saying "Good, we're on the same page."  I sat up,
and felt nothing when it was put in place.  I was told it helps control
blood loss during surgery (how, I don't know), and that it is extremely
effective for pain management.  When I awoke after surgery, I FELT NO PAIN
WHATSOEVER.  I told everyone around me I felt like I could go dancing.  The
epidural stayed in for two of the three days, and I could then basically go
w/o pain medication completely.  IT WAS GREAT and I would not hesitate to
recommend it. I had two major abdominal surgeries 9 years ago, and
morphine did not cut it - the epidural *did*.  Had no discomfort with it
at all, but did have some very minor itching on my back and neck.  I was
told they could do something about it with other medication, but I
declined as the itching was truly very minor.

Hope this helps,
John

Charles,

I don't believe it's the catheter,  but applying the brakes.  Sure, we
all have
power brakes but in an emergency stop, you're going to try to push that
pedal
right through the floor.  That's also why you won't be able to lift any
heavy
weights for awhile.

George

I must admit that the catheter was MY primary (though needless)
concern regarding pain and discomfort.

But it's inserted when you're "under," and removed in a 2 second
maneuver that felt a bit weird, but was in no way painful (a snip to
deflate the balloon-in-the-bladder, and ziiiip--it's out).

Mine was in about 8 or 10 days.  Others have had pain or irritation
where the tube exits the penis.  I found it important to leave a short
loop of tube there before taping the rest of the tube to my thigh (not
an adhesive tape--an elastic and velcro strap).  Then the bag fastened
below that with its own elastic and velcro straps.

The object is to minimize movement (friction) between the tube and the
penis.  Others have used various creams there--I never felt the need.

Perhaps you know this already, but the epidural is administered when
one is unconcious--I guess I worried it might be otherwise!  Once I
was on the table and the IV's inserted I was told to sit up, swing my
legs over the side, and bend forward.  Next thing I knew my wife was
trying to make sense out of my babbling!

They must have given me a shot of sumpin' through the IV, and then the
spinal jab.

--John W. Wells

No one has mentioned the drainage tube-  removal of my catheter was delayed
several days because the daily drainage from the abdominal cavity hadn't
dropped below a few cc.