After a robotic prostatectomy, the surgeon joins the bladder to the urethra, the tube that carries urine out of the body. A catheter is left in place while this join heals. Most men go home with it and keep it for one to two weeks. Knowing how to look after it makes those days more comfortable and less worrying.
What the catheter does
A catheter is a thin, soft tube that passes through the penis into the bladder. A small balloon at the tip holds it in place. Urine drains continuously into a bag, so you will not need to pass urine yourself while it is in.
The catheter protects the new join between the bladder and urethra while it heals. It is important not to pull on it or try to remove it yourself.
The two types of bag
- Leg bag: a smaller bag strapped to your thigh or calf, worn under clothes during the day.
- Night bag: a larger bag that attaches to the bottom of the leg bag at night, so you do not need to empty it while sleeping.
The nurses will show you how to connect, empty and change the bags before you go home.
Daily care
Simple habits help prevent infection and discomfort:
- wash your hands before and after touching the catheter or bags
- wash around the tip of the penis and the tube once or twice a day with mild soap and water
- keep the bag below the level of your bladder so urine drains well
- empty the leg bag when it is about two-thirds full
- secure the tube to your leg so it does not pull
- drink around two litres of fluid a day, mostly water, to keep urine flowing
Showering is usually fine. Avoid baths until the wounds and catheter site have healed.
Sleeping and moving about
Many men worry about sleeping with a catheter. It helps to:
- lie on your back or on the side where the bag is
- hang the night bag on a stand or place it in a clean bowl on the floor
- make sure the tube is not kinked or trapped
Gentle walking helps your recovery and reduces the risk of blood clots. Avoid heavy lifting and strenuous activity. Our guide to recovery after robotic prostate surgery covers activity in more detail.
Common and normal
While the catheter is in, it is common to notice:
- a little blood or debris in the urine
- some leakage around the catheter, especially when opening your bowels
- bladder spasms, which feel like a sudden urge to pass urine
- some discomfort at the tip of the penis
Avoid constipation, as straining can cause spasms and leakage. A mild laxative can help.
When to seek advice
Contact your surgical team if:
- the catheter stops draining for more than an hour, despite checking for kinks
- you have a fever, shivering or feel unwell
- your urine becomes very bloody or contains large clots
- you have severe pain in your abdomen
- the catheter falls out
Do not try to put the catheter back in yourself. The NHS guide to urinary catheters has further advice.
Removal day
The catheter is usually removed in clinic. The balloon is deflated and the tube slides out, which takes only a few seconds. Some centres check the join with a scan first.
Afterwards, it is normal to have leakage at first. Bring pads and spare underwear. Continence usually improves steadily over the following weeks and months. Starting pelvic floor exercises after removal, as advised by your team, helps. Prostate Cancer UK has helpful guides to managing leakage.
Our articles on preparing for your robotic prostatectomy and what to expect during recovery cover the wider recovery journey.
Professor Prokar Dasgupta and his team provide follow-up care after surgery at The London Clinic. Please contact the clinic with any questions.