After robotic prostatectomy, a urinary catheter is kept in place for 7–14 days while the anastomosis (the join between bladder and urethra) heals. This is not optional — removing it prematurely risks anastomotic breakdown. The catheter is removed in clinic once healing is confirmed.
What you'll go home with
You will be discharged with a Foley catheter — a soft flexible tube inserted through the urethra into the bladder. It is held in place by a small balloon filled with sterile water (inflated once inside the bladder). You will not be able to remove it yourself.
Attached to the catheter is a drainage bag. You will typically go home with two bags:
- A leg bag — straps to the thigh and sits hidden under clothing. Used during the day for mobility.
- A larger night bag (free-drainage bag) — hangs from the bed frame or a stand. Used overnight to avoid having to empty the leg bag during sleep.
Before discharge, a nurse will show you how to connect and disconnect these bags. If you do not feel confident, ask for a repeat demonstration. Most hospitals also provide a community nurse visit in the first 1–2 days for additional support.
Daily catheter care routine
Wash hands thoroughly before touching the catheter or bags
This is the single most important step for preventing infection. Use soap and water for at least 20 seconds. Alcohol gel is acceptable if soap is unavailable.
Clean around the catheter entry point twice daily
Use a clean flannel or gauze and plain warm water (no antiseptic soaps or wipes — these disrupt the natural skin flora and increase infection risk). Clean gently around the urethral meatus (the opening) in a downward direction. Pat dry.
Check that the catheter is draining
The catheter should drain continuously when upright. A kink in the tubing or a bag positioned higher than the bladder will stop drainage. Check that tubing has no bends and that the bag hangs below your bladder level at all times.
Empty the leg bag when it is two-thirds full
Never allow the bag to become completely full — this creates back-pressure and risks disconnection leaks. Empty into a toilet, open the tap at the bottom of the bag, drain completely, close the tap, and wash hands.
Keep everything below the level of your bladder
Gravity is what makes catheter drainage work. When sitting, the bag should hang below the seat of the chair. When lying down, the bag should hang below the level of the mattress.
Never disconnect the catheter from the drainage bag unnecessarily — this introduces bacteria. Never clamp the catheter (except as directed by your medical team). Never pull or tug on the catheter — it is held by the internal balloon and pulling causes pain and can damage the urethra.
Managing the drainage bag
Switching between the leg bag and night bag
At bedtime, connect the night bag to the port at the bottom of the leg bag (rather than disconnecting at the catheter — this maintains a closed system and reduces infection risk). In the morning, close the night bag tap and disconnect it from the leg bag. Empty and rinse the night bag before storing it.
Cleaning the leg bag
The leg bag does not need to be cleaned daily — it is typically replaced every 5–7 days. If you notice it developing an odour before then, rinse through the outlet port with a small amount of water and allow to drain.
Securing the catheter to your thigh
Use the catheter strap or leg bag strap to anchor the catheter tube against your inner thigh. This prevents it pulling on the urethra when you move. Some men also use a small piece of hypoallergenic tape. Unanchored catheters cause significant discomfort.
Sleeping with a catheter
Most men find the first night or two uncomfortable, but adapt quickly. Key points for sleeping comfortably:
Moving around and daily activities
You should be gently mobile from the first day at home. Light walking is encouraged — it reduces the risk of blood clots and aids recovery. You do not need to stay in bed because of the catheter.
- Walking: Fine from day 1. The leg bag allows full mobility. Keep the bag strapped to your thigh and below bladder level.
- Stairs: Fine, but take your time in the first week.
- Showering: You can shower with the catheter — keep the catheter site clean and dry gently. Do not submerge in a bath until the catheter is removed.
- Driving: Not recommended while the catheter is in place — the tube is uncomfortable and the airbag risk is real.
- Lifting: Avoid lifting anything heavier than 2–3 kg while the catheter is in place.
- Sex: Not possible or advisable while the catheter is in place.
What your urine should look like
Pale yellow to clear — means well-hydrated. Light pink or rose-coloured in the first 2–3 days (blood-tinged urine is normal immediately post-surgery). Small amounts of mucus or sediment in the bag are normal.
Bright red blood or large clots at any time after the first 3 days. Cloudy, foul-smelling urine (possible infection). Complete absence of urine in the bag for 2+ hours when well hydrated. Urine leaking around the outside of the catheter (bypassing).
If urine leaks around the outside of the catheter (alongside it, rather than through it), this usually means bladder spasm is pushing urine past the catheter. It does NOT mean the catheter has come out — the internal balloon is still in place. Contact your surgical team for advice; they may adjust your medication or check the catheter position.
Diet and fluids
Drink 1.5–2 litres of fluid per day. This is the most important thing you can do for catheter management. Well-diluted urine reduces the risk of blockage, infection, and bladder spasm. Do not restrict fluids to avoid filling the bag — a full bag is simply emptied more often.
Avoid or reduce:
- Caffeine (coffee, tea, energy drinks, cola) — irritates the bladder
- Alcohol — dehydrates and irritates the bladder lining
- Spicy food — can worsen bladder irritation
- Excessive fizzy drinks
Constipation is common after surgery due to opiate pain relief and reduced mobility. Straining to open your bowels increases intra-abdominal pressure and stresses the anastomosis. Use a stool softener (lactulose or docusate) preventively. Eat plenty of fruit, vegetables, and fibre. Stay hydrated.
What happens at catheter removal
Catheter removal (also called a "trial without catheter" or TWOC) typically happens 7–14 days after surgery. You attend the clinic or hospital as directed.
The procedure takes less than a minute. The balloon is deflated by draining the sterile water through a small port, and the catheter slides out. Most men describe a brief stinging sensation — it is not significantly painful.
You will usually be asked to stay for 30–60 minutes and pass urine at least once before going home. Some men experience a burning sensation with the first void — this is normal and settles within a few hours.
Bring a large pad to the removal appointment. Leakage begins immediately after catheter removal and you will need it for the journey home. This leakage is completely expected — it is not a sign that anything went wrong.
When to call your surgeon immediately
Fever above 38°C — may indicate anastomotic leak or urinary tract infection. — Catheter falls out — go to the emergency department immediately; the anastomosis must not be left uncatheterised. — No urine draining for 2+ hours despite good fluid intake — may indicate a blocked catheter. — Severe pain in the lower abdomen — particularly if the bag is empty and you feel bladder pressure. — Bright red blood or large clots in the urine after the first 3–4 days.
This guide provides general educational information about catheter care after prostatectomy. Always follow the specific discharge instructions given by your surgical team — practices may vary between centres. If in doubt, call your surgeon's team rather than waiting.