If you are having robotic radical prostatectomy, you will usually wake up with a urinary catheter in place. It drains urine from your bladder while the new connection between your bladder and urethra heals after the prostate has been removed.
You will normally need the catheter only temporarily, often for around seven to ten days. If you are going home with a catheter, you should be shown how to manage it, keep it draining properly and recognise any symptoms that may need medical attention.
What Does the Catheter Do After Prostate Surgery?
A catheter is used because robotic prostate surgery temporarily interrupts the normal connection between your bladder and urethra. After your prostate is removed, your surgeon reconnects your bladder to the remaining urethra, creating a new join called a vesicourethral anastomosis.
The catheter passes through this new connection and drains urine from your bladder while it heals. If you are recovering from surgery, this helps protect the join and allows it to heal properly without the pressure of normal urination.
What Exactly Is a Urinary Catheter?
A urinary catheter is a soft, flexible tube that passes through your penis and urethra into your bladder. A small balloon filled with sterile water keeps it securely in place, while the other end connects to a drainage bag.
If you have a catheter after robotic prostate surgery, urine can drain continuously from your bladder into the bag. It also helps support the newly reconstructed connection between your bladder and urethra while it heals.
Why Does the Bladder Need to Be Reconnected?
When your prostate is removed, the normal connection between your bladder and urethra is interrupted. Your surgeon therefore brings your bladder down and carefully stitches it to the remaining urethra, creating a new connection.
Once this connection heals, urine can flow from your bladder through your urethra as usual. If you are having robotic prostate surgery, you normally do not need a permanent urine bag or an opening through your abdomen. The catheter provides temporary support while the new connection heals.
How Does the Catheter Help the New Connection Heal?
After surgery, the new connection between your bladder and urethra is delicate and needs time to heal. The catheter acts like a temporary stent, helping keep the passage aligned while allowing urine to drain continuously.
Without the catheter, your bladder would fill and empty normally while the connection is still healing. The catheter is therefore more than an inconvenience; it helps protect the new connection during the early stages of recovery.
Does Having a Catheter Mean Your Bladder Is Not Working?
No. Your bladder continues to function while you have a catheter. Your kidneys still produce urine and your bladder receives it, but the catheter continuously drains the urine so your bladder does not fill and empty in the usual way.
Because your bladder stays mostly empty, you may not feel your usual urge to urinate. Once the catheter is removed, your bladder will gradually get used to filling and emptying normally again, so you may notice different sensations at first.
How Long Will You Need the Catheter?
If you have robotic prostate surgery, you will usually need the catheter for around seven to ten days. Your surgeon may recommend keeping it for up to two weeks if your bladder-to-urethra connection needs more time to heal.
Your exact timing will depend on how your surgery and recovery progress. If you need the catheter for a few extra days, it does not necessarily mean something has gone wrong, so follow your surgical team’s advice rather than comparing your recovery with someone else’s.
Will You Go Home With the Catheter?
Yes, you will often go home with your catheter still in place after robotic prostate surgery. This allows you to leave hospital while the new bladder-to-urethra connection continues to heal at home.
Before you leave, your nursing team should show you how to care for the catheter and empty the drainage bag. You can usually use a smaller leg bag during the day and a larger bag at night, making it easier for you to manage the catheter comfortably.
How Should You Look After the Catheter at Home?
Looking after your catheter properly can help keep it draining and reduce the risk of problems. Your nursing team should show you how to manage it before you leave hospital.
- Keep it clean: Gently wash around the penis and catheter each day with mild soap and water.
- Wash your hands: Clean your hands before and after touching the catheter or drainage bag.
- Avoid pulling: Keep the tubing secure and avoid unnecessary pulling or tugging.
- Check the tubing: Make sure the catheter is not kinked or trapped so urine can drain freely.
Follow the catheter-care instructions given by your surgical team. Contact them if you notice poor drainage, increasing discomfort or other concerning symptoms.
What Happens to the Catheter at Night?
At night, you will usually connect a larger drainage bag to your leg bag so urine can collect while you sleep. Keep the night bag below your bladder and check that the tubing is straight, not trapped or twisted, so urine can drain freely.
You should not normally need to wake up repeatedly to empty the bag. If you feel bladder discomfort and notice little or no urine draining, check that the tubing is not blocked or kinked, and contact your healthcare team if drainage does not restart.
How Should You Use the Leg Bag?
During the day, you will usually have a smaller catheter bag secured to your thigh or lower leg. Keep the tubing straight and make sure the bag stays below your bladder so urine can drain freely without pulling on the catheter.
You should empty the bag before it becomes too full or heavy. Wash your hands before and after handling it, and avoid letting the drainage tap touch unclean surfaces. Your nursing team should show you how to use your particular leg-bag system before you leave hospital.
How Much Should You Drink While the Catheter Is In?
You should usually drink enough fluids to keep your urine flowing freely through the catheter. Many UK catheter-care services advise around 1.5–2 litres a day, unless your healthcare team has told you to restrict your fluid intake.
Water is a good choice for staying hydrated while your catheter is in place. You should also try to avoid constipation, as straining can increase discomfort or leakage around the catheter.
Are Bladder Spasms Normal With a Catheter?
Yes, bladder spasms can happen while you have a catheter and are usually caused by your bladder reacting to the tube or its small retaining balloon. You may feel sudden cramping in your lower abdomen or a strong urge to urinate, even though the catheter is draining your bladder.
Mild spasms are usually not a sign that something is wrong, but you should contact your healthcare team if they become severe or persistent. You may also notice some urine leaking around the catheter, and your doctor can advise whether medication could help.
Is Leakage Around the Catheter Normal?
You may sometimes notice urine leaking around the outside of your catheter, known as catheter bypassing. This can happen because of bladder spasms or straining when opening your bowels, and it does not necessarily mean there is a serious problem.
The key thing is to check whether urine is still flowing into the drainage bag. If you have significant leakage and little or no urine is entering the bag, your catheter could be blocked, so you should contact your healthcare team promptly.
Common Catheter Problems and What to Do
| What you notice | Possible reason | What to do |
| Urine leaking around the catheter | Bladder spasms or straining may cause catheter bypassing | Check that urine is still draining into the bag and seek advice if leakage is significant or drainage reduces |
| Little or no urine in the bag | Tubing may be kinked, trapped or blocked | Check the tubing and bag position; seek prompt advice if drainage does not restart |
| Bladder pain or fullness | The catheter may not be draining properly | Contact your healthcare team promptly |
| Pink or lightly blood-stained urine | Can occur while recently operated tissues heal | Monitor it and follow your surgical team’s fluid advice |
| Heavy bleeding or large clots | May interfere with catheter drainage | Contact your surgical team promptly |
| Severe or persistent bladder spasms | Your bladder may be reacting strongly to the catheter | Ask your healthcare team for advice; treatment may sometimes help |
| Fever, chills or feeling unwell | Could indicate infection | Seek medical advice promptly |
| Catheter falls out | The healing bladder-to-urethra connection may be at risk | Seek urgent specialist advice and do not try to replace it yourself |
Is Blood in the Catheter Bag Normal?
You may notice a small amount of blood or pink-coloured urine in your catheter bag after robotic prostate surgery. This can happen as the catheter and recently operated tissues heal, and it often settles as your recovery progresses.
If you see large blood clots, increasing bright-red bleeding or debris that may block the catheter, you should contact your healthcare team promptly. You can usually help keep urine flowing by drinking the amount of fluid recommended by your surgical team.
What Happens If the Catheter Stops Draining?
If your catheter stops draining, check that the bag is below your bladder and the tubing is not bent, twisted or trapped. You can also gently change position or walk around if you feel well enough, as this may help restore drainage.
If no urine is flowing and you develop bladder pain, fullness or increasing leakage around the catheter, you should seek prompt medical advice. Because your bladder and urethra have recently been reconnected, you should not remove or replace the catheter yourself.
Can the Catheter Cause an Infection?
Yes, having a urinary catheter can increase your risk of a urinary tract infection because bacteria can enter the urinary system more easily. If you have a catheter, good hand hygiene, gentle cleaning and following your care team’s instructions can help reduce the risk.
Contact your GP or surgical team if you develop fever, chills, worsening lower abdominal discomfort, back pain or feel increasingly unwell. Cloudy, blood-stained or strong-smelling urine can occur with a catheter, but these changes alone do not confirm an infection, so your symptoms and clinical assessment are important.
What Happens When the Catheter Is Removed?
When your catheter is ready to come out, the small balloon holding it in place is emptied first. The tube can then be gently removed through your urethra, and you may feel some brief discomfort or an unusual sensation.
After removal, you may be asked to pass urine so your team can check that your bladder is emptying properly. You may also experience some urine leakage at first, so having continence pads ready can be helpful.
Why Do You Leak Urine After Catheter Removal?
Urine leakage after your catheter is removed is common and does not usually mean something has gone wrong. Your prostate has been removed, your bladder has been reconnected to your urethra, and your urinary muscles now need time to adjust.
You may leak when you stand, walk, cough or sneeze, particularly during the first few days or weeks. Your continence should gradually improve, and pelvic-floor exercises can help you regain better bladder control as you recover.
Evidence Note
A study of 230 men undergoing robot-assisted radical prostatectomy found that 90% had their catheter removed on postoperative day 7. A leak from the new bladder-to-urethra connection was seen on the initial cystogram in 3.9% of patients, with leaks more often associated with factors such as previous TURP or bladder-neck reconstruction. Six of the nine men with a leak needed continued catheter drainage, showing why catheter removal may sometimes be delayed while the new connection heals.
After the catheter is removed, pelvic-floor training can help urinary control recover sooner. A 2024 meta-analysis of nine studies involving 1,208 patients found better continence recovery with pelvic-floor exercises at one, three and six months after radical prostatectomy, although the difference was no longer significant at 12 months.
UK Guidance Note
NHS and NICE catheter-care guidance emphasises keeping the drainage system clean, avoiding unnecessary disconnection, keeping the bag below bladder level and seeking medical advice if the catheter becomes blocked or you develop symptoms of infection. Catheters should be removed as soon as they are no longer clinically needed.
You should contact your GP or surgical team if you develop symptoms such as fever, chills, worsening lower abdominal discomfort or feel increasingly unwell. Cloudy or strong-smelling urine can occur with a catheter, but these changes alone do not confirm an infection.
When Should You Contact Your Surgical Team About the Catheter?
You should contact your surgical team if your catheter stops draining, especially if you develop bladder pain, fullness or increasing leakage. You should also seek advice if you notice heavy bleeding, large blood clots, severe bladder spasms or signs of infection such as fever or chills.
If you are unsure whether a change is normal, it is better to contact your healthcare team for advice. Make sure you know who to call outside normal clinic hours, so you can get help quickly if a problem occurs at home.
Myth vs Fact
| Myth | Fact |
| Having a catheter means your bladder has stopped working. | No. Your kidneys and bladder continue to produce and collect urine; the catheter simply provides continuous drainage while the surgical connection heals. |
| Leakage around the catheter always means something has gone wrong. | No. Bladder spasms can cause bypassing, but you should check that urine is still draining into the bag. |
| Blood in the catheter bag always means an emergency. | A small amount of pink or blood-stained urine can occur after surgery, but heavy bleeding, large clots or blockage need prompt assessment. |
| Cloudy urine automatically means you need antibiotics. | No. Catheter-associated UTI is diagnosed from symptoms and clinical assessment; cloudy urine alone does not establish infection. |
| If the catheter comes out, you can simply put it back in. | No. After prostatectomy, accidental catheter removal needs urgent specialist advice because the bladder-to-urethra connection is still healing. |
Key Takeaways
- A catheter temporarily drains urine while the new bladder-to-urethra connection heals after robotic prostatectomy.
- Many UK centres remove the catheter around 7–10 days after surgery, although some patients need it for longer.
- Bladder spasms, some catheter bypassing and small amounts of blood-stained urine can occur, but the catheter should continue draining into the bag.
- A catheter that stops draining, falls out, produces heavy bleeding or is associated with fever, chills or increasing bladder pain needs prompt medical advice.
- Urinary leakage is common after catheter removal and often improves gradually as continence mechanisms recover.
Frequently Asked Questions
1. Why do you need a catheter after robotic prostate surgery?
A catheter drains urine from your bladder while the new connection between your bladder and urethra heals. It helps protect this delicate connection during the early stages of recovery.
2. How long will you need a catheter after prostate surgery?
You will usually need the catheter for around seven to ten days after robotic prostate surgery. In some cases, your surgeon may recommend keeping it for up to two weeks while the connection heals.
3. Will you go home with a catheter after robotic prostate surgery?
Yes, you will often go home with the catheter still in place. Your healthcare team should show you how to empty the drainage bag, care for the catheter and recognise potential problems.
4. Is it normal to have bladder spasms with a catheter?
Yes, bladder spasms can occur because your bladder may react to the catheter or its retaining balloon. You may feel cramping or a sudden urge to urinate even when the catheter is draining normally.
5. Is blood in the catheter bag normal after surgery?
A small amount of blood or pink-coloured urine can occur after robotic prostate surgery. However, heavy bleeding or large blood clots should be reported to your surgical team promptly.
6. What should you do if your catheter stops draining?
Check that the drainage bag is below your bladder and that the tubing is not kinked, twisted or trapped. If urine still does not flow, particularly with bladder pain or fullness, contact your healthcare team promptly.
7. Can a catheter cause a urinary tract infection?
Yes, having a catheter can increase your risk of a urinary tract infection. If you develop fever, chills, worsening discomfort or feel increasingly unwell, seek medical advice. Cloudy or strong-smelling urine alone does not necessarily mean that you have an infection.
8. What happens when the catheter is removed?
The small balloon holding the catheter in place is emptied before the tube is gently removed. You may then be asked to pass urine so your healthcare team can check that your bladder is emptying properly.
9. Is urine leakage normal after catheter removal?
Yes, urine leakage is common after the catheter is removed and does not usually mean something has gone wrong. You may leak when coughing, sneezing, standing or walking while your bladder control recovers.
10. When should you contact your surgical team about your catheter?
Contact your surgical team if the catheter stops draining, you develop severe pain, heavy bleeding, large blood clots or signs of infection. If you are unsure about a symptom, it is safer to seek medical advice.
Final Thoughts: What to Expect With a Catheter After Prostate Surgery
A catheter is an important part of your early recovery after robotic prostate surgery, helping protect the new connection between your bladder and urethra while it heals. Although having a catheter can feel uncomfortable or inconvenient, knowing how to care for it and recognising signs such as poor drainage, heavy bleeding or infection can help you recover more confidently.
If you are considering robotic prostate surgery in London and would like specialist advice, you can contact our team to discuss your options and arrange a consultation tailored to your individual needs.
References:
- European Association of Urology (2026) EAU Guidelines on Prostate Cancer. EAU Guidelines Office, Arnhem, The Netherlands. Available at: https://uroweb.org/guidelines/prostate-cancer
- National Institute for Health and Care Excellence (2018) Urinary tract infection (catheter-associated): antimicrobial prescribing. NICE guideline NG113. Available at: https://www.nice.org.uk/guidance/ng113
- National Institute for Health and Care Excellence (2012, updated 2017) Healthcare-associated infections: prevention and control in primary and community care. Clinical guideline CG139. Available at: https://www.nice.org.uk/guidance/cg139
- University College London Hospitals NHS Foundation Trust (2026) Robotic prostatectomy. Available at: https://www.uclh.nhs.uk/patients-and-visitors/patient-information-pages/robotic-prostatectomy
- Yadav, R., Bansal, S. and Gupta, N.P. (2016) ‘Selective indication for check cystogram before catheter removal following robot assisted radical prostatectomy’, Indian Journal of Urology, 32(2), pp. 120–123. Available at: https://pubmed.ncbi.nlm.nih.gov/27127354/
- Zeng, Y. and Wang, J. (2024) ‘Pelvic floor muscle exercises can effectively improve urinary incontinence after radical prostatectomy: systematic review and meta-analysis based on randomised controlled trials’, Archivos Españoles de Urología, 77(6), pp. 658–665. Available at: https://pubmed.ncbi.nlm.nih.gov/39104234/