One Week After Prostatectomy

Good luck to you on your journey. I went through salvage PT me in January 2 024. I’ve attached notes that I put together to help other men who have gone through prostatectomy surgery. I hope these notes help you in someway. Reach out if you have any questions.

I'm 70 and had NS RALP at Mayo Phoenix in late June 2024. My recovery experience was a lot like yours; very little pain, hated the catheter, minimal leakage after catheter came out. My surgeon did see me before the surgery, but I haven't seen him since. All my follow up after surgery has been with Mayo staff. However, they've all been great and I've had no issues requiring me to see the surgeon so I don't feel neglected. Also, the surgical report on their portal literally gave me the detailed blow by blow of the operation which was really detailed and specifically stated that no complications were encountered during surgery. Ditto on the pathology report of the prostrate; very detailed. I'm no medical professional, but here's a couple things I'd like to share about my first 3 months so far. First, I strictly followed their order about not lifting more than 10 lbs for 6 weeks and I'd recommend you follow whatever instructions they gave you. For me it was difficult to take it easy as I felt so good, and I literally felt better day by day. After 6 weeks I started back lifting light weights at the gym. I'm not a bicyclist, but when I started using a few of the machines I felt a pain in my perinium when I (carelessly) dropped down on their small bicycle-like seat. That was a surprise, but I've since then I've read from others on this site that area can stay sensitive for a lot longer than the 6 weeks. So be aware of this and be careful. As far as continence, I've been doing really well. I resumed my kegals some time after the catheter came out (I don't really remember exactly when) and while I don't know for sure, I think they help. I did have a few minor accidents during the first 3 months as I figured a few things out. For example, early on I almost had an accident because my flow starts so much quicker than before that I hadn't realized I really need to be ready before I start to relax at the urinal. Also, after I went back to the gym I did have some leakage while working out, especially if I was pushing. That's gotten a lot better as time has gone by. I don't need to wear a pad, but I still sleep with a pad under the sheet "just in case". But every week I feel more confident about that. But even so, I have had a few "surprise" leakage events during the first 3 months. Nothing major, just a very small amount, but there have been a few minor accidents with a little leakage. But I think that's all part of figuring out that things are a bit different. But every month I gain more confidence and control so, practically speaking, I consider myself fully continent even though it's still a bit of a work in progress. The sexual function has been improving much more slowly, but I do think it's getting better. From your post, it sounds like you doing better than me, so I really don't have too much to say. One thing I should probably mention is early on when my wife and I tried to have sex, it was much more likely there'd be some leakage. But as time goes by, that's really improved a lot. Not perfect, but less stressful than before. I guess it makes sense that trying to have sex is one of those times that will stress your ability to control leakage as you're still figuring out the new normal. I really didn't get any initial advice on the sexual aspect from the Mayo care team. I should have asked more questions early on. After 3 months, pretty much most things (other than sexual function) at back to normal. I'm still being careful at the gym on those small seats with my perinium as that's still sensitive. I suspect that'll take quite some time to fully recover. Of course my sexual recovery still has a long way to go, but it makes sense to me that'll take a lot longer and I'm still optimistic. I've very thankful because I was lucky enough to find it early and had the opportunity to go to a recognized cancer center of excellence. Other than the sexual function, practically speaking I'm fully recovered. I feel great, and have resumed all my normal daily activities (eg. the gym, hiking, etc). And even coming up on 4 months, things are still improving and I'm feeling more normal (albeit more slowly) week by week. As I said above I'm not a medical professional but I'm happy to share my experiences on this journey none of chose. Best wishes with your recovery and don't hesitate to ask any questions you may have.

Wait... what? You had surgery last week & you've already got the pathology report?
I had my surgery 3 weeks ago & I don't go in to see the surgeon for results for 6 weeks.

I'm with you on the catheter. Easily the worst part.

Sounds like you're doing great. Just keep on the bike seats for a while. A bit early for that.

Yes.. I got my report 6 days after surgery. Spoke with the doctor the next day. Im bummed about not being able to ride a bike. I usually ride about 12 miles a day.

My doctor advised me to stay off the bike for 6 weeks. 5-1/2 weeks later I tried my stationary “spin” bike with a “male friendly” seat. It hurt; a lot. I tried every week for another 6 weeks. Three months after surgery I was healed enough to ride without pain. In the interim I switched to the recumbent trike that I bought in 2023 after going through a spinal fusion. Some days I ride on 2 wheels and other days on 3 wheels.

Whether it’s on 3 wheels or 3, cycling is fun and a great workout! Good luck on your journey to all that read this.

A couple brief thoughts:

At 3 months post RALP I still had occasional leakeage and could not go more than two hours without using the bathroom. I made some limited progress and at four months post RALP I started eight weeks of pelvic floor therapy. It was covered by Medicare. I don’t have leaks anymore, I can now go up to five hours without having to use the bathroom and I’ve seen positive evidence that erections are improving.

Regarding return of sexual function I’ve re-learned that sex isn’t the cornerstone of intimacy, or the foundation either. Until nerves heal, which might take a while, it’s not just important but actually vital that we men who have gone through prostatectomy sit with, cuddle, gently and show positive non-sexual attention to our partners until the “train gets back on the tracks.” If you wait until the day when you’re good to go again, your relationship might have suffered irreparable harm in the interim.

Don’t wait until it’s too late!

Thanks! I agree completely with both pieces of your advice. I'll redouble my efforts in both those areas. Thanks for sharing.

I had an RALP January of 2023, right lower lung lobectomy on April, 2023 and they had to go back in June of 2023 to fix a chyle leak.

You guys have it easy!

Peter, yes we get the results pretty soon in the US. If memory serves, you are outside the states?

Hey Robert, you may have seen my other post but I bought bicycling underwear to wear in addition to biking shorts and it's made a huge difference.