Aggressive Bicycle Riding After Radical Prostatectomy

@cxracer -- you probably already know, but I'd be remiss not to mention to you to be sure to discuss penile rehab with your care team. Lots of info on this site, including in my past comments. Best wishes.

@cxracer You are too new. After you've been a member for a while, you can add pictures. There will be a line below the message text box that allows you to do that.

You will be able to find online info on competitive master level triathletes that returned to competition post prostatectomy. At least one of them use to participate on this forum and had advised another patient triathlete, so may see and respond to you post.

If you search for the combination of prostatectomy + triathlete, you should be able to find at least the three that I am most familiar with. All used some of the information already posted (modified racing seat, physio trainer specialized in pelvic floor muscle reconditioning, etc. I personally waited 12 weeks for higher mileage / longer term rides, but many of the competitive athletes were ramping bike miles much sooner.

I was back on my mountain bike in 5 weeks. I ride flowy technical trails with jumps and gravity ride as well.

@retireditguy Absolutely! I'll be all over this.

This is me by the way. Bottom right corner. (I just gained ability to post pics!)

I was able to get back on the bike about 6 weeks after RARP. I did suffer some incontinence getting off the bike. To address this, I found pelvic floor PT helpful. Also, at the end of the ride, standing in the pedals and coasting helped me gather myself before getting off the bike. If all else fails, make sure you’re wearing black bibs. The rides were a bit painful at first, so I went for shorter, non-aggressive rides and didn’t ride every day. As well as the seat recommendations that others have made, I’d suggest you look into a Redshift shock-absorbing seatpost to cushion bumps.

I returned to light training on the bike 12 weeks after RP. Initially, there was some soreness in the perineum, as well as some increased incontinence post-ride. The MTB was more comfortable than my gravel bike, for obvious reasons. Standing on the pedals every few miles helped with both conditions. My saddles were already pelvic friendly, so no change there. Winter weather and closed trails have slowed my mileage increases, however I’ve pretty much fully returned to all my sports after 4 months.

At age 74 I had an RARP. I was/am a life-long cyclist in all varieties, including road racing, triathlon (Ironman), MTB racing (Xterra triathlons). Before the surgery I researched return to cycling, and found suggestions ranging from 5 to 12 weeks.

I am also a retired surgeon on the female reproductive tract (including bladder and urethra work). I talked to my surgeon and his mentor at the Fred Hutch/UW in Seattle. Both advised 12 weeks. I followed their advice and returned to my usual cycling routine and racing without difficulty (except for the agony of the time off the bike.)

My own thought is this: do not follow the advice of anyone except the surgeon who actually performed your work, after he has done your surgery. Only that person knows precisely what was done to your plumbing and what the risks might be. Remember that the urethra is cut out and re-attached and the area where that is done is just inside your perineum, where you sit on a saddle (the lower down your position, i.e., the more aero you are, the more pressure there). IMO, it was worth an extra 5-6 weeks of down time to ensure I had the least potential for something going wrong which would upset my ability to pee properly and might require further rehab or even surgery. Be patient and let your body do its work healing, and you'll be rewarded with decades more two-wheeling fun.

@trusam1 12 weeks it is, or whatever my surgeon suggests. Thank you for this extremely insightful info. I am dreading the surgery and possible / probable side effects, like I've never dreaded anything before in my life. Part of me literally wants to not take any action, and to allow this to play out on its own.