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What I’ve learned in the 6 weeks since my RARP
This is my attempt to compile what I‘ve learned and tips/tricks to help cope with RARP and its side effects (while it's still fresh). Much of this info comes from these pages, but I thought a compilation might be helpful for those facing the potential of RARP. This is my experience and not intended as advice, and I coud nevere be accused of being a medical professional. I am 64 and had a Gleason of 4+3. I had a non-nerve sparing RARP on December 15, 2025. and this was written on Jan 26th, 2025.
Before Surgery - Talk openly with your spouse about concerns, fears, etc. The talking helps both of you. Go to Pelvic Floor Physical Therapy 2-3 times before your surgery. This is a head start on post-surgery recovery.
Hospital (1 night) - Walk at your earliest opportunity and as frequently as possible. I had to ask the nurses as they did not expect me to walk the day of surgery.
Going Home - I wore gym pants and routed the tube down the pants leg. Some use regular pants and route the tube out of the zipper. I had a 2-hour drive, so I came home wearing the big bag, and I wore a pad in my underwear just in case.
Catheter - it’s not particularly fun, but it’s not as uncomfortable as you think it will be.
Changing / Cleaning the catheter - I used alcohol pads to clean the tubing, connections, and my penis every time I changed bags. I also applied an antibacterial cream with pain relief around my penis to prevent any soreness. I used vinegar and water to clean the bags each time I swapped them out. Don't worry, you'll get the hang of it quickly.
Large bag – I used it when I was home for the day and overnight. Its capacity was sufficient to last all night. I put it in a bucket at the bedside or chair just in case. When up and moving, clip the bag to your pants leg and you can walk around hands free and do something.
Leg bag - In some ways, the leg bag was more convenient. I could go about two hours before it needed to be emptied. I used it when I went out or we had company over. I was initially concerned about bag leaks / spills but never had any. I went on a mild hike or two, and to our day long family Christmas celebration using the leg bag. You can and should get out and do things, life goes on.
Catheter Removal - It's not a big deal, don't worry. Take several depends with you to your appointment. We had lunch and a 2-hour drive home, and I had to change once on the way due to leakage. Don’t worry, it gets much better rather quickly.
Post Catheter
I wore depends exclusively for almost two weeks. I did learn to put a pad inside the depends when I was going to be out. This way, I could discretely take several pads with me and easily change them as needed. I still had the protection of the depends just in case. It was more discreet and much easier changing a pad vs taking everythign off to put on a fresh depends. This was very freeing. Week 2-3, I transitioned to maximum absorption pads. (I always have several spares nearby just in case.) I just recently transitioned to medium absorption pads (week 4-5).
One of my greatest fears was incontinence. I’m not back to full continence, but things are progressing nicely and I am very optimistic. Do your Kegels. My other fear is of course sexual health. I was unable to have the nerve sparing procedure, and I am not far enough down this road to offer any insight. I am doing Kegels, seeing my Pevic PT, and using a pump as suggested. However, hope springs eternal for my wife and I. One thing that surprised me was the effect on my penis length. I'd read about it being shorter due to the surgery, but franky thought it wouldn't be noticeable. I was wrong, For me, it was surprisingly noticable. It is what it is, and is a small price to pay to have the cancer out. However, it is the one thing that I was surprised about.
Lastly, I'll say this. You can do this. It is manageable and it is important to your overall health and wellbeing. Have a longterm perspective and know that things do improve with time. May God bless you on your journey!
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I had to wear a catheter for two weeks. Never Cleaned it. Isn’t really necessary since it was in a closed system.
Four days after surgery, I went to three clients office and worked on their computers. Wore the leg bag when I went, attached to my ankle. None of my clients had any idea I ever had surgery.
Seven days after surgery I went back to work full-time. Just emptied the bag when I went into the bathroom. Didn’t actually needed to empty it more than once during the day.
The trip home from the hospital is definitely not fun.
I also didn’t have nerve sparing. You should get a penis pump I was supplied one by my medical team. Taking Cialis daily can keep blood flowing properly. You probably will need to use bimix or Trimix Injections to get a good erection, but it works for many people in this forum. You can also get an implant which is very successful.
I had no incontinence after surgery, but had a problem starting nine years later.
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4 Reactions@jeffmarc I was told that I didn’t have to change or clean my catheter as well. Wore it for 9 days with no problems. Had zero incontinence issues. BTW, I appreciate your input on many of the subjects on this site. You are one of my “go to commenters” when looking for pertinent information. Thank you Jeff.
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5 Reactions@luger51, and two weeks on how is recovery going? Any new tips?
I’ve chosen to transition to thinner pads pretty quickly. I just always take 1 or 2 spare pads with me ever where I go and keep some in my car as well. Don’t be overly cautious about getting out and going.
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2 ReactionsOne tip on what to wear while the catheter is in:
I learned of tear away pants from another contributor to this forum. They're a kind of sweat pants that connect with velcro strips around the waist and from the cuffs to the waist at intervals. So it's very easy and convienient to position the catheter tube for however it's comfortable for you. About 30 US dollars from Amazon.
Deyeek Men's Tear Away Pants 2 Side Snap Open Bottom Sweatpants Loose Fit Casual Post Surgery Pants with Pockets
I am almost 5 months out from my surgery and I would like to share 2 things relevant to incontinence. Despite doing Kegel exercises on my own and then with professional help, I was going through 4 diapers a day for awhile, with it getting worse as the day progressed.
1. Get professional help from a pelvic floor PT expert and line it up before your surgery if possible. My surgeon didn't recommend it until a month post- surgery and then it took almost a month to get an appointment. My physical therapist told me the first 2 months after catheter removal are when the most significant progress can be made (I haven't confirmed this). So, I missed that window.
2. Relatively early on, she told me to switch to pads from diapers, on the theory that I will be more aware of what's going on and will be more motivated to focus on doing kegels during movements that would ordinarily trigger a leak. I initially refused, fearing a flood if I used pads. Recently, however, I made the switch and it has been a huge improvement. I was making good progress before the switch (which was why I agreed to it), so I don't know if the big leak reduction would have occurred anyway, but now I do whatever she tells me to do!
@quaddick
I never had a problem wearing black jeans attaching the bag to my calf and pulling them up. Never had a problem emptying the bag in a restroom. Didn’t need pants like that though it does sound convenient,
I should have mentioned that I only wore them around the house, and only while the catheter was in. I left the house only twice for doctor appointments. Then, I did wear the leg bag and regular pants with no problems. I wanted to go for short walks, but the high temps were in the single digits below and above zero and I was afraid of freezing my bag. LOL
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1 Reaction"Outstanding" post...Well done! One thing I would like to offer to you and everyone else is as follows:
I too put a "pad" inside my Depends diaper for the same "quick change" situations. Diapers would have been more of a hassle removing shoes, pants, etc. But..."BUT"...my "brilliant idea" of wearing that pad inside the diaper created a new problem that I was not aware of until I ran out of pads one day: I was going through lots of pads everyday, all to keep things convenient. When I ran out of pads, I had a two day wait before Amazon delivered more. I "INSTANTLY" improved. I went from 6-8 pads per day, to a temporary 2-3 diapers per day those two days waiting for the pads.
I had already noted the bit of discomfort (fullness of space being occupied) having a pad, especially a urine-soaked pad in my Depends diaper. What I realized is that Depends diapers are not designed to accommodate a Depends "pad". While it fits down there, it is occupying tight space. What my pad was doing was, it was pushing upward on my perineum which caused "more" bladder leakage. The compressed perineum, compressed my bladder, forcing it to void urine out and into the pad. I was causing my own perceived lack of regaining continence! So, I instantly went back to wearing diapers only. It was like night and day. I had previously used 6-8 "diapers" per day, then the same 6-8 "pads" in the one diaper per day, then to 2-3 diapers max per day, without the pad. I had unnecessarily extended my incontinence at least a month or two by thinking I was brilliant to insert the pads in the diaper. I was actually still progressing in regaining my continence, despite me prolonging my feelings of unresolved incontinence by wearing those pads. So...long story short...anyone wearing pads in diapers should "test themselves" once a week for several weeks in a row, by wearing only a diaper, to see if in fact you can stop using the pads as you slowly regain your continence. It was the miracle that I was looking for...I regained at least 75% of my continence by eliminating the pad in the diaper. That was about 3-4 months into my post-op recovery. I am now ~95-98% continent...just little leaks and squirts with certain motions. I only wear a thin "Shield" in my underwear now. I barely make a nickel to quart-sized spot twice a day. Since the day my catheter came out, I fortunately never have had incontinence at night. It is a "gravity" thing. Laying horizontal in bed eases gravity and pressure on my bladder, so I slept rough the night within a week after my catheter was removed. I am now 10 months post-op (April 2025). Hope this helps.
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