Prostate cancer surgery: What can I expect & prepare for?

@justmike74 , there can be a LOT of variables but I think my experience is pretty common...I'm 61

Expect to be very sore after the operation for a couple of days, it goes away fairly quickly. You'll wake up with a foley catheter inserted to relieve yourself. It's a pain in the neck but likely only for about 10-days to two weeks, goes by pretty quickly.

I was in the gym in about 3-4 weeks after the cath was removed, just went to the bathroom about every 20-30 minutes for the first few months. It was about 4 or 5 mos if I recall correctly before I could run and control well.

After that the variables are mostly dependent on amount of cancer that has to be removed and surgical skill. Once the cath was removed I was mostly continent with a little leakage when I tried to exert in any way, pass gas with any forceful assistance, sneezed or even blew my nose sometime. In these instances I'm talking about a few drops. I only wore pads for a couple days and more for a "just in case" insurance as opposed to real need. I was religious about doing the kegel exercises set of 10 at least 3 to 4 times a day. Some here swear by physical therapy to prepare for the surgery, if it had been offered to me, I'd have done it. Maybe ask your care team?

Within a 4 week period that was mostly gone, with odd exception, of passing gas by way of pushing. Mostly have to just let it go on it's own, or be standing over a toilet if possible.

The other biggie is ED, that I have had to deal with for the last 14 mos since the surgery, it is getting a little better and I can have a dry orgasm, but I don't get erect/hard enough for penetration most of the time without chemical assistance, although there have been gains in this regard lately. Apparently it takes a LONG time for nerve tissue to heal if it's going to.

In regard to what @melcanada has suggested, the way I describe the relationship to simplify to people is if prostate cancer was an animal, it eats testosterone and poops PSA. (obviously an oversimplification) So if you stop the testosterone production you can starve it. Not sure if it just slows it / makes it dormant or actually kills it, (that's a discussion I'm going to have with my radiation oncologist at the next visit), but, it can definitely slow the disease progression if you're "castrate sensitive". I'm on a drug for this called Orgovyx. It has it's own side effects which I guess are worth it if it's working. It seems a lot of docs don't prescribe this type of treatment to those getting the surgery, mine didn't.

Ultimately I had chemical recurrence and ended up with radiation as well. I got Salvage Radiation Therapy combined with the drug. It was prescribed by my surgeon but the radiation oncologist told me it only provided better outcomes 3%-5% of the time statistically. I'll take it. I think @kujhawk1978 may have provided some studies with slightly better numbers than this. He's posted some great research results you can look up here.

Knowing what I know now, I think I might have gone on it immediately after diagnosis unless a doc could've told me why I shouldn't. I'm thinking it may shrink / hide cancer making the surgeon's job a little more difficult but have never had that discussion. Maybe discuss this as well?

General health now? The only thing I'm dealing with now is the ED, everything else is almost normal except the waiting around for the next shoe to drop. That's an unfortunate psychological side effect of the disease. The best advice given to me is as soon as you are able, get out and enjoy yourself, keep active and try not to dwell on it.

Best of Luck to you !

I had a radical prostatecomy on Oct 31, so it is been 3 weeks today. They also removed many lymph nodes. It was all done with the daVinci robot. I have 6 entry and 1 exit sites on my abdomen. I spent two nights in the hospital with bad pain only to discover I developed an Inguinal hernia from the robotic surgery. I would trade cancer for a hernia anytime. 12% of patients develope this hernia so it is not unheard of. I wasn't prepared for the incontinence that follows. It might be beneficial to buy some bed pads for your furniture and floors. Also some depends and some liners for small leaks. Some wipes and extra toilet paper come in handy. Be prepared to save stress. I start my incontinence therapy tomorrow the 22nd. They will check my PSA after Christmas to determine what if any treatment is necessary. I never had 1 symptom... no pain or urination problems... even on the day I walked into the hospital for surgery. It was discovered from routine blood work.

@justmike74 , there can be a LOT of variables but I think my experience is pretty common...I'm 61

Expect to be very sore after the operation for a couple of days, it goes away fairly quickly. You'll wake up with a foley catheter inserted to relieve yourself. It's a pain in the neck but likely only for about 10-days to two weeks, goes by pretty quickly.

I was in the gym in about 3-4 weeks after the cath was removed, just went to the bathroom about every 20-30 minutes for the first few months. It was about 4 or 5 mos if I recall correctly before I could run and control well.

After that the variables are mostly dependent on amount of cancer that has to be removed and surgical skill. Once the cath was removed I was mostly continent with a little leakage when I tried to exert in any way, pass gas with any forceful assistance, sneezed or even blew my nose sometime. In these instances I'm talking about a few drops. I only wore pads for a couple days and more for a "just in case" insurance as opposed to real need. I was religious about doing the kegel exercises set of 10 at least 3 to 4 times a day. Some here swear by physical therapy to prepare for the surgery, if it had been offered to me, I'd have done it. Maybe ask your care team?

Within a 4 week period that was mostly gone, with odd exception, of passing gas by way of pushing. Mostly have to just let it go on it's own, or be standing over a toilet if possible.

The other biggie is ED, that I have had to deal with for the last 14 mos since the surgery, it is getting a little better and I can have a dry orgasm, but I don't get erect/hard enough for penetration most of the time without chemical assistance, although there have been gains in this regard lately. Apparently it takes a LONG time for nerve tissue to heal if it's going to.

In regard to what @melcanada has suggested, the way I describe the relationship to simplify to people is if prostate cancer was an animal, it eats testosterone and poops PSA. (obviously an oversimplification) So if you stop the testosterone production you can starve it. Not sure if it just slows it / makes it dormant or actually kills it, (that's a discussion I'm going to have with my radiation oncologist at the next visit), but, it can definitely slow the disease progression if you're "castrate sensitive". I'm on a drug for this called Orgovyx. It has it's own side effects which I guess are worth it if it's working. It seems a lot of docs don't prescribe this type of treatment to those getting the surgery, mine didn't.

Ultimately I had chemical recurrence and ended up with radiation as well. I got Salvage Radiation Therapy combined with the drug. It was prescribed by my surgeon but the radiation oncologist told me it only provided better outcomes 3%-5% of the time statistically. I'll take it. I think @kujhawk1978 may have provided some studies with slightly better numbers than this. He's posted some great research results you can look up here.

Knowing what I know now, I think I might have gone on it immediately after diagnosis unless a doc could've told me why I shouldn't. I'm thinking it may shrink / hide cancer making the surgeon's job a little more difficult but have never had that discussion. Maybe discuss this as well?

General health now? The only thing I'm dealing with now is the ED, everything else is almost normal except the waiting around for the next shoe to drop. That's an unfortunate psychological side effect of the disease. The best advice given to me is as soon as you are able, get out and enjoy yourself, keep active and try not to dwell on it.

Best of Luck to you !