Cycling after radical prostatectomy (RP)? Increase risk of recurrence?

Posted by mckboh @mckboh1, Aug 18, 2022

It is now over 4 months since my operation.

Anyone have any guidelines on returning to cycling.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

@dcdixon

The surgeon that did my prostatectomy is also a cyclist and recommend a specialized power saddle (any version). I have not yet had a chance to do any serious riding, so the jury is still out.

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Thank you!

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@jonbuuck

Would you share what brand of a saddle seat you purchased? I bought one and it is quite uncomfortable. Thanks.

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Terry Liberator saddle, bike shorts, and chamois butter are helpful.

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@ctpaul

Question: If the entire prostate has been removed, why are some people worried about riding a bike? I simply do not understand...

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Prolonging incontinence and ED ...

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@bcarr

Prolonging incontinence and ED ...

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Might it also be related to the removal of the part of the urethra which is with in the prostate? The urethra must then be sewn back together ("re-anastomosed"). That portion of the urethra is quite close to the skin surface of the "taint", or perineum, between the anus and the base of the penis. My surgeon said he was concerned about disrupting that particular part of the surgical repair.

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@maxvt

When I was cycling 100+ miles per weekend, about 12 years ago, I found the comfort came in a combination of your rear, the saddle and the cycling shorts. The shorts ($80) I bought at REI, as they will take anything back if not a good fit, said their cycling expert. The brand I cannot recall, but I think the logo was a crown within a circle. My cycling shop recommended a $60 saddle, but the fellow said save the packaging and go for about 4 20+ mile rides and bring it back if it is not comfortable. It took a little time but with the help of REI and the cycle shop in Houston, I was riding comfortably. I searched a couple of websites, but cannot find what may be the brand of cycle shorts I used, though they did have the "gel pack" for comfort. Good luck and happy cycling.

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That would be "Canari" or as stylized "canari" brand cycling shorts. REI stocked that brand 12 years ago. Actually I had a pair of canari gel shorts that I wore out over the years :-). Gel does not seem so popular now. There are now many seats like the "power" series from specialized, but they're some of the best for male anatomy, I think. Women have less good options, but that does not concern us at the moment....

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Hello,
I’ve posted a few answers preciously. If you search for them, they may be helpful.

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For those of you interested in exercise and prostate cancer, you'll be interested in this month's guest speaker at the monthly support group meeting on May 10 at 12pm CT.

Dr. Edward Laskowski, a sports medicine physician at Mayo, has been a team physician for the USA Olympics team and has been on the USA President’s Council for Fitness. Dr. Laskowski is an advocate for exercise as medicine and has given a multitude of lectures across the globe about the topic. He will be sharing his recommendations for exercise for prostate cancer patients.

How to join in-person or online: https://connect.mayoclinic.org/event/prostate-cancer-support-group-6/

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@colleenyoung

For those of you interested in exercise and prostate cancer, you'll be interested in this month's guest speaker at the monthly support group meeting on May 10 at 12pm CT.

Dr. Edward Laskowski, a sports medicine physician at Mayo, has been a team physician for the USA Olympics team and has been on the USA President’s Council for Fitness. Dr. Laskowski is an advocate for exercise as medicine and has given a multitude of lectures across the globe about the topic. He will be sharing his recommendations for exercise for prostate cancer patients.

How to join in-person or online: https://connect.mayoclinic.org/event/prostate-cancer-support-group-6/

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Will that be available online after the event?

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@spino

Will that be available online after the event?

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@spino, these meetings are not recorded.

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Reporting in on my experience returning to cycling.

Prior to surgery 14 weeks ago, cycling was one of my passions as a 74 y/o. I'd done it all - mountain biking, multi-day trips, including across the USA, down the west coast, through mountains of BC, OR, WA, tandem riding with my wife and kids, commuting 20 miles round trip, and twenty + years of triathlons, including 35 Ironman races. So potentially losing it was probably as big a deal to me as penile dysfunction.

All the surgeons I consulted (3) said "no cycling for at least 3 months" after the RALP. The risk: the urethra needs to be sewn back together, and the perineum (between the scrotum and the anus) is where that repair is. It needs time to heal to prevent scarring up and causing problems.

For the past twenty years, all of my bike seats have had center cut-outs, useful to prevent numbness and infertility. The perineum has minimal pressure on it while riding as a result. The weight is carried on the "sit bones", the ischial tuberosities. Still, I was leery of getting back on, worried about pain. I started with 15 minutes indoors, on a bike trainer. Next day, 45 minutes, then one hour 15 minutes outside, and then a 45 minute ride indoors, working harder. After this first week, I felt ready to go out riding with my weekly group, who tackle the mountains here in Washington. First ride: two hours up Mt. Rainier. Still no pain (except on those sit bones.) I was gruesomely tired, but did not have any soreness in my legs or pelvis.

I'm now starting my third week back, going a little harder each ride. Second mountain ride was 2 hours 40 minutes, aiming for a bit more each week.

I'm a retired surgeon myself, and I knew better than to second guess the guy who was re-arranging my innards. I tried not to think about riding during the hiatus. Luckily, being a triathlete, I could still swim and run, so exercise was not a problem. My message to any serious cyclists who find this thread: not cycling for 3 months is a significant side effect of the RALP. But given the proper equipment - a saddle which puts no pressure on the perineum - you should be able to get back out on the road. So far, I'm able to ride in the drops for minutes at a time, and on the trainer as well. I have yet to try my new pelvis off-road, which might be a bit more demanding, I want to get most of my fitness back before then. Right now, I'd say I'm at 65-70% or my pre-surgery level.

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