Anyone experience pain, discomfort, tenderness along perineum post-RP?

when I started I did so many kegels that I could not sit. I had that muscle so sore I thought I might have damaged something. I backed off the kegels and it started to ease up.

I had pain in the perineum for about 4-5 mos. I went back to the gym as soon as I got the green light from the doc and found that anytime I sat on a tapered bench it caused pain, sometimes it was also like pushing a "leak" button. When sitting on something contoured that described above I kind of side saddled it putting the weight on one glute or the other. Obviously that's not going to help much with a bike seat..

It simply got better over time. I think around 9 mos it was mostly gone. Patience is your friend here. You have to get used to the new you!

I had occasional perineal pain for most of the first year after my prostatectomy. I also developed a reoccurrence of an inguinal hernia, so some of the pain may have been related to the hernia. Time and hernia surgery have eliminated that pain, but I still occasionally get muscle spasms if I overdo it with my Kegel exercises.

There are hints of inguinal hernia-like pain. I had a lapro-inguinal hernia surgery 11 years prior to RP. It was a slight "complicating factor" in my RP surgery (because the "mesh" they used in hernia surgery made access to prostate and related areas more challenging). That pain is in a different area - but very interesting to hear of your experience. Thank you!

I had the single-incision DaVinci robotic radical prostatectomy in mid-April 2025. Catheter came out April 29th. My incontinence has been exasperating and frustrating. I sleep well at night, except I do get up once to urinate which I do not understand. Without a prostate to exacerbate urinary problems, I am very disappointed that I have to get up at night. Right now my incontinence really accelerates after breakfast. By 10:00 - 11:00 a.m., I have gone through a second pad inside my diaper. The presence of the pad increases discomfort in the genital and perineum area (crowded inside that diaper). I also need Tylenol at 09:00 a.m. because I start to feel a strong, rather heavy level of increasing perineum pain by 9:00 a.m. I switch to Mortrin at ~1:00 - 2:00 p.m. because the Tylenol doesn't help very long. Then by 6:00 - 7:00 p.m., I need the Tylenol again. I have done my Kegel exercises, but having no prior experience, I don't know if I am doing enough, too many, or not enough. All I know is that they do not work, and that I am in pain. I have resorted to hourly visits to the bathroom that sees me urinate a very good volume. It is exasperating that within 5-10 minutes after using the bathroom, and replacing a wet diaper and/or pad, I leak again. The biggest source of leaking is when I have been sitting down (chair, couch, car seat, etc.), and then I stand up. There is apparently a release of pressure down there, and like a flood gate opening, it just starts flowing out of me. I try to use a Kegel move on it to halt it, but as soon as I release the Kegel move, it resumes. I carry 2-3 pads in my car if I am out on errands because when I park my car, and stand to exit the car, I flood my pad. I just stand there, let it happen, then get back in the car, pull the wet pad out, and insert a new, clean, dry pad. I can't stand walking around in a store with a completely soaked pad or diaper. I find myself parking in distant places to make sure I have the privacy for the quick change of pads without being seen. I have been having thoughts of my dad who, like a lot of men, had prostate cancer and never did a thing about it. My dad lived with it for more than 20 years and died at age 99 years. My maternal grandfather had prostate cancer in the 1970's - 1980's. He had injections straight into the prostate (ouch!), and lived to age 96 without having had the surgery. I am now regretting that I ever had the surgery. I have no genetic predisposition (genetic testing), and my Gleeson Score was 3+4 = 7 and a PSA of 6.2. Pathology report did say that there were surgical margins and slight invasion into my left seminal vesicle, so I am classified a pT3b which means that I have a likelihood of the cancer returning. My doctor says we need to talk about radiation. That will happen in my 3-month, post-catheter removal follow-up in July. Anyone have any ideas on resolving the perineum and deep penis paid? And how many Kegel exercises do you do...how many is "enough"?

I can certainly empathize with your situation. I am 50 years old with a pT3b but with Gleason 9. I will also be having follow up radiation sometime soon. My RALP was 2 weeks ago 5/22. I have similar incontinence issues and I hope they get better over the coming months. The perineum pain when I sit down is also bothersome but I’m hoping that too will resolve over the next few months. I am also doing Kagels but I may ask doctor if I should be referred to a physical therapist. I have heard it helps.
I hope things get better for you.

Nice to hear from you John. I forgot to mention that I too have requested a referral to a Pelvic Floor Physical Therapist ("PFPT"). I should receive notice of the approved referral within days...surprised that I haven't received it already. I never knew they existed, but thank goodness they do. They have a 92% success rate. It is hard to comprehend how the prostate - the size of a walnut - when removed, can cause such disruption to your pelvic floor muscles. I envisioned logically - or not - that because the prostate sits immediately below the bladder, that the bladder must "sag" when the prostate is no longer there. I'm just fed up with all of this.

Same! And when I think about how they had to reconnect urethra to bladder neck it make me want to vomit.

One thing I was not happy about, amongst many, is that my physician never said that by removing the prostate, you lose two of your three urinary sphincters that control your continence. The one that remains is the weakest of the three, thus the need for Kegel exercises that include strengthening that one remaining sphincter in the hope you’ll regain control/continence.
I’m only about 39 days into the 60-90 days of post-catheter removal where we use Kegel’s to hope to be one of the 66% of men who regain continence in that period. I just don’t want to be one of the remaining 34% who can take 6 months to a year before or if they regain it. I am unexpectedly hemorrhaging $$ buying diapers and pads. I have forms sent by my health plan to have them reimburse me for those products through Medicare. Hopefully I will get all that money back.

I had similar numbers and Gleason 7 (3+4) when I elected RP. I recovered from incontinence in 2 months however experienced urethral pain for 3 years after. This went mis diagnosed or dismissed by several doctors until it finally resolved itself gradually after 3 years. As many others have reported life has changed in regards to sensation and how I live day to day but my psa is still testing undetectable. I am thinking my post RP pain problems must have been due to nerve trauma and took a lot longer to heal than expected. I had 2 cystoscopies over that period of time which did not help but determined that any scarring was not enough to require more invasive treatments.
The perineum pain was never as severe as the urinary tract pain.
Best wishes to you.
Brice