I also am very active and amped up my workouts considerably beforehand just to be as ready for recovery as possible. But, to that end, I hired (re-hired) my personal trainer to incorporate pelvic floor engagement into what I do, I think this made a world of difference. It's like Kegel on steroids. By the end my pelvic floor therapist (yet another pre-surgical professional I saw regularly) said I had the healthiest male pelvic floor she'd worked with.
Lack of ED is also a bit of luck. If you keep your nerves then you have a fighting chance.
I did have a catheter for 7 days, and had an erection the same day as surgery, so that was very encouraging - if not uncomfortable. Once it came out I was prepared for some level of incontinence for a few weeks, if not certainly that day - and wore depends to be safe. Not a single drip, still to this day.
Radiation can still fry your nerve bundles, although they try to prevent that if they can. Radiation can also fry your bowels, leading to bowel incontinence, which they also try to avoid, but to me that was the main deal breaker. I already wasn't prepared to live in diapers for bladder incontinence but adding bowel to it sealed the deal.
Remember that radiation is always available to you post RARP. Surgery after radiation is called salvage surgery where they essentially scrape the goo that used to be your prostate out. There are focal therapies but none of my doctors believed they would benefit me more than RARP. Get it out and know what's going on was the prevailing recommendation.
So, for me, the only side effect is dry orgasms - which take a bit to get used to, but still have the same sensations as before.
And, if this comes back, I still have radiation and ADT and other options open to me. I hope it doesn't but cancer is cancer and no matter what treatment you get you cannot guarantee it won't return.
My Gleason was the same as yours - mostly 3 + 3 with one core 3 + 4, but only 5% of that. I would be on active surveillance due to this if not for my Decipher score showing 0.68, high risk, so I (and all I consulted with) recommended removal instead. By the way, this was totally accurate, my cancer was far worse than the biopsies and MRI's showed and all my scores, including my cancer stage, were upgraded after the prostate pathology came back. This re-affirms that I did the right thing, had I left it I may have lost my nerve bundles and a lot more.
Recovery is pretty fast, really. Within a couple days you are up and about, even with the catheter. You have lifting restrictions for 6 weeks, but it's easy to deal with. Perineal pain is real, so get a cushion designed to relieve the stress on it when you sit on a hard chair - I only had problems when I sat in my office chair, my recliner was just fine. Even with that, I only used that cushion for about a week and was able to sit all day in my office with no problem.
I'm happy to go into detail about my experience if you want to message me me on here, I hate to hijack your thread with good news - I've experienced a bit of blow back on here from folks who are still struggling greatly and don't want to read about folks who came out unscathed.
I can tell you that finding people to talk to that came out OK is hard - I searched everywhere, so I'm here if you need me!
@survivor5280 Thank you, survivor5280, for your valuable input!
I have been on Active Surveillance for two and a half years, and now it's definitely time to get this thing out of my body. The last biopsy was enough to show me that I have truly inherited this disease from my poor father, who died a painful death years ago. Poor guy didn't have the technology at that time.
I am having RARP on Feb. 4, and have been doing my pre-op Physical Therapy for a week to build up the Pelvic Floor muscles. I appreciate the positive attitude from you, as mine has been the same. I will continue to work it, just like other surgeries I've had in the past.
@survivor5280 Thank you, survivor5280, for your valuable input!
I have been on Active Surveillance for two and a half years, and now it's definitely time to get this thing out of my body. The last biopsy was enough to show me that I have truly inherited this disease from my poor father, who died a painful death years ago. Poor guy didn't have the technology at that time.
I am having RARP on Feb. 4, and have been doing my pre-op Physical Therapy for a week to build up the Pelvic Floor muscles. I appreciate the positive attitude from you, as mine has been the same. I will continue to work it, just like other surgeries I've had in the past.
@scottfish
Hang in there
I am just about a year post RARP. It has been a difficult recovery, much of which I did not expect. However, in the end I would go through it all again to have a good shot at longevity and keeping cancer at bay.
Sometimes we have to do our best at getting ready and then just let things take their own course
@scottfish
Hang in there
I am just about a year post RARP. It has been a difficult recovery, much of which I did not expect. However, in the end I would go through it all again to have a good shot at longevity and keeping cancer at bay.
Sometimes we have to do our best at getting ready and then just let things take their own course
The bottom line is - like my own physician said when I asked about Active Surveillance, surgery, or radiation - "YOU HAVE PROSTATE CANCER...IT IS NOT GOING TO 'GO AWAY' OR 'HEAL ITSELF', SO WHY GIVE IT TWO YEARS TO GET FAR WORSE WITH ACTIVE SURVEILLANCE?" He then declared rather emphatically: "I AM TAKING YOUR PROSTATE." I had no choice...I was going to have a radical prostatectomy. He also said that he never ever does radiation "first" and then radical prostatectomy after radiation, because radiation fries and scars your prostate, turning it into a walnut sized chunk of concrete that is nearly impossible to surgically remove if the cancer somehow comes back after radiation. It seems to recur enough after radiation, that for most physicians, they always do radical prostatectomy, and then wait to see if/when the cancer might return. Only then would they move to radiation therapy. I hope that helps.
I had a prostatectomy in October 2025. I hade to side effects I have but I’d do it again! I’m hoping in time my side effect with improve but now I’m cancer free!
In February I will be marking my third anniversary of RALP surgery, my second anniversary of inguinal hernia repair, and my first anniversary of having a Boston Scientific Male Urinary sling implanted, all thanks to Prostate cancer. While my PSA has remained at very low levels, I obviously have had some negative side effects too. My RALP surgeon denied causing the hernia, but if you research on this site, you will find many men got a hernia after their surgeries too. The sling was to remedy stress incontinence, and it has worked well so far. The last two side effects are a shorter penis and impotence. When they reconnect after removing your prostate-size length of urethra, the doctor has two choices; pull the penis towards the bladder or vice versa. I think my shorter length is a compromise of those two. As for the impotence, my nerve sparing surgery didn't spare the nerves and now any erections are self-induced with my VED or Trimix shots. Orgasms are dry and very challenging to achieve. Mentally, I am happy with being cancer free (so far) but the rest of it does take its toll.
I had surgery a little over two years ago. Surgery went fine and I had ZERO incontinence(many Kegels before and after surgery). Sex is not an issue because of a condition my wife has had for years(talk about suffering! Lol). One thing that happened was my post RP pathology report came back with a higher Gleason score than was indicated from my biopsy(something to consider?). My PSA has been < 0.01 since; with my next test in April🤞🙏. Hope this helps. Good luck whatever you decide!
I keep seeing this same question. While others may have been told different things by their urologist, "my" urologist was quite adamant: you never want radiation "first" because the radiation turns your prostate into a walnut sized chunk of concrete that would be extremely difficult to remove if that had to occur after the fact. My urologist said he "always" does the DaVinci robotic -assisted Radical Prostatectomy 'first", and "if" and "only if" the patient needs radiation later on because the cancer returns, would he recommend radiation. And actually, you don't want traditional radiation therapy. Go to a facility that can do Proton Beam Radiation. Proton Beam method has far less side effects and consequences. The proton beam is directed at the prostate bed (or wherever), and the proton beam "stops" at that location...it does not continue through and onto other healthy tissue. Traditional radiation just fries everything. While it can be reasonably focused, it goes to and through the intended area. That is why radiation fries your urethra (life long incontinence), your bladder, and even your rectum. There is a low probability or "chance" of radiation causing bladder and/or rectal cancer later on, but it does exist. That is a bad deal. Proton Beam therapy does not do that. I am personally just into 10 months post-op with three regular PSA values of < 0.1ng/ml and one Ultra-sensitive PSA of 0.006 ng/ml. The radiation oncologist to whom I was referred said I am not yet a candidate for radiation of any kind...perhaps never. He wants a second Ultra-sensitive PSA in April to see if it still nice and low, or might show the start of Biochemical Recurrence (BCR). Good luck to you. Keep us posted.
I had surgery a little over two years ago. Surgery went fine and I had ZERO incontinence(many Kegels before and after surgery). Sex is not an issue because of a condition my wife has had for years(talk about suffering! Lol). One thing that happened was my post RP pathology report came back with a higher Gleason score than was indicated from my biopsy(something to consider?). My PSA has been < 0.01 since; with my next test in April🤞🙏. Hope this helps. Good luck whatever you decide!
@kjacko thanks for posting! Your post caught my attention as I am also a vet of PP! I too lost my ability to have an erect ion however, my wife and I had an active sex life up to and including the night before the surgery! It has been 3 months now. We have had romantic moments but of course my penis doesn’t function. Am I wrong to worry about how this sudden loss of sexual intimacy will affect our marriage? We have always had a monogamous relationship but now I wonder with my situation if I am being selfish? Do thoughts such as this ever come up after a RP?
@kjacko thanks for posting! Your post caught my attention as I am also a vet of PP! I too lost my ability to have an erect ion however, my wife and I had an active sex life up to and including the night before the surgery! It has been 3 months now. We have had romantic moments but of course my penis doesn’t function. Am I wrong to worry about how this sudden loss of sexual intimacy will affect our marriage? We have always had a monogamous relationship but now I wonder with my situation if I am being selfish? Do thoughts such as this ever come up after a RP?
@billybwbf2 I’m in a completely different situation. My wife has a “condition” which made a regular sex life impossible for 25 years. At first I was angry, but realized it wasn’t her fault, just as my BPH, PC and RP are not my fault. This really puts to the test, “ through sickness and in health” the vow we took. But we’ve made it together. Best of luck.
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@survivor5280 Thank you, survivor5280, for your valuable input!
I have been on Active Surveillance for two and a half years, and now it's definitely time to get this thing out of my body. The last biopsy was enough to show me that I have truly inherited this disease from my poor father, who died a painful death years ago. Poor guy didn't have the technology at that time.
I am having RARP on Feb. 4, and have been doing my pre-op Physical Therapy for a week to build up the Pelvic Floor muscles. I appreciate the positive attitude from you, as mine has been the same. I will continue to work it, just like other surgeries I've had in the past.
Again, thanks for your story!
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4 Reactions@scottfish
Hang in there
I am just about a year post RARP. It has been a difficult recovery, much of which I did not expect. However, in the end I would go through it all again to have a good shot at longevity and keeping cancer at bay.
Sometimes we have to do our best at getting ready and then just let things take their own course
I really wish you the best.
Ed
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6 Reactions@edinmaryland
Thank you, Ed, I appreciate it!
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1 ReactionThe bottom line is - like my own physician said when I asked about Active Surveillance, surgery, or radiation - "YOU HAVE PROSTATE CANCER...IT IS NOT GOING TO 'GO AWAY' OR 'HEAL ITSELF', SO WHY GIVE IT TWO YEARS TO GET FAR WORSE WITH ACTIVE SURVEILLANCE?" He then declared rather emphatically: "I AM TAKING YOUR PROSTATE." I had no choice...I was going to have a radical prostatectomy. He also said that he never ever does radiation "first" and then radical prostatectomy after radiation, because radiation fries and scars your prostate, turning it into a walnut sized chunk of concrete that is nearly impossible to surgically remove if the cancer somehow comes back after radiation. It seems to recur enough after radiation, that for most physicians, they always do radical prostatectomy, and then wait to see if/when the cancer might return. Only then would they move to radiation therapy. I hope that helps.
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4 ReactionsI had a prostatectomy in October 2025. I hade to side effects I have but I’d do it again! I’m hoping in time my side effect with improve but now I’m cancer free!
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5 ReactionsIn February I will be marking my third anniversary of RALP surgery, my second anniversary of inguinal hernia repair, and my first anniversary of having a Boston Scientific Male Urinary sling implanted, all thanks to Prostate cancer. While my PSA has remained at very low levels, I obviously have had some negative side effects too. My RALP surgeon denied causing the hernia, but if you research on this site, you will find many men got a hernia after their surgeries too. The sling was to remedy stress incontinence, and it has worked well so far. The last two side effects are a shorter penis and impotence. When they reconnect after removing your prostate-size length of urethra, the doctor has two choices; pull the penis towards the bladder or vice versa. I think my shorter length is a compromise of those two. As for the impotence, my nerve sparing surgery didn't spare the nerves and now any erections are self-induced with my VED or Trimix shots. Orgasms are dry and very challenging to achieve. Mentally, I am happy with being cancer free (so far) but the rest of it does take its toll.
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Like -
Helpful -
Hug
3 ReactionsI had surgery a little over two years ago. Surgery went fine and I had ZERO incontinence(many Kegels before and after surgery). Sex is not an issue because of a condition my wife has had for years(talk about suffering! Lol). One thing that happened was my post RP pathology report came back with a higher Gleason score than was indicated from my biopsy(something to consider?). My PSA has been < 0.01 since; with my next test in April🤞🙏. Hope this helps. Good luck whatever you decide!
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Like -
Helpful -
Hug
3 ReactionsI keep seeing this same question. While others may have been told different things by their urologist, "my" urologist was quite adamant: you never want radiation "first" because the radiation turns your prostate into a walnut sized chunk of concrete that would be extremely difficult to remove if that had to occur after the fact. My urologist said he "always" does the DaVinci robotic -assisted Radical Prostatectomy 'first", and "if" and "only if" the patient needs radiation later on because the cancer returns, would he recommend radiation. And actually, you don't want traditional radiation therapy. Go to a facility that can do Proton Beam Radiation. Proton Beam method has far less side effects and consequences. The proton beam is directed at the prostate bed (or wherever), and the proton beam "stops" at that location...it does not continue through and onto other healthy tissue. Traditional radiation just fries everything. While it can be reasonably focused, it goes to and through the intended area. That is why radiation fries your urethra (life long incontinence), your bladder, and even your rectum. There is a low probability or "chance" of radiation causing bladder and/or rectal cancer later on, but it does exist. That is a bad deal. Proton Beam therapy does not do that. I am personally just into 10 months post-op with three regular PSA values of < 0.1ng/ml and one Ultra-sensitive PSA of 0.006 ng/ml. The radiation oncologist to whom I was referred said I am not yet a candidate for radiation of any kind...perhaps never. He wants a second Ultra-sensitive PSA in April to see if it still nice and low, or might show the start of Biochemical Recurrence (BCR). Good luck to you. Keep us posted.
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3 Reactions@kjacko thanks for posting! Your post caught my attention as I am also a vet of PP! I too lost my ability to have an erect ion however, my wife and I had an active sex life up to and including the night before the surgery! It has been 3 months now. We have had romantic moments but of course my penis doesn’t function. Am I wrong to worry about how this sudden loss of sexual intimacy will affect our marriage? We have always had a monogamous relationship but now I wonder with my situation if I am being selfish? Do thoughts such as this ever come up after a RP?
@billybwbf2 I’m in a completely different situation. My wife has a “condition” which made a regular sex life impossible for 25 years. At first I was angry, but realized it wasn’t her fault, just as my BPH, PC and RP are not my fault. This really puts to the test, “ through sickness and in health” the vow we took. But we’ve made it together. Best of luck.
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