RARP Scheduled After Transperineal Biopsy

I was 70 last year when I had RARP. You can click on my name and see my past comments as this topic has come up before. Also, I'm not a medical professional so this is just my layman opinion of what was helpful for me:
1-- I strictly followed my care teams instructions (diet, walking, meds, catheter hygiene, etc) and that, coupled with a great surgeon, is why I think I had an easy recovery. In fact, the temptation was that I felt so good so quickly (after the catheter came out) that I had to consciously remember not to over exert, but rather wait and give my body time to heal.
2 -- my care team recommended a non-stimulative stool softener (such as Colace). I looked up the active ingredient and got a similar product at Costco. Then I tried it about 10 days before surgery so I knew how it affected me (as I didn't want to try it for the first time after surgery). I don't recall their exact instructions, but I religiously followed their instructions for diet and using a non-stimulative stool softener and never had any constipation after surgery.
3 -- I strictly followed my care teams directions for using the OTC meds (they had me alternate acetaminophen and ibuprofen) and my pain never got to the point that I needed any of my opioid pain prescription we had on hand.
4 -- I sat around a lot with my feet up, so I tended to use the bigger night bag rather than an ankle bag since the bag needs to be lower than the bladder. Because of that, I found cheap velcro breakaway pants on Amazon that made dealing with the tubing easier than if I have regular pants and an ankle bag.
5 -- Cheap plastic bucket for holding the night bag on the floor.
6 -- I used pads in my underwear with the catheter which was useful for catching the odd fluids escaping past the catheter.
7 -- I used a disposable absorbent pad on the bed and that was useful one night when I turned over in my sleep and the catheter tubing pulling apart. Instead of a big mess, I just swapped out the pad.
8 -- I found the OTC antibiotic ointment my care team recommended for where the tubing exited the penis to be helpful to reduce the soreness from the catheter. But the week of the catheter was unpleasant, but manageable.
9 -- I don't remember exactly, but I think my care team told me that after the catheter came out I couldn't lift more than 10 lbs for 6 or 8 weeks. So if there's any heavy chores around the house (eg. filling the water softner salt, yard work, etc) do it before you get the surgery because you'll have to take it easy for at least 2 months after the surgery.
10 -- I used an elastic band for holding the catheter tubing on my leg. If you use an elastic one keep an eye on it as it tends to slip down the leg during the day. That can put stress on the catheter that is bad, so keep an eye on it and adjust the position and tension accordingly.
11 -- Be sure to talk to your care team before surgery about what penile rehab makes sense for you after surgery. I didn't talk about this with my care team until a few months after surgery. That was ignorance on my part; I wasn't aware of how important it is after surgery. I suggest discussing this with them now so you have a plan for it in place. For some reason my (otherwise outstanding) care team either didn't bring it up to me or I missed it. I had to figure out I needed it on my own. I don't know why, but I suspect people are just a bit shy about bringing it up. Discuss it with them now.
Best wishes.

the waiting is 100% the worst part. I had my surgery 7/30 so i'm 2+ months out since my robotic surgery. the surgery prep included 2 IV lines for the surgery. when i was waiting the surgeon came in and asked how i'm doing and i said i'm nervous as hell and he said you'll do great. when the anesthesiologist came in she asked the same question and i told her - yeah i'm pretty nervous. she said - OH, i can help with that and put something in my IV and within 30 secs I was literally the happiest guy on the planet. I only remember about a minute after she gave me that shot but i can tell you it certainly took away ALL of my nervousness and anxiety.

i also did pelvic floor PT before and after and it def helped. i do have slight leakage but its getting better every day and at this point i don't think i would have an any leakage except i was on a 6 month trial before surgery which included ADT+olaparib which took my T levels to zero and they have still not recovered (will prob take 6 months). The ADT caused some muscle loss and the surgeon warned me that my incontinence recovery may take a slightly longer bc of the trial drugs.

As you can imagine the most uncomfortable part is the catheter - mine was in for 6 days and i wont say it was fun but i got through it. i also still have no erections yet but again my T levels are basically zero and i've been in that state for 6 months so my recovery for that will take a lot more time. I do have full feeling so I'm hopefully I eventually get back my erections. I'm also on low dose Cilias - def take that if they offer it. It's a great idea because it increases blood flow to that area and also helps your incisions heal.

In Nov I get my 3 month bloodwork and hoping my PSA is undetectable. All in all I would say it was def worth it - there were a couple of days after surgery where I got down and I think that's normal but I can tell you that it gets better and 2 months out i can literally do everything I was doing before surgery.

Good luck in your journey and keep us up to date with your pathology and progress.

Other than what's been said. Stay strong and you will do fine. The waiting is the worst part of before surgery. Pay attention to your path report and get a print copy for your records. Your hospital might have it on a patient portal or your surgeon will discuss it. Create a folder of all your test results etc. Get a copy to your PCP and meet with them post op. You can read on the forum about cath care and the supplies you will need.

The only thing I wish I would have done was to have more sex/masturbate more before my surgery. I can have orgasms 🙂 post RARP but I miss the sensation of ejaculation.
update the forum on your progress this is an amazing forum and you aren't alone in this. 🙂

It will be 3 years come 1/31/26 since I had my RALP and life is pretty much back to normal for me, although in some respects it's better! ( I lost 40 lbs prior to my surgery). You'll do great too!

I had RARP two years ago at age 70. No pain after surgery. I didn't even take OTC pain medications. I found that recovery can be broken down into several stages. First, what I would call the catheter stage. My catheter was in for 10 days. Not pleasant, but tolerable. I found medical supplies online that were superior to what the hospital sent me home with. Rather inexpensive. I didn't want to bother with cleaning the bags, Etc. During this period, make sure you are following all instructions, including walking. The next phase was dealing with side effects. I took me longer than some of the stories to regain continence. This can be very depressing, but stick with your routine. I used depends and found them to be very reliable. Never had leaks outside them. I walked regularly and did my pelvic floor exercises religiously, but after a couple of months I started using a Concept II rower and that proved to be a fantastic decision. Phase 3 is the follow up. Even after two years of undetectable PSA, I get nervous before each follow up test. Just normal I guess, but know it's going to be there.

Best of luck.

I am wishing you the best of luck 🍀, complete eradication of cancer and zero side effects 👍😃 ! You are doing it at the right time when the best results are expected.

My husband had RP mid August and his recovery was very fast and he also had zero problems with catheter or anything else. His incontinence is negligible at this point (25 milliliters a day and improving). ED also on the mend. He just wishes he had procedure sooner, but not our fault.

Keep us posted 😊🌺

@retireditguy

Thank you for your good wishes and detailed response. I'm glad you are doing well a year out from your RARP. I especially appreciate your encouragement about being patient and following the medical team's instructions along with the catheter tips and penile rehab.

@jayhall

Thank you for your encouragement! I will be sure to update the forum on my progress and agree this is an amazing forum. So grateful that I have found it as it helps to keep me grounded, focused, and encouraged.

@jmacpa

Thank you for sharing your experiences and for your encouragement. I will be sure to ask my doctor or anesthesiologist for some calming meds before surgery:) I am glad that you are recovering very well 2 months out, and I do hope your November check-up goes very well. I will be sure to keep the forum updated on my pathology and progress. Thanks again!

@kenhorse

Thank you for your kind response and encouragement! I am glad you are doing well as you approach the three-year mark of your RALP.