Recovery prostratectomy: What should I expect? How long?

I’m 58 years old, PSA 4.2, asymptomatic. Checked PSA every 6 month only because my dad has had PC for the last 5 years (he is under hormone therapy). My PSA slowly increasing from 3.0 in 2021 to 4.2 this year. I,m pysically active, run 5 km every morning. Discovered Gleason 3+4 in early March 2023.

Just had a radical prostatectomy in June 20, 2023 with Single Port (1 + 1 incisions). Surgery went well. No pain whatsoever since surgery. One night observation in the hospital. The only discomfort was during the catheter (6 days). Not painful, but discomfort. Walked 2 miles everyday during catheter including daily grocery shoppings. Brought the catheter with me around town. During catheter, took tylenol every day for prevention (unnecessary but I did for prevention only).

Removed the catheter on day-6. Removal process was quick and not painful. Gain continence immediately after removal, but I still wear a small pad during day-time for prevention. Day time is okay. But until today I wear diapers every night, as I frequently go to toilet (4-5 times) every night vs 1 time before surgery. My Doctor said this is normal and will be back normal post trauma.

Glad to have the surgery done.

I am just turning 69. I Had my RALP performed on 10/25/23. The surgery went very well. Removed 100% of detectable cancer and my PSA continues to be undetectable at a steady < 0.014. I had a wound in my bladder which took more time to heal than normal. Unfortunately, I got a really bad bacterial, urinary tract infection during the first 10-14 days wearing my FOLEY CATHETER. Ended up requiring a 10 day hospital stay to attend to that. However, after my immediate setbacks were resolved I’ve been fine to date. My continence is almost 100% normal. My erections are NOT. Before my RALP, I had strong erections and enjoyed very satisfying sexual intercourse twice a week with my incredibly gorgeous and sexy wife of 11 years. Occasionally, I would take a 20mg CIALIS tablet if my PEYRONES Disease was adversely affecting the quality of my erection. The CIALIS made me even firmer and harder with an incredibly strong erection. Unfortunately, to date, I can only achieve about 60% of a normal erection. Just enough to barely have intercourse. Post surgery, the CIALIS does absolutely nothing at all and no longer provides any benefits to me. I started using a penile pump about a month ago to increase the total blood flow in my penis as part of my Penile Rehabilitation. Additionally, the pump provides the opportunity to fill my penis with more blood and achieve a full erection. I can now guarantee myself and wife an erection capable of enjoying a pretty normal experience of sexual intercourse. I get very aroused, turned on and sexually stimulated by my wife. However, no matter what we do, I can’t get my normal erection, (without the pump), to exceed the 60% of normal stiffness to really enjoy stimulating penetration for me and my wife. Not sure why the pump gets me almost 100% erect but nothing else will. Obviously, it forces more blood into my penis versus what I can do. Additionally, by placing the penis band at the base of my penis after obtaining a full erection. This prevents all of the the blood from rushing back out of the penis which loses and discontinued your erection. I start consulting with a Penile Rehabilitation Specialist in several months to address these issues in more detail. Thankfully , I had a successful “nerve sparing” surgery and my orgasms are almost as enjoyable as my pre surgical “wet ones”when I could still ejaculate!. However, the “dry orgasms” still feel really good and are quite enjoyable! I realize I am still healing but I was told that whatever state of physical sexuality I had and could attain and perform prior to my surgery would return after my surgery. This has not been the case for me after 9 months following my surgery. I am thankful and grateful to be where I am at but I will need more improvement to really be sexually fulfilled and satisfied. Best wishes and good luck to all of my fellow patients out there who are dealing with the same or similar challenges.

I'm 3 months post RALP now, 74 y/o. My experience with sexual function is similar to yours. My understanding is that return to normal "usually" takes 18-24 months. This was confirmed during my post-op check a week ago. In the interim, daily pump use and every-other-day cialis use are recommended to keep the penile tissues from "scarring" up by inducing expansion of the blood vessels on a regular basis. Penile ring or injection are necessary to mimic more normal, sustained erections during that 2 year wait for nerve function to return. The penile rehab practitioner I consulted acknowledges the frustration of the seeming lack of progress, but insists on persistence nonetheless. The trick for me is to combine orgasm with penetration. Both are possible individually (and my wife will still orgasm), but not yet together.

"Do what you can with what you've got!"

Thanks for your reply and comments. Yes, I do realize that I am doing, (recovering) better than many men while not as food as some. It’s been a back and forth of progress and regression thus far. I suppose it’s the periods of regression that are most challenging for me. That, plus the desire to be “ready” on the ready with my wife when we are both up for some infancy. Of course, that also means “standing well at attention!” Luckily, I’ve had several or more occasions when my wife and I have “climaxes/orgasmed” together! Of course, all men and women are different. My wife is definitely a “slow simmering type” and then explodes into very intense, multiple orgasms! I consider myself a fortunate man in that sense. It just requires great persistence on my part. I also take some of the credit for knowing what and how to be a good lover. I am looking forward to working with a Penile Rehabilitation Specialist to discuss and strategize what the best and most beneficial strategies for me to take etc. Thanks again for sharing your experience. Unfortunately, I find that too little men are willing to share their stories and experiences with other men about most of the challenges associated with Prostate Cancer. Wishing you the very best of health, happiness and well-being,
Phil

@matthew61, when is your surgery?

Scheduled for August 29th.

I am 12 weeks post RALP and bladder surgery to remove cancer tumors. I do my Cagle‘s and walk but still have a lot, a lot of incontinence. I augment pull ups with a washcloth between my leg and go through probably 18 to 20 a day. This limits how far or where I can go from home, this is very frustrating. Urologist says it takes time and I’m not sure what that means’s at four, six, 10, 12 or longer to regain confidence. Any advice would be helpful thank you and God bless.

I foolishly watched those YouTube videos posted by men who were fully continent really early in their recovery. I expected that to happen to me and it didn't. I am 6 months post RALP and can finally see real improvement in my stress incontinence. I never changed pads many times each day, I typically went through two heavy duty pads, one in the morning, one in the afternoon, each put into my depends. In the evening I would take the latest wet pad out and just stay with the depends. But now, when I am just having a normal day (no extremes in activity) I can get by with one heavy pad for the entire day, or two light pads. When I go for a long walk, or play a sport (golf, pickleball) I still leak, but not as profusely as I used to. I found that a condom catheter works very well for 18 holes of golf. I do my Kegels, not as punctually as I should now that I am far more active, but definitely I do some everyday. I do believe my body will soon figure it out and resolve this problem. But a word of caution, one of my friends who went through this years ago, says he still wears a light pad everyday just in case of a cough, or a sneeze or something unexpected. I keep telling myself, being cancer free is worth having a shorter penis, no ejaculations, and incontinence. Some days I believe it, some days I don't.

Formal PT was helpful for me for Kegel exercises.
Best wishes for a recovery soon.

tomf:
Believe.
Keep good thoughts.
Best, Michael