What is a Prostatectomy Like?

Posted by surveyr @surveyr, Jan 29, 2025

It is living hell
You wear a catheter for 7-10 days after surgery,
Then the fun begins.
You are now incontinent, and you must wear diapers, you actually leak pee,
It at times squirts out of you. You have constant urge to go meaning trips to bathroom every hour or less.
You have to deal with constant leaking, ED, potential UTIs.
Embarrassing and
Humiliating absolutely terrible time.
The care team will tell you that the
Incontinence last 9 months or more.
Remember prostrate cancer is slow growing
Surgeons will encourage surgery and your cancer will be gone but your life has changed forever because the incontinence is a daily challenge. Assuming you regain continence then you have to deal with ED.
Research as much as you can before making the decision to have prostatectomy. It is your body and your life afterwards.
But you potentially traded quality for quantity of life.

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

Profile picture for kjacko @kjacko

I had my RP a little over two years ago. One month prior to my surgery, I did Kegels religiously. After the surgery, the only problem I had was terrible pain as I was coming out of the anesthesia. I wore my catheter for seven days. After removal, I did Kegels every hour on the hour. Never had one drop of incontinence. My surgeon said I was one of the lucky 10% who have zero problems. If you do choose RP, I hope you are one of the 10%. 🤞

Jump to this post

@kjacko
I never did kagles Before or after surgery. 16 years ago, when I had the surgery, they never even discussed the issue. I had no incontinence after they took out the catheter. Results may vary.

REPLY

I had my RP a little over two years ago. One month prior to my surgery, I did Kegels religiously. After the surgery, the only problem I had was terrible pain as I was coming out of the anesthesia. I wore my catheter for seven days. After removal, I did Kegels every hour on the hour. Never had one drop of incontinence. My surgeon said I was one of the lucky 10% who have zero problems. If you do choose RP, I hope you are one of the 10%. 🤞

REPLY

I had ZERO pain, & no incontinence. I had ED, but that was because I chose "non-nerve-sparing" as a surgical option. I chose non-nerve-sparing because the cancer had already reached the surface of the prostate, so the nerves were probably already compromised.

I drove the day after, & walked my usual two miles a day after that. At the ten day mark, my catheter & drain tubes were removed without incident. Before they removed the catheter, the PA poured a measured amount of saline fluid INTO the bladder via the catheter. He then removed the catheter & measured how much I could then urinate, to verify that I could empty the bladder.

REPLY

My husband had very fast recovery with no issues. "Gas pain" the first morning after surgery was the only pain he experienced. Catheter was non issue for him also (maybe because he is not circumcised), no pain, no irritation. Some pressure in perineum area for the maybe first 2 weeks but no pain. Yes, he had some incontinence at the beginning, no big deal - he is now 4 and a half mos post surgery and incontinence is gone completely. ED was present at the beginning and is now nicely resolving with Cialis. It is all so very individual and a lot depends on age, fitness of a patient, expertise of a surgeon and extension of surgical margins as well as of the size of a gland.

Besides , 60 % of general population of men over 60 years old has ED (70% over 70 years old etc.) , and about 25% over 60 has an incontinence due to aging.

Both my husband and I are very happy that cancer was removed and he would do it all over again if he could turn the time back.

Find the best surgeon that you can find, do recommended exercises and rehabilitation protocols and you have about 95% chance to recover completely.

Radiation therapy can cause both ED and incontinence, 5-20% for incontinence with 2% for permanent incontinence which is just 3% better result than for RP (5% for permanent incontinence).
Regarding ED - if you need ADT , you can count in it , about 70-90% patients have ED while taking ADT . For some patients testosterone levels never returns to normal range and ED becomes permanent issue.

So - there is no "perfect" treatment for PC or the one that will not effect body in some way, and probably in multiple ways, either temporary or permanently.

However, the main goal is cancer elimination and life extension and one should keep an eye on the prize ; ) !

REPLY
Profile picture for survivor5280 @survivor5280

I believe I’m in a position to finally provide my own input into this. While I’ve not quite completed the entire process, I’ve experienced enough of it, and it’s fresh enough in my mind, that I can comment.

This is my second robot assisted surgery and, in fact, the exact same surgeon did my prostatectomy and he used almost all the same incision points and, in the end, the recovery from surgery itself is almost identical.

I keep relatively fit, with an emphasis on my core strength (think abs, etc), so having incisions to my abs became very painful to recuperate from both times.

So, what was it like? I just had it out a few days ago. No part of it is fun, but for me the worst part is the ab pain. I take the walking seriously and, like last time, I use a couple of canes to help stabilize me as I walk a bit more each day. Yesterday I pushed probably a bit hard and my abs were absolute murder for about an hour after, I mean more agony than I can remember in a long time. I had the option to take Oxy for this but skipped it because I only use that if the Tylenol doesn’t do the trick.

The second worse part, and it’s far worse this time, is dealing with the gas they pump into you for the surgery. It rises to the high points of your body, shoulders mostly, but if you favor one side while in bed then that entire side gets saturated and the pain is extremely intense. It dissipates over time but takes a few days, it’s already about 1/2 what it was before and that 1/2 is still pretty painful..

Getting used to a catheter for a week is an adjustment. While it generally doesn’t “hurt” (sometimes it does a little), it’s a constant annoyance that varies between you simply always being aware of it there or it actively reminding you that it’s there. I’m counting the days until it comes out - 4 days and change now.

Losing the ability to encourage the relief of your bowels is a huge adjustment. You just can’t do it. For one, you have a surgical zone to worry about breaking open and irritating, a urethra that is just barely stitched on and healing and your muscles are shot. For this reason they give you Gas X and a stool softener to help, but this entire process is pretty not fun. On top of all of this, Oxy constipates you so then you have to deal with that too. Once healed up you can operate in a similar fashion but have to remember that you no longer have independent control of bladder and bowel, so it’s a new “normal” to get used to.

Would I do it again? Probably. It sucks, but that little sucker is gone and so far the doctor is very optimistic that the cancer is taken care of for now. I could have opted for the other primary treatment, radiation, but since the side effects could be the same and then some, I opted out of that (plus every doctor said that at my age it wasn’t recommended, since I’m pretty young for this). There are also the outlier treatments that some have reported success with, maybe those would be better but they just weren’t for my case.

If you get RARP then just know you are NOT going to be back to normal in a few days. You could probably hobble around and try to get back to normal life but you are risking serious injury or even death if you tear something. Even sitting in my recliner doing very little, I thought I would be able to fire up my laptop and work more than I’ve actually been able to. Healing zaps your energy, your whole body is tired and it’s hard to keep up - add to that the bevy of pharmaceuticals and you have a recipe for resting rather than returning to normal.

That’s my $0.02 on my third day post-op.

Jump to this post

@survivor5280

Thank you for your straight forward, non-sugarcoating assessment. My prostatectomy is one month away. Your shinning light on what for me is the unknown is very helpful. Thank-you!

REPLY

I had it done in May 2024, had pads for maybe a month and I am dry since then. I had the catheter for 10 days. I had 38 radiation treatments and they were not fun either.
My doctor explained everything to me fully and while I was disappointed my pathological report showed some cancer left behind I did know it was possible since I was a Gleason 9 PSA 40. I am still happy with my decision and know I have a long road ahead to build up my muscles and get past the fatigue from the radiation and Orgovyx.

REPLY
Profile picture for jeff Marchi @jeffmarc

Yes, the doctors you saw were all telling you that surgery was the answer. After attending weekly advanced prostate cancer meetings at Ancan.org we heard where surgery was recommended for people that it just didn’t make sense to do. They were either too old or their cancer had spread too much.

Not all urologists are the same. One of the doctors who comes to almost every meeting is in his 80s and his urologist kept telling him he was fine as his PSA kept rising. He ended up very high risk because his urologist didn’t pay attention to his results. Not all urologists are equal.

I ran a computer consulting business. I had no real backup. I really did go to the office of some of my clients four days after surgery. By a week after surgery, the only issue was the catheter, the bag for which I had in my pants leg. No one ever knew I had surgery. I was 62 at the time and I just didn’t have any pain from the surgery, so I went to work. I didn’t do any heavy lifting for a couple of weeks.

Jump to this post

Don’t. Opt for radiation instead. That leaves everything intact and functioning as nature intended.

REPLY

Had my prostate remove and cancer taking off my bladder. Cafeter is out and yes I wear diapers but feel great now. 3 weeks to go back to work and 2 weeks of light duties. Glad I had the surgery. At 63 I got to becareful and get my yearly checks on my bladder.

REPLY
Profile picture for peterj116 @peterj116

I reckon he had a midget standing just off-camera, turning water on & off.
🙂

Jump to this post

LOL!!!

REPLY
Profile picture for survivor5280 @survivor5280

It makes me think of Airplane where they inflate the auto pilot.

Jump to this post

I am f lying high with it and so is my wife!

REPLY
Please sign in or register to post a reply.