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Cycling after Radical Prostatectomy-Open Surgery

User
Posted 11 Jan 2016 at 17:03
Happy New Year to All

It is now 11 weeks since I had a Radical Prostatectomy. I am a keen Mountain Biker and am planning a return to the bike.

I am continent during the night and morning but get small leaks afternoon and night, usually from some sort of stress.

Have any of you had the experience of returning to cycling, and what were your experiences regarding leakage and comfort?

Has anyone found that cycling hinders progress regarding erectile dysfunction?

Thanks

Rich Wyson

User
Posted 11 Jan 2016 at 19:31

Hello Wyevalrich.

Can't help with the question, just wanted to greet you. I'm sure that you will get a definitive answer soon

We can't control the winds - but we can adjust our sails
User
Posted 25 Mar 2016 at 15:02

Hello Marco Polo (you little lurker you!) and belated welcome to the site !

Glad everything seems to be going well for you, long may it continue.

I know there are a few distance cyclists on here so hopefully one of them will be along to advise you.

Isn't there some sort of belt available (like a protection belt for the back) that you could get?

Anyway, best wishes

Sandra

We can't control the winds - but we can adjust our sails
User
Posted 25 Mar 2016 at 18:48

Sorry, can't give you any advice on this - my keen cyclist husband was told (by his keen cyclist surgeon) not to get back in the saddle for 6 months in case it prevented recovery of erections. However, hernias are a fairly common side effect of RP so you are wise to keep it in mind for the next couple of years.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 28 Mar 2016 at 12:57

My prostate gland, left nerve bundle, 12 lymph nodes and a margin of tissue were removed by laprascopic surgery in December 2012. 

I returned to cycling short distances on a Hybrid Bike with front suspension in 2013.  I progressed to longer distances and in March 2015 restarted club cycling on a road bike covering distances of 30 to 60 miles.  In 2015, I completed several sportives of 25, 65, 75 and 93 miles.  

My road bike is a TREK DOMANE 4.5 with the standard saddle.  I suffer from incontinence and wear pads night and day.  However the combination of wearing a pad under my tight fitting Lycra Cycle clothing and my urethra being mostly against the saddle has allowed me to ride distances of ups to 100 miles without any problems. Providing I can access some form of toilet (Tree bush whatever) when I get of the bike.  I ride every week end often both Saturday and Sunday with a group of club cyclists between 30 and 100 miles and often during the week.

The repeated questions by specialist nurses and the so called incontinence service regarding pelvic floor exercises has often caused me some amusement.  As given the amount of exercise I do I would be surprised if my pelvic floor is not in peak condition.  Or if not any pelvic floor exercises would be unlikely to help.  However a Dynamic Video Study of my urinary system in 2015 confirmed that my incontinence is due to nerve damage.  Hardly surprising following removal of my left nerve bundle in 2012 and permanent damage at T9/10 in my Spinal Cord due to an Intramural Tumour removed in February 2009. 

This month I successfully completed two STRAVA CHALLENGEs to gain an electronic badge for my on-line trophy case.  The first being a GRAND FONDO (100 Km in one round trip recorded on a Cycle computer and uploaded to STRAVA) the second being to climb at least 4,500 Meters in March.  I rode 117.5 Km to complete the distance challenge and so far have climbed 5,687 M on my bike with four days to go.

The sportive I completed in 2015 were the Prostate Cancer Scotland (Auchterarder) 26 miles, The DCC Tour of the Kingdom (Fife) 65 miles, The TESCO BANK Tour of the Borders (Peebles) 75 miles and the Isle of Sky Mor 93 miles.

I hope the above encourages others to get on their bikes.  

For those who don't know STRAVA provide the following definition at STRAVA.COM.

About Us
Strava is the Swedish word for “strive,” which epitomizes who we are and what we do: If you’re striving to improve, no matter your goals or ability, you’re one of us.

Strava is the social network for athletes. We’re a global community of millions of runners, cyclists and triathletes, united by the camaraderie of sport. Our website and mobile apps bring athletes together from all walks of life and inspire them to unlock their potential – both as individuals and as communities. From Olympians to weekend warriors, we’re out there on the road and trail, all over the world, day after day.

As for Erectile problems see the following:

There have been attempts to prevent NHS prescriptions for Vacuum Pumps for men with erectile dysfunction. So a petition has been started to persuade the government to debate the issue.

PetitionVacuum Erection Devices should remain as a high priority treatment for ED

An increasing number of CCG's are restricting the availability of Vacuum Erection Devices as a treatment for erectile dysfunction on community FP10 prescription by listing it as a "low priority" treatment against the grain of clinical evidence and recommendation by Urological Consultant Specialists

More details
Numerous published studies exist supporting the use of VED's as a safe, effective and high compliance treatment for erectile dysfunction of all aetiologies and as a penile rehabilitation tool post pelvic cancer treatment eg prostatectomy. Supported also by organisations such as the British Society of Sexual Medicine, MacMillan and Prostate Cancer UK, and sexual health specialists across the UK. Low cost option with up to a 5 year warranty with no effective restriction on frequency of use.

NOTE: Having had problems obtaining a Vacuum Pump but when I did finding it very beneficial I supported this petition immediately. The petition is fairly new so when i signed the total number who had signed was 80 and at least 10,000 signatures are required before the government will respond.

Please sign the petition by following the link: https://petition.parliament.uk/petitions/120674/sponsors/7Ioz2agBQwVobayJYydt

 

Edited by member 28 Mar 2016 at 13:02  | Reason: Not specified

User
Posted 10 Dec 2016 at 15:55

Hi

Just to close this out

I spoke with both my surgeon and oncologist about this. Neither was aware of any risk of the 'seeds' moving as a result of cycling. However, they pointed out that I may find my perineal is sore and cycling could make urinary and ED symptoms worse but these could be countered by increasing Tamulosin and Cialis. On balance the advice was give it a go see what but start small c20k.

They did say that spin classes should be no problem as you are out of the saddle more.

C

User
Posted 04 Oct 2018 at 19:19
You have already picked up that different surgeons have different views on this. John was horrified at the idea of not being back on his bike immediately but the surgeon said what was the point of him going to the trouble of saving the nerves if the patient didn’t then give them the best chance of recovery - that he could just have done the quicker less complicated non nerve-sparing and got straight back on the bike. Once it was put that way, it was easier to accept I think - in the end, he waited until after his second review (so about 7 months). Other members’ surgeons have said either that it makes no difference or there is no data to prove that it makes a difference.

We will never know whether the no cycling advice is the reason John recovered erectile function but if he had ignored the advice and remained impotent there would perhaps always have been that niggling doubt that he had brought it on himself.

Physiologically, it does seem to make a bit of sense. RP batters, bruises and burns the nerve bundles and they go into shock. For fortunate men, once the shock wears off and the burning / bruising heals the nerves come out of hiding and can kick-start. For less fortunate men, the nerves retreat and cannot get going again - the point of Cialis is to increase blood flow which brings oxygen to the area to speed up the healing and reduce the chance of the nerve bundles switching off permanently. Whether being jiggled on a bike can also stop the nerve bundles from kick starting seems to be unproven.

You must be due your post-op consultation with the surgeon, or may have just had it. What is his / her advice?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 04 Oct 2018 at 19:21
PS You could explore the prostate-friendly saddle option?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

Show Most Thanked Posts
User
Posted 11 Jan 2016 at 18:17

I'm. Sure if Lyn wasn't on holiday she would provide a concise answer. But if you have had nerves spared I think the advice is to wait 6 months. I believe that is what her husband's consultant said. This is to ensure time for the nerves to get over the trauma if the operation.

Sure others will respond

Bri

User
Posted 11 Jan 2016 at 18:26

I'm gutted I didn't read this when I joined. I was cycling small distances at 12 wks. Only slightly tender and adjusted saddle positioning a bit. BUT no erectile recovery at all at 7 months post-op. Take care.
Chris

User
Posted 11 Jan 2016 at 19:31

Hello Wyevalrich.

Can't help with the question, just wanted to greet you. I'm sure that you will get a definitive answer soon

We can't control the winds - but we can adjust our sails
User
Posted 12 Jan 2016 at 00:09

Your Consultant is best able to advise on this - perhaps an idea to give his/her secretary a ring. You don't want to possibly set back your recovery. I suggest you mention it is a mountain bike you want to ride because I would think this would give more of a hammering than a road bike even if some roads are so rutted and pot holed they give a hard ride.

Barry
User
Posted 12 Jan 2016 at 08:02
Thanks for reply.

Could I ask who Lyn might be?

New to this website.

User
Posted 12 Jan 2016 at 09:07

Lyn is a member (currently on holiday for a week) who has a great deal of experience of Prostate cancer with a husband, father and father in law all having had it.

As Barry says, get it from the horse's mouth and you can't go wrong. Ring the secretary and ask the question. If you do though please let us know the answer !!

We can't control the winds - but we can adjust our sails
User
Posted 12 Jan 2016 at 09:32

wyevalrich,

If you enter "cycling" into the search facility on this forum you will get, hopefully, several posts in various discussions about the advisability of cycling after an RRP.

The general rule seems to suggest waiting 6 months before getting back into the saddle to allow the area best time to recover without receiving a battering or aggravation.

Mountain bikers may spend a lot of time out of the saddle, so that should not be an issue for you, I would guess, but it is only a logically arrived at guess. Looking back at the advice given it is best to avoid blows to the groin and bottom area, and any continual rubbing and friction in the area. Maybe remove your saddle, which will give your quads and gluts a good workout.

search "cycling", and good luck with your recovery.

oh and your leaking may also be due to tiredness as your body is, without you even being aware of it, exerting extra pressure to maintain control during the day.

have a good day

dave

 

PS this is another topic which should be included as a "stickie" as it comes up as often as the sun and moon and stars. :-)

Edited by member 12 Jan 2016 at 09:34  | Reason: Not specified

All we can do - is do all that we can.

So, do all you can to help yourself, then make the best of your time. :-)

I am the statistic.

User
Posted 12 Jan 2016 at 15:07
Hi Dave

Thanks for your thoughts on returning to the saddle

You are right about mountain biking regarding being out of the saddle more.

I spoke to my GP who is also a mountain biker and he thinks it's a good thing for me to return providing I don't over do it. He also said I should keep taking taldafill (ciallis ) as this helps blood flow to this region, and stop if I Feel any numbness from the perineum nerve.

I have had a few issues of anxiety recently and believe, as he does, that it will be beneficial for me to get out.

So my plan is

1.wear two pairs padded shorts

2. Stay out of saddle as much as possible

3. Don't over do it. One hour max initially.

4.. Keep taking the cialis

5. Take a small pad in case!

I will also check with Urology Nurse as well.

User
Posted 12 Jan 2016 at 15:14
Hi Barry

Thank for comments. I have a high end full suspension mountain bike so believe that when I'm in the saddle I will have adequate protection together with good saddle and 2 pairs of padded shorts.

Will speak with urology nurse first.

Rich

User
Posted 17 Jan 2016 at 13:18

Just a personal view but I think some men would be better to just opt for non-nerve sparing RP in the first place, it is a cheaper and more straightforward op. Having chosen nerve sparing, presumably it is the patient's responsibility to do everything they can to help those nerves to repair. John is a keen cyclist and found it very frustrating to wait what in effect for us was 7 months before he could get back on a bike but as one of the 10% who regain natural erections, it was worth the wait.

I am not sure if your GP fully understands how and why impotence occurs post RP or how cycling can impede your chance of recovery so I do think that your surgeon is the best person to advise you Rich. If you are intent on cycling sooner rather than later, at least consider buying a prostate friendly saddle?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Jan 2016 at 13:22

PS Yes, research has shown that cycling impedes nerve recovery - Google 'European data cycling erectile dysfunction' I think

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Jan 2016 at 18:58
I have the prostate friendly selle Italia saddle,the full suspension bike, the padded shorts, and I hope some common sense so will be taking things very easily, which is the advice I have been given, and greatly appreciate from persons like yourselves, and others in medical profession.

Just doing one ride a week for approx 1hr. Standing as much as possible! See how it goes?

Edited by member 17 Jan 2016 at 19:00  | Reason: Not specified

User
Posted 25 Mar 2016 at 13:50

Hi all, my first post on this forum. I was diagnosed last Sept, Gleason 4 + 3, had my surgery on Nov 21, laparoscopic 50% nerve sparing. I am a very keen road cyclist, usually do 3500-4000 miles annually. I felt pretty awful for the first month after surgery and had no desire to cycle, but at 6 weeks, I was told by my urologist and surgeon to go back to normal activity, so I did. In early January I started gently with spin classes, not pushing it too hard, felt good, so I then began to ride outdoors again. The weather through Jan/Feb was pretty wet and windy, so I was still mostly indoors on the Keiser spin bike, both in hard classes and on my own, and outside when the weather allowed. Everything felt good, so gradually I started pushing myself harder and harder. Slowly -- and it has felt slow -- I am regaining my bike fitness. Everything else is coming along pretty well, all things considered (ED is improving, though I hate the side effects of the drugs, but that's another story -- and thread; continence is pretty good too, still wear a very thin pad through the day and at night but only to catch the occasional squirt). So 4 months in, I guess I've been very lucky so far. I'm very glad that I was able to cycle again relatively soon after surgery: it has helped to keep me sane through all of this nightmare. My main worry, however, has been about the possibility of a inguinal hernia. It's very hilly here in Devon and I've been a little concerned after steep climbs out of the saddle. I saw my GP about this who checked me over and said everything seems OK but it is still a worry (along with everything else). I'm trying to climb in the saddle as much as possible. Has anyone else had any such problems? All the best to everyone who has or is going through all of this. Marc

User
Posted 25 Mar 2016 at 15:02

Hello Marco Polo (you little lurker you!) and belated welcome to the site !

Glad everything seems to be going well for you, long may it continue.

I know there are a few distance cyclists on here so hopefully one of them will be along to advise you.

Isn't there some sort of belt available (like a protection belt for the back) that you could get?

Anyway, best wishes

Sandra

We can't control the winds - but we can adjust our sails
User
Posted 25 Mar 2016 at 18:48

Sorry, can't give you any advice on this - my keen cyclist husband was told (by his keen cyclist surgeon) not to get back in the saddle for 6 months in case it prevented recovery of erections. However, hernias are a fairly common side effect of RP so you are wise to keep it in mind for the next couple of years.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 28 Mar 2016 at 12:57

My prostate gland, left nerve bundle, 12 lymph nodes and a margin of tissue were removed by laprascopic surgery in December 2012. 

I returned to cycling short distances on a Hybrid Bike with front suspension in 2013.  I progressed to longer distances and in March 2015 restarted club cycling on a road bike covering distances of 30 to 60 miles.  In 2015, I completed several sportives of 25, 65, 75 and 93 miles.  

My road bike is a TREK DOMANE 4.5 with the standard saddle.  I suffer from incontinence and wear pads night and day.  However the combination of wearing a pad under my tight fitting Lycra Cycle clothing and my urethra being mostly against the saddle has allowed me to ride distances of ups to 100 miles without any problems. Providing I can access some form of toilet (Tree bush whatever) when I get of the bike.  I ride every week end often both Saturday and Sunday with a group of club cyclists between 30 and 100 miles and often during the week.

The repeated questions by specialist nurses and the so called incontinence service regarding pelvic floor exercises has often caused me some amusement.  As given the amount of exercise I do I would be surprised if my pelvic floor is not in peak condition.  Or if not any pelvic floor exercises would be unlikely to help.  However a Dynamic Video Study of my urinary system in 2015 confirmed that my incontinence is due to nerve damage.  Hardly surprising following removal of my left nerve bundle in 2012 and permanent damage at T9/10 in my Spinal Cord due to an Intramural Tumour removed in February 2009. 

This month I successfully completed two STRAVA CHALLENGEs to gain an electronic badge for my on-line trophy case.  The first being a GRAND FONDO (100 Km in one round trip recorded on a Cycle computer and uploaded to STRAVA) the second being to climb at least 4,500 Meters in March.  I rode 117.5 Km to complete the distance challenge and so far have climbed 5,687 M on my bike with four days to go.

The sportive I completed in 2015 were the Prostate Cancer Scotland (Auchterarder) 26 miles, The DCC Tour of the Kingdom (Fife) 65 miles, The TESCO BANK Tour of the Borders (Peebles) 75 miles and the Isle of Sky Mor 93 miles.

I hope the above encourages others to get on their bikes.  

For those who don't know STRAVA provide the following definition at STRAVA.COM.

About Us
Strava is the Swedish word for “strive,” which epitomizes who we are and what we do: If you’re striving to improve, no matter your goals or ability, you’re one of us.

Strava is the social network for athletes. We’re a global community of millions of runners, cyclists and triathletes, united by the camaraderie of sport. Our website and mobile apps bring athletes together from all walks of life and inspire them to unlock their potential – both as individuals and as communities. From Olympians to weekend warriors, we’re out there on the road and trail, all over the world, day after day.

As for Erectile problems see the following:

There have been attempts to prevent NHS prescriptions for Vacuum Pumps for men with erectile dysfunction. So a petition has been started to persuade the government to debate the issue.

PetitionVacuum Erection Devices should remain as a high priority treatment for ED

An increasing number of CCG's are restricting the availability of Vacuum Erection Devices as a treatment for erectile dysfunction on community FP10 prescription by listing it as a "low priority" treatment against the grain of clinical evidence and recommendation by Urological Consultant Specialists

More details
Numerous published studies exist supporting the use of VED's as a safe, effective and high compliance treatment for erectile dysfunction of all aetiologies and as a penile rehabilitation tool post pelvic cancer treatment eg prostatectomy. Supported also by organisations such as the British Society of Sexual Medicine, MacMillan and Prostate Cancer UK, and sexual health specialists across the UK. Low cost option with up to a 5 year warranty with no effective restriction on frequency of use.

NOTE: Having had problems obtaining a Vacuum Pump but when I did finding it very beneficial I supported this petition immediately. The petition is fairly new so when i signed the total number who had signed was 80 and at least 10,000 signatures are required before the government will respond.

Please sign the petition by following the link: https://petition.parliament.uk/petitions/120674/sponsors/7Ioz2agBQwVobayJYydt

 

Edited by member 28 Mar 2016 at 13:02  | Reason: Not specified

User
Posted 28 Mar 2016 at 14:13

Hi Abprops, great update and useful to know about this petition - I will certainly be signing in a few minutes. Just out of interest, how quickly in 2013 did you get back on the bike and has there been any suggestion that the nerve damage was as a result of cycling too soon?

One of J's road bikes is a Trek Domane 4 series - spooky !

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 28 Mar 2016 at 14:44

Have signed abprobs.

We can't control the winds - but we can adjust our sails
User
Posted 28 Mar 2016 at 16:47

Willingly signed....

 
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