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Recent radical prostatectomy

Posted 09 Aug 2017 at 10:11

I've just joined this site following my recent (late July 2017) radical prostatectomy.  My story is that I went to see my local GP with symptoms of lack of flow when urinating.  After he examined me he suspected an enlarged prostate and sent me for blood tests and a further examination from a specialist urologist.  The blood tests showed a very low PSA level of just 0.08 so I was hopeful that no cancer was involved.

The urologist sent me for a biopsy as he had noticed an unusual lump on my prostate, again after the PSA results I was feeling hopeful.  I was bowled over when I went to the hospital for the biopsy results and was told I had prostate cancer, luckily for me it was in the very early stages with a Gleeson score of just 6.

Following my consultation with the surgeon I opted to have the prostate removed so as to eradicate the cancer completely, this was carried out as I said late July 2017.  So I am in the early stages of recovery and have no control of my bladder since my catheter was removed on 7th Aug, I'm trying to do the pelvic floor exercises as often as I can, but at the moment I can only mange short contractions of a second or so.

Well that's my story so far and I'm looking forward to searching the site to read of the experiences other users have had.

Posted 09 Aug 2017 at 22:42

Taking aside the life or death aspects of this cancer after that. . . . it's all about continence (incontinence) and erections (lack of / inability). Your PSA number and you Gleeson number are enviable I.e. few here will be that low. If I had been in your enviable position (numbers) I would expect the surgeon to be able to save many of the nerves and muscles that control continence and erections i.e. I would expect the have good continence and good prospects of 'erection' within months.

Posted 10 Aug 2017 at 00:03

It doesn't necessarily work like that though. It may be that the tumour is tiny and of low grade but very close to the edge of the gland rather than in the centre. Or it could have been right at the end where the urinary sphincter sits, necessitating a replumbing job. And it could be a low-secreting type of prostate cancer, there are at least 27 types not all of which cause a PSA rise.

Coxy, your catheter has only been out 2 days. On average it takes 3 - 9 months to fully regain continence so don't expect so much of yourself. Leaking at this stage is nothing to do with your pelvic floor - your urethra has been cut, a bit removed (including the valve that controls urine flow out of the bladder) and the pipe ends have been joined back together with stitches. Our uro described bladder control after RP as 'peeing into a sieve' - as the joins heal you should leak less and THEN the pelvic floor works with the newly slung pipe work to hold it all. Having said that, I don't think you are doing the PF exercises correctly if you are concentrating on how long you can hold; did anyone give you any information about how to do them?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
Posted 10 Aug 2017 at 10:08

Thanks for your replies, this is exactly the reason for joining this site as you only get so much information from the medical profession before heading down the road of recovery,  it is only afterwards that questions start to pop into your head.  I know that I am at the very start of recovery and I admit that I expect too much too soon.  When I have my post Op appointment with the surgeon I'm sure I will have a multitude of questions for him.

As for the pelvic floor exercises I was told on having my catheter out to start them straight away and was given leaflets on how to perform them and the frequency, hence my frustration on not being able to do them properly, having read your reply LynEyre I now know why they have little effect if at all.

Regarding my low PSA and Gleeson scores my surgeon recommended RP rather than spend the next 30 years (Hopefully I have 30 years plus to go) undergoing tests and biopsies and then having to undergo treatment at a later date if anything developed.  I'm happy that my cancer was found at such and early stage and that I have received treatment to eradicate it. 

Posted 10 Aug 2017 at 12:08

Yes it is important to start them as soon as possible but they won't have a direct effect on your current leaking. You will hopefully see the benefit of the PFEs in the coming weeks and months. It is the number of repetitions that you need to build up, not how long you hold each one.

I find the PFE debate quite interesting. John's surgeon said not to bother as they make no difference to regaining continence after RP, which was the complete opposite of the PCUK advice. But any woman that has had a baby will tell you that PFEs are essential regardless of your prostate, and help to prevent age-related stress incontinence and / or prolapse.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
Posted 11 Aug 2017 at 07:16

There is a phone app called prostate aerobics that is a useful aid to doing the exercises. I was told to imagine trying to stop passing wind was the way too get the right contraction. I now find I can separate the stages. The first stage is the same as when you used to flex an erection and has not contracted enough. The second stage is activating the right pelvic muscles. The third stage is clenching the buttocks and you have contracted too much.

Thanks Chris
Posted 11 Aug 2017 at 22:58

Thanks Chris, I've now downloaded the app, it seems to be quite a useful aid.



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