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RP or LDR Brachytherapy for a cyclist

Posted 02 Sep 2017 at 09:30

Hello All,

I am recently diagnosed and am thinking through the options of Robotic surgery as offered by my consultant or alternatively pursuing the LDR Brachytherapy alternative.

I am a keen road cyclist and so I'm looking for experiences of getting back on the bike after either procedure. I have seen suggestions that after surgery, cycling may delay recovery from ED and incontinence, equally that Brachytherapy may leave you with a tender prostate which does not like the bashing up and down on a saddle.


Any advice please? 

Posted 02 Sep 2017 at 14:01

Hello virtualreality and welcome tot he site

Could you please give a bit more detail. PSA and gleason scores always help when giving advice

We can't control the winds - but we can adjust our sails
Posted 02 Sep 2017 at 16:03

Research suggests that cycling too soon after nerve-sparing RP can reduce the chance of regaining erections. John is a keen rider and his urologist banned him from the bike for almost 7 months post op, which he found frustrating at the time. But really, in the grand scheme of things 7 years post op with a fully functioning penis, it was worth the embargo.

Some uros suggest staying off the bike for only 3 months but our view was why go to the bother of trying to save the nerves and then risk it being pointless.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
Posted 02 Sep 2017 at 16:08

PS whatever treatment you opt for (or even if you decided to just stay on monitoring for a while) you could do yourself a favour by investing in a prostate-friendly saddle.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
Posted 02 Sep 2017 at 16:38

Hello Virtualreality

I can understand your concern about the terror of bike withdrawal symptoms but maybe even then the time to get back on the bike is secondary to the best choice of treatment for you. Whatever you choose, my experience says you'll be back on the bike.

I can't help with the choice of op, but I had a robot procedure.  Apart from the fact that disease was not eliminated (I was T3a at the time of op),  the main adverse outcome was a stricture which has required several dilations to get a reasonable stream.  I'm not saying that to influence your choice - as my experience was not typical for RP, robotic or trad - just as background re cycling.

My main criterion on my undercarriage's fitness to resume cycling, which was about 3 months after the op, was whether it was comfortable to get back on the saddle. (But remember I had about three procedures to reduce the stricture in that period). The way I felt the discomfort was in the business end of the penis when I road-tested my readiness, and I seem to recall my surgeon mentioning that any pain/trauma to the urethra is referred there, though I'm not really sure about that.  I started off with a hybrid bike with a broad fat saddle, with the thought that it was more likely to get my weight on to my sit bones.

Currently, I'm in the middle of RT.  In an attempt to reduce the potential for problems, I've adjusted the saddle rail to fullest forward position to try to force my weight over the sit-bones.  Not too ergonomic but it works after a fashion on a shiny Italian saddle. If I get any significant symptoms, I'll give up the bike until after RT.

I don't know if that helps, but best wishes with your choice.



Posted 02 Sep 2017 at 17:23

Whatto VirtualReality.


I am 7 years 5 months on from L.D.R. Brachytherapy in April 2010 and ride my mountain bike regularly over rough terrain. Do not be in any hurry to resume your cycling and then be very sure and I think that you will know when the time is right. I have a user friendly soft saddle and wear four layers of clothing around my under carriage.

Please take a peek at my profile for more details of my recovery.


Chigwell 2010.

Posted 04 Sep 2017 at 09:51

I am a lot further down the food chain than "keen road cyclist" but cycling the local lanes is the exercise I pursue for fitness and general sanity. When I had the operation I don't recall the surgeon saying anything about risks of cycling, but when I tried getting on my bike first it took less than a second to recognise I wasn't ready for it! The middle of the sit area was extremely tender, possibly as a direct result of the operation but also perhaps because having had a catheter means the whole urethra downstream of where the prostate used to be was pretty sore.

However, six weeks after my operation we went on a pre-booked family beach activity holiday, where road cycling is one of the things I would normally have done. My wife noticed that some of their road bikes had a groove down the middle and suggested I tried one out. To my relief a gentle ride turned out OK. When I got home I googled advice about prostate-friendly saddles, of which there are many at a huge range of prices. In the end I just got the cheapest Halfords saddle with a cut-out where the root of the penis would otherwise contact, and that has been fine.

That holiday was a big psychological turning point for me. Although I was leaking rather a lot at that stage so having to negotiate frequent pad changes, finding that I could do most of the things I would have done anyway was hugely reassuring. Cycling as a routine activity was resumed on return once I had the new saddle. In terms of its effect on getting over side effects, I can't see that cycling was a factor in my slower than average return to urinary control (still need a medium pad a day at nearly 18 months post-op), and erectile function has continued improving with the help of Cialis and the pump such that sex has been reliably working for quite a long time now despite having lost the nerve on one side.

Obviously that is a single experience which might or might not turn out the same for you. But the psychological benefit could tip the balance for you too, as long as you don't suffer obvious pain I think it is worth trying out your bike and gently working up towards your old levels of activity. Good luck!

Posted 23 Nov 2020 at 12:46

Hello all, I hope all is well with you. Apologies for jumping on this old thread - it was the first one that came up in a search for “prostate brachytherapy cycling” and I would like to add my experience in the hope that it benefits others who are considering RP versus brachytherapy.

I’m a keen runner, cyclist, triathlete and hillwalker. I had brachytherapy in August 2020. This is my progress so far post-op:

Day 0 - operation

Day 1 - managed to drive home but I wouldn’t recommend driving, slept

Day 2 - felt like a hangover, tired and dizzy when walking

Day 8 - gentle 5K jog

Day 9 - hilly 9K run and 1500m sea swim

Day 10 - 5 hour hill walk

Day 17 - 9 hour hill walk

Day 20 - 1.5 hour bike ride on hardtail MTB with soft noseless slotted saddle (ISM Typhoon). Not painful but it was difficult to find a comfortable spot on the saddle and I still had some discomfort a few hours afterwards

Day 21 - 45 mins turbo trainer ride on tri bike with harder slotted saddle. Again, a bit difficult to find a comfortable spot on the saddle when riding on the brake hoods, but no problem when down on the aerobars. Some discomfort for a while afterwards

Day 27 - 1 hour off road ride on full suspension MTB. The normal saddle (fairly soft but not slotted) was too uncomfortable so I had to swap it for a noseless slotted one. Probably won’t be able to use the normal saddle any more.

Day 28 - 2 hour road ride on cyclocross bike with harder noseless slotted saddle, reasonably comfortable

Day 34 - 4 hour road ride on cyclocross bike

Six weeks - CT scan to check placement of radioactive pellets

Ten weeks - ran a marathon at my usual pace

Three months - PSA 1.4 (was 6-7 before the operation), check up with doctor, who seemed happy with my progress so far and suggested I should try stopping Tamsulosin (muscle relaxant to ease urination) for a few days

A friend gave me a doughnut-shaped cushion which made sitting a lot more comfortable in the week after the operation.

Finally, if you’ve had a lot of Achilles problems, tell your doctor before the operation. I was given Ciprofloxacin as a post-op antibiotic and one of its possible side effects is Achilles’ tendon problems. I took the full ten day course, with an accidental double dose on the first day, and noticed soreness around my heels, which was still sore a few weeks after I finished the course.

I hope this helps and good luck to anyone reading this.

Posted 23 Nov 2020 at 23:40

I did 4½ weeks external beam radiotherapy, immediately followed by HDR Brachytherapy.

I cycled all through my external beam radiotherapy.

I cycled 12 miles 5 days after HDR Brachytherapy.

I had fitted nose-less saddles on my bikes when starting radiotherapy (they told us not to ride, but were OK with this saddle):

I found they took a few rides to get used to and the adjustment right. Now that I have got used to them and find them comfortable, I still have them on my bikes nearly 18 months later.

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