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Recovering Cyclist, any advice?

User
Posted 16 Apr 2021 at 11:59

Hi there,
 
A family member has recently been diagnosed with early stage Prostate Cancer, after a number of consultations, it appears that Radical Prostatectomy is the best course of action.....given their age (62), fitness level (very keen cyclist), general health. They are likely to lose the right hand side nerve banding as the small tumour is close to the nerves and Sphincter. I’m looking for any advice on recovery best practice exercises or techniques for Bladder control, Erectile dysfunction etc. Also, if there are any cyclists out there, how long did it take to get back on the bike? Are there any particular cycling exercises that will help?
 
Thank you so much

User
Posted 16 Apr 2021 at 15:16

He will need to ask his urologist's view about how long before he cycles again but buying a good quality prostate friendly saddle would be a wise investment. John is a keen cyclist and was very disappointed when the urologist (also a keen cyclist) said that he should stay off the bike for 6 months - the urologist then said "what's the point of me doing everything I can to preserve the nerves, if you aren't willing to do everything you can to help the nerves to repair?" I know that other surgeons don't all feel that strongly and some only say to stay off the bike until the 6 week post-op appointment.

Edited by member 16 Apr 2021 at 15:17  | Reason: Not specified

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

User
Posted 16 Apr 2021 at 17:01

I am a keen cyclist but my first priority was to make the fullest recovery possible. Obviously makes sense to do the PFE's regularly but for me I found walking daily from day 2 and gradually building this up over 8 weeks or so worked really well. I then started some gentle jogging and I think around week 12 started to build up the cycling on the turbo (prostate friendly saddle). I definitely wouldn't be back on the bike before some erectile function returned

User
Posted 16 Apr 2021 at 18:03

I am a super-fit lifelong runner and cyclist.

After my RaRP in May 2019 (then aged 63), I made myself walk at least a little every day, starting from the day after the operation and within the limits of discomfort (which was mainly from the catheter). I think the most I did was about half a mile, twice a day, just round the block. By the time the catheter came out 10 days later, I was desperate for some decent heart-rate-elevating exercise. To get my exercise "fix", from the day the catheter came out onwards, I went out on my bike and cycled without sitting on the saddle.The first day, I just cycled about a mile but I remember feeling such exhilaration, after basically lying on a bed for nearly two weeks.

If your friend is a keen and experienced cyclist, cyling while standing on the pedals should be no problem for him. Non-cyclists may not appreciate this, but it is easier to cycle up and down a steep hill without sitting down, than it is to cycle along a flat road without sitting down. I live near Shooters Hill in London and after building up for a few days, I basically just cycled up and down a few times.

Due to the abdominal wounds, running was out of the question until four weeks after the operation, but I started gently with about a mile and just built up from there. From that point, I still cycled a few miles a day and started sitting towards the back of the saddle (on the "sit bones").

Luckily I was completely continent from day 1. I think this was a combination of luck, a good surgeon and having good core muscles to start with. My surgeon told me that he finds that runners generally do better with continence than non-runners. In the run up to the operation, I practised starting and stopping weeing loads of times as well as the recommended pelvic floor exercises (I seem to remember an Australian bloke has a good video on Youtube which I can look out if you are interested).

In terms of ED, I was nerve-spared on one side and was only potent with viagra for the first year or so. Things have gradually improved and I now get the occasional non-viagra erection at night.

I am not advising anyone else to do what I did but my surgeon (who is a runner himself) was quite happy about it when I saw him six weeks or so post-op. Your friend will have to make his own mind up but, personally, I was more prepared to risk nerve damage (whilst being careful saddle-wise) and potentially worse ED than to gain weight and lose cardiovascular health.

PS Forgot to say that my post-operative mental health was much improved by my daily bike rides.

Edited by member 16 Apr 2021 at 18:16  | Reason: Not specified

User
Posted 16 Apr 2021 at 22:26

Originally Posted by: Online Community Member

Also, if there are any cyclists out there, how long did it take to get back on the bike? Are there any particular cycling exercises that will help?

I was told "No vigorous exercise for 4 weeks and no cycling or horseriding for 6 weeks".

Walking was encouraged, so I gradually increased walking whilst planning my return to the saddle. I built up a set of new wheels and airbrushed a new time trial helmet so I had something to do that was low load but related to cycling.

When 6 weeks was up, I started gently, just half an hour at first. The following week I had my followup with the surgeon and he told me I could now do as much as I wanted and "your perineum will tell you if you've done too much" (this at 7 weeks).

But Lyn has it right. The surgeon's advice to the individual patient should be followed. They are the best placed to tailor the instructions to the patient.

This time last year I was going in for pre-op assessment only to be then told my surgery was cancelled "indefinitely". It happened in June and went well. Tomorrow I'm off for a bike club ride. We'll probably do about 50 miles.

_____

Two cannibals named Ectomy and Prost, all alone on a Desert island.

Prost was the strongest, so Prost ate Ectomy.

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User
Posted 16 Apr 2021 at 15:16

He will need to ask his urologist's view about how long before he cycles again but buying a good quality prostate friendly saddle would be a wise investment. John is a keen cyclist and was very disappointed when the urologist (also a keen cyclist) said that he should stay off the bike for 6 months - the urologist then said "what's the point of me doing everything I can to preserve the nerves, if you aren't willing to do everything you can to help the nerves to repair?" I know that other surgeons don't all feel that strongly and some only say to stay off the bike until the 6 week post-op appointment.

Edited by member 16 Apr 2021 at 15:17  | Reason: Not specified

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

User
Posted 16 Apr 2021 at 17:01

I am a keen cyclist but my first priority was to make the fullest recovery possible. Obviously makes sense to do the PFE's regularly but for me I found walking daily from day 2 and gradually building this up over 8 weeks or so worked really well. I then started some gentle jogging and I think around week 12 started to build up the cycling on the turbo (prostate friendly saddle). I definitely wouldn't be back on the bike before some erectile function returned

User
Posted 16 Apr 2021 at 18:03

I am a super-fit lifelong runner and cyclist.

After my RaRP in May 2019 (then aged 63), I made myself walk at least a little every day, starting from the day after the operation and within the limits of discomfort (which was mainly from the catheter). I think the most I did was about half a mile, twice a day, just round the block. By the time the catheter came out 10 days later, I was desperate for some decent heart-rate-elevating exercise. To get my exercise "fix", from the day the catheter came out onwards, I went out on my bike and cycled without sitting on the saddle.The first day, I just cycled about a mile but I remember feeling such exhilaration, after basically lying on a bed for nearly two weeks.

If your friend is a keen and experienced cyclist, cyling while standing on the pedals should be no problem for him. Non-cyclists may not appreciate this, but it is easier to cycle up and down a steep hill without sitting down, than it is to cycle along a flat road without sitting down. I live near Shooters Hill in London and after building up for a few days, I basically just cycled up and down a few times.

Due to the abdominal wounds, running was out of the question until four weeks after the operation, but I started gently with about a mile and just built up from there. From that point, I still cycled a few miles a day and started sitting towards the back of the saddle (on the "sit bones").

Luckily I was completely continent from day 1. I think this was a combination of luck, a good surgeon and having good core muscles to start with. My surgeon told me that he finds that runners generally do better with continence than non-runners. In the run up to the operation, I practised starting and stopping weeing loads of times as well as the recommended pelvic floor exercises (I seem to remember an Australian bloke has a good video on Youtube which I can look out if you are interested).

In terms of ED, I was nerve-spared on one side and was only potent with viagra for the first year or so. Things have gradually improved and I now get the occasional non-viagra erection at night.

I am not advising anyone else to do what I did but my surgeon (who is a runner himself) was quite happy about it when I saw him six weeks or so post-op. Your friend will have to make his own mind up but, personally, I was more prepared to risk nerve damage (whilst being careful saddle-wise) and potentially worse ED than to gain weight and lose cardiovascular health.

PS Forgot to say that my post-operative mental health was much improved by my daily bike rides.

Edited by member 16 Apr 2021 at 18:16  | Reason: Not specified

User
Posted 16 Apr 2021 at 22:26

Originally Posted by: Online Community Member

Also, if there are any cyclists out there, how long did it take to get back on the bike? Are there any particular cycling exercises that will help?

I was told "No vigorous exercise for 4 weeks and no cycling or horseriding for 6 weeks".

Walking was encouraged, so I gradually increased walking whilst planning my return to the saddle. I built up a set of new wheels and airbrushed a new time trial helmet so I had something to do that was low load but related to cycling.

When 6 weeks was up, I started gently, just half an hour at first. The following week I had my followup with the surgeon and he told me I could now do as much as I wanted and "your perineum will tell you if you've done too much" (this at 7 weeks).

But Lyn has it right. The surgeon's advice to the individual patient should be followed. They are the best placed to tailor the instructions to the patient.

This time last year I was going in for pre-op assessment only to be then told my surgery was cancelled "indefinitely". It happened in June and went well. Tomorrow I'm off for a bike club ride. We'll probably do about 50 miles.

_____

Two cannibals named Ectomy and Prost, all alone on a Desert island.

Prost was the strongest, so Prost ate Ectomy.

User
Posted 19 Apr 2021 at 15:33

Thanks all for your experience and perspectives! We'll be sure to get specific feedback from the Urologist based on the details and success of the surgery.

Definitely going to build up movement gradually once the catheter is out, and work towards getting on the bike when ready. We've got a turbo trainer, so I like the idea of removing the saddle on the bike and starting with stand-up pedaling initially! And a soft wide saddle sounds like a very wise investment for the first year.

I'll let you know how it goes :)

User
Posted 19 Apr 2021 at 23:36

Originally Posted by: Online Community Member

And a soft wide saddle sounds like a very wise investment for the first year.

A saddle with a perineal cutout is highly recommended. There's a good selection available depending on what sort of riding you want to do.

_____

Two cannibals named Ectomy and Prost, all alone on a Desert island.

Prost was the strongest, so Prost ate Ectomy.

 
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