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Advice following robotic radical prostatectomy

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User
Posted 07 Feb 2025 at 16:11

I was diagnosed with prostate cancer on 10 January with a Gleason score of 7 showing aggressive signs. So I’m due a radical prostatectomy on 14 Feb (this time next week, I guess I’ll be waking up from the general anaesthetic).

I’m 42 and in reasonably good shape, don’t smoke or drink so was wondering if anyone in similar age group has any recovery stories that were positive on the incontinence aspect and future sex life?

I’ve been trying pelvic floor exercises and downloaded the Squeezy app but paid £100 to see a pelvic floor physio to be told I’ve been doing them wrong. This left me feeling demoralised as I still don’t think I’m doing them correctly. Any tips for this would be great too.

Psychologically I can get my head round that my sex life will be no more - being single, I can’t imagine many women will be lining up to date someone with erectile issues but I’m more concerned with incontinence. Will age be on my side or will I have to ensure I’m doing pelvic floor exercises correctly?

 

User
Posted 13 Feb 2025 at 21:30

Good luck with everything tomorrow.

I was in a similar situation to you in 2022: low PSA, Gleason 7 (3+4), four positive cores, and 20% pattern four. At 47 I was a bit older, though still young in prostatectomy terms. Like you, age was a big factor in my choosing RP.

In your first post you say that you are resigned to your sex life being over, but I just wanted to say that definitely does not have to be the case. It will likely take some adaptation but I don't think it's true that no women will now be interested. There are all sorts of people looking for, prioritising and valuing different things in a partner. 

Anyway, for now the main thing will be to rest, recover and get back on your feet. Hope it goes really well.

User
Posted 07 Feb 2025 at 23:00

Had my prostatectomy almost 6 months ago. I was fortunate with no incontinence when the catheter was removed. Also some ED issues, but are resolved with now a need to take Viagra on date night. This does not surprise me as I am 71, and although I did not need viagra prior to my surgery, I knew I was getting older and probably on borrowed time before ED issues anyway at my age. At your age they say the ED continues to improve over 18 months. You have great prospects at your age. Best of luck!

User
Posted 08 Feb 2025 at 00:16

Hi 

I’m sorry that you’ve had to join us at a young age. I’m 43 and now 6 weeks post surgery, the recovery has gone reasonably well. The first couple of days you have to learn what works best for you in terms of mobility, getting in and out of bed/chairs etc and the catheter but then it gradually gets easier. I was incontinent when the catheter was removed but this is improving each week and now mostly down to just leakage when walking. I’ve got used to it and being young you will hopefully be ok. I was using the Squeezy app for a few weeks before surgery and found it useful to get reminders throughout the day when I was at work. Now I’m working the hospital physios range of exercises.

I’ve had some movement on the erection front and so hopefully this will gradually come back. I’m due for medication when I see the consultant in 4 weeks to help with blood flow and then a follow up appointment with the specialist team which you should also have, so there is lots of support to deal with any potential ED issues. If your surgery is nerve sparing then this will also help. 

I wish you all the best 

JP 

User
Posted 08 Feb 2025 at 07:16

Hi Craig.

I'm sorry that you've had to join the club, but welcome to the forum, mate.

Coincidentally, I had robotic surgery on Valentine's Day two years ago. ❤️ 

Here's how I've got on:

https://community.prostatecanceruk.org/posts/t30214-Almost-a-year-on-after-RARP

Good luck. 👍

Show Most Thanked Posts
User
Posted 07 Feb 2025 at 16:26

It is really quite simple to do pelvic floor exercise. When you start passing urine stop the stream, count up to 10 and let go and repeat. When you stop the urine  flow you are using your pelvic floor muscles. The process is intuitive and you don't need to pay a physio to teach you that. That is what I was told by my consultant surgeon after  I had prostatectomy over 14 years ago and it worked for me.

You are young and have an excellent chance of coming through both continent and functioning erectile function. Even if you have problems there are excellent options such that you don't have to give up your sex life.

 

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 07 Feb 2025 at 23:00

Had my prostatectomy almost 6 months ago. I was fortunate with no incontinence when the catheter was removed. Also some ED issues, but are resolved with now a need to take Viagra on date night. This does not surprise me as I am 71, and although I did not need viagra prior to my surgery, I knew I was getting older and probably on borrowed time before ED issues anyway at my age. At your age they say the ED continues to improve over 18 months. You have great prospects at your age. Best of luck!

User
Posted 08 Feb 2025 at 00:16

Hi 

I’m sorry that you’ve had to join us at a young age. I’m 43 and now 6 weeks post surgery, the recovery has gone reasonably well. The first couple of days you have to learn what works best for you in terms of mobility, getting in and out of bed/chairs etc and the catheter but then it gradually gets easier. I was incontinent when the catheter was removed but this is improving each week and now mostly down to just leakage when walking. I’ve got used to it and being young you will hopefully be ok. I was using the Squeezy app for a few weeks before surgery and found it useful to get reminders throughout the day when I was at work. Now I’m working the hospital physios range of exercises.

I’ve had some movement on the erection front and so hopefully this will gradually come back. I’m due for medication when I see the consultant in 4 weeks to help with blood flow and then a follow up appointment with the specialist team which you should also have, so there is lots of support to deal with any potential ED issues. If your surgery is nerve sparing then this will also help. 

I wish you all the best 

JP 

User
Posted 08 Feb 2025 at 07:16

Hi Craig.

I'm sorry that you've had to join the club, but welcome to the forum, mate.

Coincidentally, I had robotic surgery on Valentine's Day two years ago. ❤️ 

Here's how I've got on:

https://community.prostatecanceruk.org/posts/t30214-Almost-a-year-on-after-RARP

Good luck. 👍

User
Posted 08 Feb 2025 at 16:08

I think it’s fair to say that while there may be some commonalities, everyone’s individual pathway and outcome will be different.

I was diagnosed with about a year ago, aged 49, with similar Gleason 7 to you. After a few months of consideration, I had surgery 12 weeks ago and am doing well. See my profile for more.

I think age and physical health will absolutely have played a part in my recovery prospects - as would the degree of cancer spread, the skill of the surgical team and a sprinkle of luck.

So do what you can and try not to stress. You have caught this early and you have age on your side!

User
Posted 10 Feb 2025 at 15:32

42 seems awfully young to be having an RP can you tell us more about your PSA history,  gleason score, staging etc ?

User
Posted 10 Feb 2025 at 17:35

Hi

Went to doctor with tailbone pain and mentioned Chris Hoy so doctor referred me for blood test in November. Had a PSA of 3.93 and second blood test few weeks later of 4. Lesion found on right side of prostate during MRI.

18 samples taken in biopsy and with four coming back with Gleason score of 3+4=7 with some early more aggressive changes with cribriform pattern present (pattern 4 is 20%)

was told radiation used for older men because if cancer came back I wouldn’t be able to have prostate removed and can cause secondary cancers eg bladder.

Edited by member 10 Feb 2025 at 17:39  | Reason: Add info

User
Posted 10 Feb 2025 at 18:45
Just a thought if you don't have kids and think you may still want some you will need to get some sperm frozen.. While sex can be great after RP you will not be having any kids however much you try!
User
Posted 10 Feb 2025 at 19:04

Yeah had that surreal experience two weeks ago

User
Posted 12 Feb 2025 at 19:22

What about HIFU  have you not been given HIFU option ?

 

User
Posted 12 Feb 2025 at 20:01

Good luck with your surgery. I think and this is only my personal opinion formed by reading around the subject, given your age and your diagnosis that surgery is probably the best option for you. Being so young you potentially could be bothered by the side effects of radiation that can occur many, many years after treatment. Of course if needs must you could have salvage radiotherapy if needed some way down the line. That however may never be required. Again given your age and the potential aggressive features of your diagnosis focal treatments may not be a sensible option. Again only a personal opinion there is no very long term data available about some of these focal treatments because they are relatively new and therefore long term studies have not been possible. You may have another 45 years plus so you would want to know the long term outcomes.

You are young which hopefully will mean that you will recover from surgery quickly. Most men recover from any incontinence within a few months although ED can be longer to overcome. Hopefully you will have nerve sparing surgery which will improve your chances of overcoming ED.

Do you have a family history of prostate or breast cancer? If so it may be worthwhile having genetic testing. Just a thought.

User
Posted 12 Feb 2025 at 20:45

Thank you. Yes, all told I was recommended having prostate removed and due to my age hopefully the after effects will not be as bad as I’m fearing.

I’m doing a genetics thing with Royal Marden as have many male cousins and they all have sons. My grandmother had breast cancer and I know there’s a possible link there.

I’m lucky I caught it early as if I’d waited until 50 for a blood test I’d be dead or the cancer would have spread causing all sorts of problems. So I’m just getting word out to any men under 50 to get checked out.

User
Posted 13 Feb 2025 at 21:30

Good luck with everything tomorrow.

I was in a similar situation to you in 2022: low PSA, Gleason 7 (3+4), four positive cores, and 20% pattern four. At 47 I was a bit older, though still young in prostatectomy terms. Like you, age was a big factor in my choosing RP.

In your first post you say that you are resigned to your sex life being over, but I just wanted to say that definitely does not have to be the case. It will likely take some adaptation but I don't think it's true that no women will now be interested. There are all sorts of people looking for, prioritising and valuing different things in a partner. 

Anyway, for now the main thing will be to rest, recover and get back on your feet. Hope it goes really well.

User
Posted 13 Feb 2025 at 21:34

Thank you, yeah I know women all have different needs and wants so hopefully not too much of an issue. Like I say, incontinence is my biggest fear but again, hoping age will help with that too.

User
Posted 15 Feb 2025 at 02:26

Hey there. Just thought I'd chime in aith a positive story. In May of last year, I was diagnosed with PCa stage T3a (psa 12.7). My biopsy also showed some Cribriform pattern as well. I was 51 and in relatively good health otherwise so I had RARP in August. Because my cancer had penetrated one of the nerve bundles, I had only partial nerve sparing. Despite all this, when my catheter was removed, I was already 99% continent which gradually became 100% somewhere around the 2 month mark. Better yet, I immediately had FULL erectile function following catheter removal. No need for any pills or pumps etc... 

The best things you can do for yourself leading up to your surgery are eat healthy,  exercise, get (or keep) your weight and BP down, and continue regularly with the Kegels. Good cardiovascular health is important for erectile function and the Kegels absolutely aid in regaining full continence.

You are young and have been diagnosed early. Take care of yourself both mentally and physically. You will do well.

 

-Mike

User
Posted 16 Feb 2025 at 15:58

Hello i am 61 and had my prostate removed robotically. Surgeon says it went well and used nerve sparing procedure. Im from Canada. I had to wear a catheter for 2 weeks after surgery. Once removed i leaked like a sieve. But within a week i was completely fine and never leak, which really surprised me. I never even did any keigel excercises. 
I currently am experiencing a lot of pain and discomfort in the perineal area and some discomfort when i pee. I have a follow up with a urinary wellness clinic next week ao i will be asking about that. I haven’t given much thought to impotence yet as i just want to get the soreness dealt with first. But i will definitely want to address this soon. I had no issues in this are prior to my diagnosis. My PSA was. 12, and Gleason score of 7 3-4 low/med. this all came as a complete shock…but working thru it as best i can. Wish everyone on this platform the very best!! I just realized i didnt start a new post but responded to an existing one. For the bloke who had this in his forties i would think everything will come back fairly quickly for you given the fact you didn’t have any previous issues. Though ED issues can take some time. Wish you the best!! 

Edited by member 16 Feb 2025 at 17:07  | Reason: Forgot to add my PSA level

 
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