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User
Posted 15 Oct 2025 at 08:09

Less than 24 hours post RALP. So far so good - catheter is a bit sore, is that normal? Also pain just under ribs - is that normal? Apologies for the questions - best wishes to all in this group

User
Posted 15 Oct 2025 at 09:38

Hello.

Welcome to the forum, mate.

Yes, the catheter can cause tenderness and discomfort and you can get aches and pains in the abdominal area and shoulders apparently. Because you're usually only in for a night people tend to forget that they've had major surgery.

Good luck with your recovery and please keep us updated with your progress. 👍

Edited by member 15 Oct 2025 at 09:41  | Reason: Additional text

User
Posted 15 Oct 2025 at 10:33

Cheshire, get some instilagel, hydrocaine or optilube from the chemist. They are gels designed for catheter care available without prescription at most pharmacies except Boots. They contain anesthetic, antiseptic and lubricant. They cost around £3 a syringe, they have a plastic tip. In hospital the nurse puts the tip slightly into the eye of the penis.At home just try to get some gel into the eye of the penis , do not try pulling the catheter out push the penis back to expose a bit more of the catheter and lube it. 

These gels are designed for catheter use , many medical sites say do not use vaseline.

User
Posted 01 Jan 2026 at 22:12

Was there any talk of having radiation treatment to the prostate bed or being referred to an oncologist. I have seen it said on here that sometimes urologist don't like to think there surgery has not worked and are slow to refer you onto oncology. A PSA that rises some time after surgery could be out side the prostate bed , mine was.  While a PSMA scan may not usually pick up anything below, the case of Ulsterman springs to mind, a PSMA scan at 0.023 saw a tumor and I believe it was successfully treated. 

Thanks Chris 

User
Posted 02 Jan 2026 at 09:15

A similar situation to me. Histology showed a positive margin and my fist PSA was 0.28. I know that's the last thing you want to hear after going through surgery. I can only reiterate what Colwick Chris has already said. Push for a PSMA PET scan to try to locate the source. My PSA was around 0.45 by the time I had my scan but nothing was detected. It's a bit of the luck of the draw with PSMA scans. In the end I had radiotherapy  to the prostate bed (as a best guess) and that did the trick.

User
Posted 02 Jan 2026 at 11:13

Originally Posted by: Online Community Member
 Saw my urologist earlier this week, and some disappointing news - or at least I think it was. Histology showed some areas where there was no clear margin. Also my PSA was 0.12 - I was hoping it would be undetectable 8 weeks post surgery. I’m now worried that there were some rogue cells left behind.

Hello, mate.

I can understand your disappointment. I believe 'immediate' detectable PSA levels following surgery, are known as BCP (biochemical persistence) As opposed to BCR, where initial PSA levels were 'undetectable' than rose to detectable levels. A recent study of over 1000 patients who had RARP showed that 13% had BCP. So it is fairly common.

https://pubmed.ncbi.nlm.nih.gov/36979706/#:~:text=Results:%20Of%20all%201155%20patients,design%20and%20incomplete%20follow%2Dup.

As for PSMA scans, I believe the eminent, Dr Scholz, equates their success rate as 90% at a PSA level of 0.9, on a sliding scale down to 10% at a PSA level of 0.1.

Good luck, with any further results and treatment that may be deemed necessary. 👍

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User
Posted 15 Oct 2025 at 09:38

Hello.

Welcome to the forum, mate.

Yes, the catheter can cause tenderness and discomfort and you can get aches and pains in the abdominal area and shoulders apparently. Because you're usually only in for a night people tend to forget that they've had major surgery.

Good luck with your recovery and please keep us updated with your progress. 👍

Edited by member 15 Oct 2025 at 09:41  | Reason: Additional text

User
Posted 15 Oct 2025 at 10:33

Cheshire, get some instilagel, hydrocaine or optilube from the chemist. They are gels designed for catheter care available without prescription at most pharmacies except Boots. They contain anesthetic, antiseptic and lubricant. They cost around £3 a syringe, they have a plastic tip. In hospital the nurse puts the tip slightly into the eye of the penis.At home just try to get some gel into the eye of the penis , do not try pulling the catheter out push the penis back to expose a bit more of the catheter and lube it. 

These gels are designed for catheter use , many medical sites say do not use vaseline.

User
Posted 16 Oct 2025 at 15:32

Hi Cheshire.   My top tip for catheter is do away with the stand for your night bag and place it in a cat litter tray as I found it easier to sleep with    Hopefully you’ve got 2 thigh straps so shower with one , take it off and use the other that dry and vice versa    You will get used to it.   Good luck with recovery 

User
Posted 16 Oct 2025 at 16:27

Post op I also had pain under the ribs. It shifted about a bit. Took a while to resolve. I also got really bad colic as well 3 weeks post op. When I mentioned this to surgeon he said he could not be responsible for anything I described key hole surgery is just that. The clinical nurses begged to differ, she said it's common and my body was resetting itself after a lot of internal trauma....

User
Posted 16 Oct 2025 at 20:23

The pain you are experiencing around the diaphragm sounds like trapped carbon dioxide gas in the abdominal cavity. It often causes a referred pain in the shoulder. I had it and its not very nice. Thankfully it doesn't last too long. CO2 is used with laparoscopic surgery to inflate the abdomen and separate the organs. Some gets left behind. It's not surprising it's painful when you think about it. Have you ever belched after a fizzy drink and the gas comes out of your nose? Ouch.

User
Posted 17 Oct 2025 at 07:30

I didn’t have any pain per se post op but was full of wind and ended up belching for about 3 days to get rid of it. At least it was not from the rear! As my wife said at the time it reminded her of the scene in the elevator in the original Willy wonka film. Good luck with the recovery. 

User
Posted 17 Oct 2025 at 09:09

Thank you for the replies. Back home now, still painful but seems to be getting better. Just need to speak with my nurse about number 2s now!

User
Posted 01 Jan 2026 at 21:58

Just an update and a further question. Had surgery in October - and recovery has gone as well as can be expected. Saw my urologist earlier this week, and some disappointing news - or at least I think it was. Histology showed some areas where there was no clear margin. Also my PSA was 0.12 - I was hoping it would be undetectable 8 weeks post surgery. I’m now worried that there were some rogue cells left behind. Lets hope 2026 is better for all of us. 

User
Posted 01 Jan 2026 at 22:12

Was there any talk of having radiation treatment to the prostate bed or being referred to an oncologist. I have seen it said on here that sometimes urologist don't like to think there surgery has not worked and are slow to refer you onto oncology. A PSA that rises some time after surgery could be out side the prostate bed , mine was.  While a PSMA scan may not usually pick up anything below, the case of Ulsterman springs to mind, a PSMA scan at 0.023 saw a tumor and I believe it was successfully treated. 

Thanks Chris 

User
Posted 02 Jan 2026 at 09:15

A similar situation to me. Histology showed a positive margin and my fist PSA was 0.28. I know that's the last thing you want to hear after going through surgery. I can only reiterate what Colwick Chris has already said. Push for a PSMA PET scan to try to locate the source. My PSA was around 0.45 by the time I had my scan but nothing was detected. It's a bit of the luck of the draw with PSMA scans. In the end I had radiotherapy  to the prostate bed (as a best guess) and that did the trick.

User
Posted 02 Jan 2026 at 11:13

Originally Posted by: Online Community Member
 Saw my urologist earlier this week, and some disappointing news - or at least I think it was. Histology showed some areas where there was no clear margin. Also my PSA was 0.12 - I was hoping it would be undetectable 8 weeks post surgery. I’m now worried that there were some rogue cells left behind.

Hello, mate.

I can understand your disappointment. I believe 'immediate' detectable PSA levels following surgery, are known as BCP (biochemical persistence) As opposed to BCR, where initial PSA levels were 'undetectable' than rose to detectable levels. A recent study of over 1000 patients who had RARP showed that 13% had BCP. So it is fairly common.

https://pubmed.ncbi.nlm.nih.gov/36979706/#:~:text=Results:%20Of%20all%201155%20patients,design%20and%20incomplete%20follow%2Dup.

As for PSMA scans, I believe the eminent, Dr Scholz, equates their success rate as 90% at a PSA level of 0.9, on a sliding scale down to 10% at a PSA level of 0.1.

Good luck, with any further results and treatment that may be deemed necessary. 👍

User
Posted 28 Jul 2026 at 14:00

So, 6 months further on and my PSA continues to rise. It’s now 0.22 and I’m waiting on a referral to the oncologists - HT and radiotherapy? Situation not helped by the need to remove a small bowel neuroendocrine tumour. It never rains……

User
Posted 31 Jul 2026 at 06:50

It must be difficult to see your PSA rise from 0.12 after surgery to 0.22 six months later, particularly when the surgical margin was not completely clear. Hopefully, the oncology referral will help explain what the PSA trend means in your situation and whether further prostate cancer treatment, such as radiotherapy, hormone therapy, or a combination of both, may be worth considering.

The small bowel neuroendocrine tumour understandably makes everything feel even more overwhelming. It may be helpful to ask whether the prostate and bowel teams can coordinate their plans and explain which treatment needs to happen first, as well as how one may affect the timing of the other. I hope you receive a clear and manageable plan soon.

 
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