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Radical prostatectomy in mid/late 30s

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User
Posted 27 Apr 2026 at 15:02

Hi,

I honestly dont know where to start with this. 

I have been diagnosed with prostate cancer 2 years ago. My main issue has been slow flow and painful urination (which had previously been dismissed for 15 or so years by various doctors as 'normal')... I had been given an estimated span before needing any surgery of about 10 or so years. With the potential for whatever surgery is available then.

My consultant is now suggesting a couple of options to help reduce the pain and flow issues, 1 will fix just the urination, the other will resolve my urination issues and the cancer would be a radical prostatectomy. 

I am swayed towards the radical prostatectomy option as it will be a big weight off my mind. However I am concerned about the long term consequences on the physical relationship with my GF. We are close and do talk a lot but she is very concerned its going to end up a sexless relationship, I am hoping quite a bit that this will not be the case. 

Has anyone got any advice to keep it going/working?

User
Posted 27 Apr 2026 at 17:39

Hi Sussex30s

You are very unfortunate to have been diagnosed with prostate cancer so young. One thing I can say to you is that this does not mean end to your sex life. I speak from experience. I was much much older than you when I had prostatectomy 15 years ago. Before the surgery we had a very passionate relationship and post surgery we are equally active.  With luck you should have a complete recovery because you are young. Of course you have a difficult decision to make - whether to have surgery or choose a non-surgical option. Good luck.

 '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 27 Apr 2026 at 21:06

Thanks for the additional details.👍

Many years ago I had similar urination problems and was prescribed Tamsulosin, it helped me.

It's great that your Gleason score is low. Have you ever been diagnosed with an enlarged prostate or prostatitis? Both conditions can cause urination difficulties and elevated PSA levels.

If you decide to remain on active surveillance, I hope it is successful. You may be one of the lucky ones who never need radical treatment. Make sure that you continue with regular PSA checks and follow up MRI scan and possible further biopsies.

I also hope that your urination problems get effectively treated.

Good luck.👍

 

Edited by member 27 Apr 2026 at 21:58  | Reason: Typo

User
Posted 27 Apr 2026 at 22:13

If you decide to have surgery, and it can be nerve sparing, it is possible that you may avoid any erectile dysfunction side effects. 

Here's an informative video made by a very experienced prostate surgeon. 

It's worth viewing.

https://drive.google.com/file/d/1fyYTLZpxnB9HaR7O4xQ5Ff58Pj4Cn6ZB/view

 

User
Posted 27 Apr 2026 at 23:04
Sorry for calling this one spam, hope you get yourself sorted soon.

User
Posted 27 Apr 2026 at 23:10

Thank you. Fingers crossed it can be nerve sparing. Will give the video a watch in the morning.

User
Posted 27 Apr 2026 at 23:18

Hi

I’m sorry to read that you’ve had problems for a while and also at such a young age. I had a radical prostatectomy at the age of 43 in December 2024 following a diagnosis of 3+3 at T2c. Like you I was worried about the ED impact, sex life and incontinence. The surgery was nerve sparing and within a few months with the help initially of an ED pump I was able to achieve erections again, now they are happening naturally and the sex life has continued on. I’m lucky on this front but have had problems with a urethral structure which means I have to self catheterise every few days in order to reduce the risk of going into urinary retention, I also still wear a small pad when going out. I’ve got used to this situation and it doesn’t bother me now but some potential side effects for you to consider when making your decision. Physically I feel pretty good, the odd twinge but I’m running reasonable distances and active with the children so I’m happy. 

Good luck, Jamie 

User
Posted 28 Apr 2026 at 08:02
I went from Gleason 6 (3+3) T1c to Gleason 7 (3+4) T2c over the course of my Active Surveillance and was on Tamsulosin for a few years for LUTS symptoms. Details in my profile.

In March this year I had radical prostatectomy, nerve sparing, performed by the surgeon in Adrian56's video linked above. Of course I was also worried about after effects but I was continent as soon as the catheter was removed after 2 weeks and have no ED, everything was normal after catheter removal. I am taking daily Tadalafil 5mg for rehabilitation. A beneficial side effect is that urine flow is now completely back to normal, even better that when taking Tamsulosin - I have stopped Tamsulosin now as it is not needed after surgery.

I would definitely advise talking to a high volume surgeon to discuss your cancer location and potential for nerve sparing surgery, they can review the MRI and biopsy results.

Wish you well with your decision and treatment plan whatever you decide.

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User
Posted 27 Apr 2026 at 17:39

Hi Sussex30s

You are very unfortunate to have been diagnosed with prostate cancer so young. One thing I can say to you is that this does not mean end to your sex life. I speak from experience. I was much much older than you when I had prostatectomy 15 years ago. Before the surgery we had a very passionate relationship and post surgery we are equally active.  With luck you should have a complete recovery because you are young. Of course you have a difficult decision to make - whether to have surgery or choose a non-surgical option. Good luck.

 '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 27 Apr 2026 at 18:00

Thank you. My consultant thinks im the youngest he's ever had to tell. It was a battle getting diagnosed, im so young so of course I wouldn't have prostate cancer! But eventually a consultant booked a template biopsy and after a cancelled operation I got a diagnosis. 

It is a difficult choice with the surgery options, along with a sort of rushed feeling about making a choice on children as I thought I would have a few more years before having to make a decision. 

User
Posted 27 Apr 2026 at 18:02

Im sorry you feel that way. I promise you I am a very real bloke who has been lucky/unlucky to be diagnosed at this age.

User
Posted 27 Apr 2026 at 18:03

Im not a big forum person, im sorry if my etiquette isnt right. I just felt a need to try and discuss this with other people that have it. Rather then hearing 3rd hand stories from a very small sample size.

User
Posted 27 Apr 2026 at 19:57

Hello.

I wonder if you'd be kind enough to provide more information. It would enable us to make more informative comments.

What is your PSA? What is your cancer staging? What is your Gleason score? If you were diagnosed two years ago, what treatment, if any, have you been having?

Thanks.

User
Posted 27 Apr 2026 at 20:05

Sorry, Of course.

My PSA is 9 and has slowly been increasing. My gleason score from the original biopsy was 7 (3+4), my recent one was 6 (3+3).

The treatment has been active monitoring with tamsilosin to help urination (not much of an improvement). I tried a month of ciprofloxacin to see if that would reduce the inflammation that they have mentioned at every appointment but never really looked into it, this has had no effect on the PSA.

I have had cameras, ultrasounds and urodynamics done on my bladder and the prostate is pushing up at the outlet creating a cup, making it painful and slow to urinate. This was originally what made me go and a big symptom to prompt PSA check and now they are saying its not the cancer causing it.

User
Posted 27 Apr 2026 at 21:06

Thanks for the additional details.👍

Many years ago I had similar urination problems and was prescribed Tamsulosin, it helped me.

It's great that your Gleason score is low. Have you ever been diagnosed with an enlarged prostate or prostatitis? Both conditions can cause urination difficulties and elevated PSA levels.

If you decide to remain on active surveillance, I hope it is successful. You may be one of the lucky ones who never need radical treatment. Make sure that you continue with regular PSA checks and follow up MRI scan and possible further biopsies.

I also hope that your urination problems get effectively treated.

Good luck.👍

 

Edited by member 27 Apr 2026 at 21:58  | Reason: Typo

User
Posted 27 Apr 2026 at 21:13

I've been told that they still base the situation on the original gleason score? Anything lower is potentially just missed where the 4s were last time.

They are saying right anterior (the side with the cancerous cells) is enlarged and firm.

The ciprofloxacin was to try and see if prostatitis was a problem but didn't seem to do anything.

The consultants believe that the prostatectomy will solve the urination and cancer at the same time. At this point if it makes urination less painful then im willing to give it a go. And the bonus of becoming cancer free seems like a good thing.

Its just the worry that things wont work again after the surgery.

User
Posted 27 Apr 2026 at 22:13

If you decide to have surgery, and it can be nerve sparing, it is possible that you may avoid any erectile dysfunction side effects. 

Here's an informative video made by a very experienced prostate surgeon. 

It's worth viewing.

https://drive.google.com/file/d/1fyYTLZpxnB9HaR7O4xQ5Ff58Pj4Cn6ZB/view

 

User
Posted 27 Apr 2026 at 23:04
Sorry for calling this one spam, hope you get yourself sorted soon.

User
Posted 27 Apr 2026 at 23:07

No worries :) im sure you do get bots so better safe than sorry.

User
Posted 27 Apr 2026 at 23:10

Thank you. Fingers crossed it can be nerve sparing. Will give the video a watch in the morning.

User
Posted 27 Apr 2026 at 23:18

Hi

I’m sorry to read that you’ve had problems for a while and also at such a young age. I had a radical prostatectomy at the age of 43 in December 2024 following a diagnosis of 3+3 at T2c. Like you I was worried about the ED impact, sex life and incontinence. The surgery was nerve sparing and within a few months with the help initially of an ED pump I was able to achieve erections again, now they are happening naturally and the sex life has continued on. I’m lucky on this front but have had problems with a urethral structure which means I have to self catheterise every few days in order to reduce the risk of going into urinary retention, I also still wear a small pad when going out. I’ve got used to this situation and it doesn’t bother me now but some potential side effects for you to consider when making your decision. Physically I feel pretty good, the odd twinge but I’m running reasonable distances and active with the children so I’m happy. 

Good luck, Jamie 

User
Posted 28 Apr 2026 at 08:02
I went from Gleason 6 (3+3) T1c to Gleason 7 (3+4) T2c over the course of my Active Surveillance and was on Tamsulosin for a few years for LUTS symptoms. Details in my profile.

In March this year I had radical prostatectomy, nerve sparing, performed by the surgeon in Adrian56's video linked above. Of course I was also worried about after effects but I was continent as soon as the catheter was removed after 2 weeks and have no ED, everything was normal after catheter removal. I am taking daily Tadalafil 5mg for rehabilitation. A beneficial side effect is that urine flow is now completely back to normal, even better that when taking Tamsulosin - I have stopped Tamsulosin now as it is not needed after surgery.

I would definitely advise talking to a high volume surgeon to discuss your cancer location and potential for nerve sparing surgery, they can review the MRI and biopsy results.

Wish you well with your decision and treatment plan whatever you decide.

User
Posted 28 Apr 2026 at 08:41

Originally Posted by: Online Community Member
In March this year I had radical prostatectomy, nerve sparing, performed by the surgeon in Adrian56's video linked above.

I 'borrowed' his video from

https://prostatematters.co.uk/

Which is an excellent resource, with contributions from many doctors and surgeons with specialist skills in various prostate cancer treatments. 

I often post that particular video as I believe it is a 'must view' for anyone considering surgery.

However, I presume access to these top surgeons is 'private only' and most seem London based. 

Edited by member 28 Apr 2026 at 09:04  | Reason: Reduce text.

 
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