The surgery removed the cancer. Now you rebuild the function. Here is what changes, what comes back, and what is yours to work on.
The prostate sits under the bladder and wraps around the urethra. Removing it means cutting through muscle, nerve, and connective tissue that kept you dry without a thought.
So four things change for a while. Bladder control. What your body can do. Sex. And how you feel about all of it.
Two sphincters kept you dry. The internal one sat where the prostate was, and surgery damages or removes it. The external one is part of your pelvic floor, and you can train it.
Leaking is common at first and it fades for most men. Most see significant improvement within three to six months. The muscle does not get stronger by waiting. It gets stronger with training.
Walking starts right away. Lifting waits. Most men are back to light activity at four to six weeks and to full activity around twelve weeks, with their doctor's clearance.
Golf, the gym, and running all come back. They come back in steps, and the rule is the same for each: if it makes you leak, you are not ready for it yet.
The nerves that control erections run along the sides of the prostate. Even with a nerve-sparing surgery they are stretched and bruised, and they heal slowly.
Most men have some erectile dysfunction after surgery. For some it is temporary. Erections may start returning between months two and six, and improvement continues through eighteen months. If they have not started returning by six months, ask your urologist about options.
Some men leak urine at orgasm. It is called climacturia. It is not dangerous. Emptying your bladder first helps.
The pelvic floor plays a direct part in erections, so the same training that helps you stay dry helps here too.
You are supposed to feel grateful, and you do. You may also feel frustrated, embarrassed, and angry. Both are true at once.
Some men pull back from their partner or stop going out. If that is you, you are not weak. You are dealing with a real loss of function. Talk to someone. The men who recover best rarely do it alone.
Your recovery depends more on what you do after surgery than on what happened during it. Walk. Learn the pelvic floor muscle. Train it in a set order. Keep going on the bad days.
The pad is temporary. The embarrassment fades. The strength comes back.
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Kegel Exercises After Prostate Surgery: How to Do Them Right
Exercises to Do Before Prostate Surgery
When Can You Exercise After Prostate Surgery? Walking, Lifting, Golf, Running
The First Week After Prostate Surgery: What to Expect
Recovery After Prostate Surgery: A Week-by-Week Guide
Pads for Men After Prostate Surgery: What to Buy and How to Leave the House
Pelvic Floor Physical Therapy After Prostate Surgery: Do You Need It?
The Stages of Incontinence After Prostatectomy
Still Leaking 3 or 6 Months After Prostate Surgery? What to Do Next
Kegel Exercises for Men: How to Do Them Right
Your Husband Is Having Prostate Surgery: How to Help
Dr. Meg Cochran is a licensed Doctor of Physical Therapy specializing in pelvic floor rehabilitation, and treats men after prostate surgery through Where You Are Physical Therapy in Oxford, Mississippi.
This article is educational and is not medical advice, a diagnosis, or a substitute for in-person care. Follow your surgical team's instructions. If you have urgent symptoms including severe pain, fever, unexpected bleeding, or a sudden change in function, contact your healthcare provider.
The first week after prostate surgery, written out step by step by Dr. Meg. What to do with the catheter in. What to skip. What to have in the house. Enter your email and it opens right away.
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Educational content. Not medical advice.
The Prostate Recovery Quick Start is Dr. Meg showing you the first exercises on video, from before surgery through week 4, with the two sheets to print. Open it on any phone, tablet, or computer, from anywhere. It is educational, not physical therapy.
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