A notation on a desk calendar I saw this morning reminded me that one year ago I took a short ride on a gurney into an operating room to have my cancerous prostate removed.
Looking back, it also was a relatively short road back to bicycling, although at the time I worried whether I would ever be able to sit on a bike saddle again. As it turned out, I was able to ride the 2-day, 200-mile Seattle to Portland bike ride with my son less than 10 months later (here we are with our patches).
In the past year, I occasionally receive e-mails from men who are about to undergo prostate surgery or who have recently undergone the operation. Because they read this blog, they’re interested in how the surgery will affect their bicycling. Here’s how it affected my riding.
Diagnosis
I went in for surgery about six weeks after I received the definitive word that I had cancerous tumors on both sides of my prostate. The tumor had not yet escaped the confines of the prostate, however, and my doctor said removal of the prostate would probably stop the cancer.
He recommended minimally invasive prostatectomy using the da vinci robotic device. Instead of opening my abdomen like a zipper, the procedure required making five small incisions to get at my prostate. Only one incision required stitches (the one in my navel); the others were closed with tape.
Early recovery
Even with the small incisions, my abdomen was plenty sore after the operation. That soon passed, although my navel was tender to the touch for months afterward. There was no scar to heal though, no blood loss. I was walking around the block with my catheter the day I got home and was walking four-mile roundtrips to the shopping center a couple of days later.
A nurse removed the catheter a week after the operation, which made walking much easier and more comfortable. Incontinence wasn’t much of a problem; I wore a pad for a couple of weeks but it stayed dry most of the time.
Any long-time sitting was uncomfortable though. I kept walking, wondering if I would ever get back on my bike.
Back in the saddle
Near the end of October, however, I started riding again. The first ride was about as short as my first walk after returning home — about a half-mile. I stopped 2 or 3 times to readjust my seat — a newly purchased Terry Liberator Y — to find a comfortable spot. I never did find it, but settled on a position slightly forward. About a month later I moved it back to its normal position.
On Oct. 31, I recorded a 5-mile ride. That’s 35 days after my operation. I never stopped riding after that.
In November, I went on 15 bike rides. The average distance was about 11 miles. I see notations like: “A little tender.” “Feel OK.” “Took it easy.” “Picked up pace.” I was avoiding hills when I could and taking it slow.
I rode 21 miles on Nov. 24 (about two months after the operation) at a 13 mph pace, and did a couple of more 20-mile rides in December. All in all, though, most of my rides were slow (12 mph) and short (8 to 10 miles) through the end of the year.
2008
My first 50-mile ride came on a visit to Sacramento in January, four months after my surgery. I bicycled 312 miles that month and have been bicycling that much, or more, every month since.
The pleasure rides turned into training rides when my son and I decided to do the STP on July 12 and 13. By the time that ride rolled around, I had no problems riding the back-to-back centuries, finishing the second century in 6 hours and 15 minutes.
Success
I’m not a bike racer and never was. I rarely even get into the hammerhead mentality of racing anonymous cyclists out on the road. I’d rather match their pace — if I can — and chat with them.
So for me, success isn’t measured in winning races or even hanging onto the peloton. It’s measured in getting the opportunity to ride my bike out in the fresh air.
This is what worked for me:
1. Minimally invasive surgery. I had very little blood loss and could get on my feet the next day. Not for long periods, but I was on my feet. I’ve read and have been told that surgeons using the da vinci procedure can reconnect the bladder to the uretha better so the healing is quicker, causing less incontinence.
2. Post-operative walking. I walked several times a day; not fast to get out of breath but far enough to feel tired. No straining, just easy walking. (Also not much coffee or alcohol, which also helped me retain continence.)
3. Short, easy rides. When I returned to the bicycle, I did short rides. I didn’t go fast or hard. Think of the old lady with the wicker basket on the handlebars. That was me (although not in an upright position).
I did feel discomfort in my urethra after riding at first. But it was still sore anyway, with the stitches and scar tissue.
4. Picking up distance after a month. My early rides, every other day, were pretty short. When I could ride without feeling much soreness down below, I picked up the distance occasionally.
5. Back to normal bicycling. By the end of January I was feeling fine all the way around. I had no deadlines for bicycling or racing or touring. My only goal was just to be able to get back on the bicycle and ride like the old days.
State of mind
Probably more important than all those recovery techniques was my state of mind during this.
Lance Armstrong’s efforts to increase the visibility of his anti-cancer crusade by returning to professional cycling recently made me think about how I was feeling at the time.
I never felt like a victim. I didn’t wonder why this happened to me; it happens to one-in-six men. Fortunately there was a cure — surgery — and I had insurance coverage to afford it. (There are other types of surgery and radiation. You decide which is best for you. I just chose what was best for me.) Also, I have a loving and supportive family.
Now, I almost never think about my run-in with prostate cancer when I ride. But if I ever do, it’s only that I feel very happy to be back on the bike again.
Permanent link to this article: https://www.bikingbis.com/2008/09/27/how-i-returned-to-bicycling-after-prostate-surgery/
Thanks for sharing your story. My recent experience with prostate cancer is is similar to yours. I was fortunate to have a great surgeon perform the DaVinci robotic surgery with very minimal side effects. I was in fairly good shape prior to the surgery which always helps. I was an active cyclists prior the being diagnosed and the biopsy procedure. Its been about 10 weeks since the surgery and I have been aggressively working out running elliptical and weights. I have been afraid to get back on the bike for fear damaging any work that was so sucessfull. I did take a short ride about a week ago (a 3 min trip in the neighborhood). Afterward I was sore and concerned I had made a mistake but was feeling better in a few days.
What was your experience with beginning to ride and the soreness experienced?
I’m glad your recovery is going well, and I hope things continue to improve for you as time goes on. Be sure to stay on track with regular doctor visits and PSA tests!
I do remember being sore for weeks after the surgery, but I don’t think it was made any worse by bicycling, which I started 4 or 5 weeks after the surgery Just sitting in a chair made me sore, as I recall. My first rides were very short, and I spent as much time adjusting my saddle as riding. The soreness should go away as you ride more, but TAKE IT EASY!
Scheduled for robotic prostatectomy. Thanks for this information. Was experiencing a lot of fear about not being able to ride.
Don’t worry. Just give yourself some time to heal, and you’ll be back in the saddle just like before. Good luck with the surgery.
Gene, great article! It was just the information I was looking for. My first question to my surgeon was not what the surival rate or post surgery issues were but when and if I could ride again. I just bought a 2012 Cannondale Supersix and I was terrified that it would go to waste…lol. The general concensus seems to suggest a 5-6 week hiatus and then slowly easing back into it. I suspect that most of my muscle tone will be lost by that point so slow and short rides should not be a problem.
Thank you again.
Good luck, Dave. I’m sure you’ll be back on our bike before you know it! I still remember my first decent ride after surgery; I felt like a kid riding away from home for the first time.
After riding for the last 5 years, including a fabulous 3-day rise along the Icefields Parkway in the Canadian Rockies, I am heading to prostate cancer surgery at age 60 and hoping to get back on my bike. Your article is very encouraging. Has anyone found a seat that feels more comfortable after the surgery? Looking back I don’t think my seat did me any favors! Any suggestions? EasySeat? Horseshoe seat? Schwinn No-Pressure? My big riding days are behind me…just want to find comfort so I can continue post-surgery. Thanks.
Good luck on your operation. It sounds like you’ve been keeping yourself fit and that certainly helps with the recovery.
As for saddles, I switched to a Terry Liberator Y after the surgery and got it tuned in after what seemed like endless adjustments. It’s a touring saddle, so it made for a little more upright bicycling. There’s also a gel version that should be even softer, if that’s a problem.
There could be many other saddles that would be better, but that’s the one that worked for me.
Good luck…
Thanks for sharing the information on your operation.
My operation was 10-24-2013. Same operation. I am doing GREAT.
Good! Keep on rollin’!
Just had my 6 week checkup this morning for prostate removal via DaVinci robotic surgery. When I asked about bike riding my surgeon said “no, no, no, no”. He thought riding a bike this soon after surgery was probably the worst thing I could do. Hopefully when I see him next time he will have better news for me.
It’s always good to hear from someone recovering from prostate surgery. Let’s hope he allows you back on the bike soon… I’m sure you’re looking forward to pedaling again. In the meantime, take those walks.
Good luck!
Green Laser surgery was the ticket for me when an enlarged prostate actually sent me via ambulance to the emergency room. Four weeks after my operation I took my first long ride (2 hours) without a single problem. I would have biked sooner, but the Spring Nordic skiing conditions were the best in years. I actually cross-country skied over 22 miles in one day just 8 days after my operation. Folks reading this blog should definitely research Green Laser surgery. No actually incision is involved, and at least for me the road back to being normal has been very fast.
I documented everything via my own blog through a series of five posts. I had the same worries as everyone else, but the results have been fantastic. Here is my final post:
Thanks for sharing this story. I will have my surgery on June 10, 2013 and have been concerned about riding afterwards. I have a Livestrong friend who I ride with and he has been supporting me with encouragement and weekly 25-30 mile rides. The rides and company have been wonderful for my spirits and have been helping me stay in shape for the surgery. I hope to continue riding asap after surgery. Your blog has given me hope. Thanks!
Good luck, Philip. Just give everything time and take it slowly. You’ll do great!
I’m looking forward to Da Vinci surgery in April after we shrink my cancer a bit. Thanks for giving some guidance on coming back. I’ve been commuting for years and had worked up to about 100 miles per week before my diagnosis. Winter and reaction to hormone treatment have reduced that dramatically. I am as anxious about returning to cycling as I am the surgery. I depend on my bike to keep my weight down and heart healthy.
Thanks again for sharing.
Gene,
Thank you for sharing your experiences. I am six days past my Da Vinci surgery. My Gleason score was a 9 and there was originally concern that the cancer had escaped the prostate. However, preliminary frozen sections of the surrounding lymph nodes taken during the operation came back negative. At least initially, what a relief!! I am now beginning to focus on recovery and moving forward.
Like you, I have started walking, and even after a few days, I find that I can go further without tiring as much. The old adage of “listen to your body” is extremely true in this case. I was questioning when I might expect to get back on my bike and came across your wonderful commentary. I will plan to try a very easy ride in about four-to-five weeks and see what happens. At that point “listen to your butt” should truly control.
Thank you again for your encouraging words and insightful comments.
You’re welcome, Bill. Good luck with your recovery. I’m sure you’ll be itching for a ride when the time rolls around!
My robotic surgery was February 4, 2014. The cancer was confined to my prostate. Thank God that it didn’t spread. I have 2 more weeks before my six week check. I have been taking it easy but I’m chomping at the bit to climb back onto the saddle and ride. But I’ve learned during the recovery that I must listen to my body. Thanks for your article. It definitely has helped me. Good luck to everyone that has to go through the surgery. Stay positive and listen to your Dr and your body!
Hi, I had robotic surgery a week ago ,The technology now is just fantastic,.
I have been given the all clear in regard to the cancer being contained within the prostrate but have been informed I was lucky as it was about to spread. One section was a 9 on the Gleeson score.
I’m 59 Years old and love riding my bike, I only ride for fun and fitness ,and love exploring new bike paths etc.
I have started walking again, and I’m listening to my body and not pushing it, going further every day.
I have just ordered a moon saddle for my bike as I’m worried that in a month when I start riding again I may do damage with my old racing type saddle. So I’ll see how that goes.
Thankyou for your inspiring letter, and great advise. Good luck to all.
Cheers from Brisbane Australia. Ian.
I’m glad you had your surgery when you did! I’d be interested in hearing how that moon saddle works for you. Good luck with your recovery…Gene
Thanks Gene, I’ll give you an update on the saddle when I start riding again.
Cheers, Ian.
Hi Gene, its been about 20 days since my surgery and I have just tried out the moon saddle,
I barely noticed the difference in riding from a normal saddle, except for the lack of pain of course.
I found that I could ride one handed easily and could probably ride hands free with a little practice. Your weight is on the sit bones and nothing is between your legs so it is pain free.
The control of the bike feels the same to me.
I didn’t ride far, I’m as weak as a kitten now and will have to build up my strength again, but it sure was great to be zooming along again.
Cheers and regards to all, Ian.
I had a green light PVP several years ago. Had to use laser since I am on Coumadin due to lone afib. Tried the saddle I had been using and a couple of others from the local bike shop. All caused urinary bleeding. Did a bit of research, and my urologist agreed with me that the Selle SMP saddles should work. They did. No more bleeding. Expensive but worth it. Have been monitoring PSA, and last one was noticeably higher. Got another one a month later, and will see urologist shortly. When he ordered the PSA redo, the C word was mentioned, as well as radical prostatectomy. My first thought was will I still be able to ride?
This blog has put that issue to bed. Robotic surgery seems to be the way to go. Has anyone had such good results with regular surgery?
Can anyone in the northeast US recommend a good surgeon – Boston maybe.
Good luck to you all-Reed
Had my deVinci surgery on 16 June. it’s great and encouraging to see your biking results. I expect to be on my Tour Easy in August. Looking forward to the ride!
Had my DaVinci surgery on 16 June. it’s great and encouraging to see your biking results. I expect to be on my Tour Easy in August. Looking forward to the ride!
Reed, in answer to your q about reg surgey. It all depends on your surgeon. I read for a year and a half on all alternatives. Robotics is fine if your surgeon is well experienced. It takes at the very least 200 surgeries for a doctor to become comptent at it. One tiny mistake and you have incontinence for your life. A good regular urologic surgeon with 1000 surgeries under his belt would be better than a urologist with 100 robotics . The down side on reg surgery is possible long recovery time. Dont be the guy your robotics urologist is practicing on or else he will not get all the cancer and you are then in for radiation. I opted for seeds and radiation at Dattoli clinic in Fl because of the small size of my prostate and that the cancer had gone outside the prpstate, I am free and clear for 2 1/2 years. I chose Dattoli because they only do prostate work and are one of the best in the world. I didn’t want to take any chance and regret it later. Good luck.
Hi Jim, did you say the cancer had spread outside the prostate? Just curious, I just had robotic surgery July 5, 2022 and they took out 5 lymph nodes and one had cancer. Glad to hear you came through ok…. I go for my psa check November 14th to see if the Dr got all of it out…
Thanks, Perry
I thought that I would add my experience to this. I had the DaVinci procedure in London a little over seven weeks ago. I was home after a couple of days and back to work after four weeks. I had initially thought that I would be fit enough to return to work sooner than that but I did need all of that recovery time to face my longish commute by train. Since then, my recovery has been swift; I had anticipated a phased return to work but in the event got straight back into it. As for cycling, I tried out a Wattbike in the gym at four weeks; a brief spin up the road on my tourer at six weeks and a couple of 15 milers last weekend, seven weeks after surgery. I haven’t needed to replace the Brooks saddle that I favour but I suspect this must just be the luck of the draw, in fact I think that I had more discomfort cycling after the biopsy. I am now looking forward to building up my fitness and getting some miles in. As far as the Big Project is concerned, I have a post-op PSA test next week which will dictate what further treatment is required; hopefully none!
Thanks for the information provided here. I found it really encouraging to read prior to the surgery when I was wondering whether I would ever be able to cycle again, and to lose what has become a major of my life was quite gloomy to contemplate. I am sure others had similar thoughts, so chapeau Gene!
I can understand not being able to take long train rides after the surgery. Sitting is definitely an issue for the first few weeks. Nice that you’re back on the bike! Good luck with your continued recovery!
Inspiring thread ! As a very keen MTB, road and track cyclist and 48 yrs old its been tough getting diagnosed with prostate cancer. Thankfully bone and MRI scans are normal so going for keyhole prostatectomy in a few weeks. Lots of depressing stories online but this thread is helping with the post op planning of route back to riding.
Thanks for posting this. I just had my catheter removed yesterday and am getting twice daily walks in to warm up. Sadly DaVinci was not an option for me and my prostrate was removed via full frontal assault. I have been worried about bike riding since I too experience discomfort when seated for long periods. While I need a little longer to heal due to the invasive surgery I can at least look forward to the start of the Spring riding season. Thanks!
For some additional encouragement, I want to tell avid riders that I underwent DaVinci prostate removal At the end of April 2014. I went into surgery in the best cycling shape of my life. I started walking a bit a day after the surgery, and started walking more after catheter removal a week later. After 2 weeks I started using my Nordic Track ski machine which provided a good endurance workout without having to sit and risk problems. Two months after surgery I started riding again, settling on a Selle Italia Superflow saddle which I have come to really like. By September I was able to repeat as fastest rider in my age group (65+) in a good-sized Gran Fondo, bettering my performace of the previous year. So far this year I have ridden 4,000+ miles and am feeling great and look forward to more competitions.
My pathology report indicated a Gleason score of 7 (3 + 4), extension outside the prostate capsule, clear margins, and extensive perineural invasion. My latest PSA count last month continues to stay at the zero level ( < .02), initial problems with leakage have disappeared, and sexual function is probably 75% restored.
Hi Greg, I am glad all went well in your recovery, and your enjoying being back on the bike. But I had a question that I haven’t seen mention. After your initial first rides, was there any blood in the urine? I too just had my prostate removed in May 2015 and its going on 12 weeks, so i started riding 10 weeks and after surgery short 5-10 miles and after a 25m ride I noticed some light blood. So I wondered if anyone also experienced this at first and if so will it go away.
I am 45yr old and I am worried that i just sent my self back a month in recovery. If any one has had a similar experience please comment.
I had robotic surgery 15 weeks ago to remove my cancerous prostate(25percent) contained to the prostate. I have minimal incontinence and have started 7 1/2 weeks of radiation. My doctor will not allow me to get back the bike. I can run and walk but no bike. Prior to the cancer I was riding close to 70 miles per week.
Anybody advice or comments you could provide would be appreciated.
Thank you. I’m 3 months post surgery (42 yrs old) and want to start riding but was worried that it would be an impossibility.
I had the robotic surgery in March of this year. I started 7 weeks of radiation on as June 22nd. Now that radiation has concluded I want to begin to riding the bike. My problem is incontinence. Is it possible that riding will increase the incontinence level. Also, I did purchase a nose-less saddle.
Any advice?
I did not experience any incontinence in the weeks after surgery, but that was probably due to luck rather than anything I did. There are exercises to help control incontinence …
I have no idea how bicycling will affect your incontinence. I would think that it might help to tighten the muscles in that area, but I have no real experience with that. Here are some suggestions from road.cc.. http://road.cc/content/forum/74748-urinary-incontinence-how-do-i-ride-now
I am scheduled for a davinci prostatectomy on April 22, 2916, 1 week after the BP MS-150 ride (2 days, 170 miles from Houston to Austin). Accordingly, I should be in good shape at the time of the surgery. I typically ride 60 miles every Saturday. Before diagnosis I had been planning to do the Copper Triangle ride in Colorado in August – which will be 3.5 months after surgery. The ride is 78 miles and 6,000 feet of climbing. Any thoughts on the likelihood that I can still do the ride? I know best case I’m pushing it.
Hey George, it’s always good to hear from someone who plans to return to bicycling after prostate surgery.
There’s really no way to know how quickly you’ll recover. Some of it depends on your doctor’s expertise. Also how you respond to the surgery and wearing the catheter for a time. I think you’ll know by listening to your body as you start riding again. There’s a lot of plumbing that needs to heal, and I’m sure you don’t want to risk complications in the long run. If you’re unsure as the time for the ride approaches, you can probably sell your registration to someone and just plan to do it next year.
Either way, good luck.
Thank you for the information Gene. I needed this. I’m recovering from a davinci prostatectomy , Jan 25th. Cath removed Feb. 8th. I was trying to find any information when I could start wheeling. A quick Google search pulled this up ;-)
Wife has a Electra cruiser I can try out tomarrow. Incontinence is not much an issue but I am careful when I caugh , laugh , sneeze and ya know dribble .
Won’t have a follow up PSA till May. Hopefully be fully back at work and back to norm as fast as you. This article is great.
Don
Just got diagnosed. Thanks to all for sharing your experiences which are encouraging. You may remember trying to figure out what this will mean to your lifestyle, all while hoping to survive. Very helpful. Thanks again…
First, thank you Gene Bisbee for sharing your story! Your first-hand account helped relieve a lot of anxiety while recovering from my own prostatectomy.
i have been an avid mountain biker for roughly 20 years, riding 2 or 3 times per week with a regular group on Saturdays and solos in between. Then came the diagnosis of prostate cancer. The only warning was a modest, but gradually increasing PSA reading that reached 4.6 last February. The urologist recommended an MRI, which looked suspicious. A follow-up biopsy confirmed cancer within the prostate (Gleason scale 3+4=7). I am 70 years old (but could pass for 55), and otherwise in great shape.
Different treatment options were discussed, but all things considered, da vinci robotic laparoscopic surgery made the most sense for me. That happened a little over 6 weeks ago in March, 2016. According to the surgeon, all went spectacularly well. Then came recovery. I was not psychologically prepared for it, I think because mainly I was unaware of what to expect in the weeks following surgery. Which is why I am sharing this now.
I spent only one night in the hospital and was sent home the following afternoon, weak and totally dependent on my wife to prepare meals and run interference for me while I dealt with the foley catheter and changed urine bags around the clock for a week – counting the minutes until the catheter could be removed.
The catheter was removed on schedule and I was handed a diaper and instructed to be sure to do Kegel exercises twice a day. Naively, instead of going straight home, I accompanied my wife to the grocery store as the diaper got heavier with dribbled urine. I had to change diapers often for most of the week with visions of enduring a lifetime of this while spiraling into despair – which sharpened the pain from my abdominal muscles and referred pain from I don’t know where. The urine flow gradually abated over the weeks. But even as leakage slowed, the feeling of urgency to pee left me deeply distracted.
A friend sent me an ‘adult coloring book’ along with a set of colored ink gel pens to help pass the time. Coloring in between the lines is NOT my thing, but this gift took my mind off the pain like magic for hours on end – for which I am truly grateful.
Then the pains abruptly stopped week 4 post-op and I began walking 3 mile circuits around the neighborhood and regaining strength.
At week 6 post-op, I still leak a little, about 90% recovered from incontinence and without that sense of urgency to constantly pee. The surgeon tells me that I am right on schedule for recovery. Expect to regain full continence at around the 3rd month post-op (with an occasional leak now & then). I guess my expectations for a super quick recovery were unrealistic.
The good news is that as of week 6 post-op, my PSA is undetectable. As for my sex life (none, post-op) I was prescribed 5 mg daily Cialis on Monday, and woke up with an erection on Thursday. Life looks beautiful once again!
As for bike riding, the surgeon strongly cautioned me to wait 3 to 6 months post-op before attempting a bike ride. As much as I miss riding, I’m inclined to wait to heal before risking building up unnecessary scar tissue in that sensitive area. The doc also wanted me to increase the Kegel exercise sets from 2 per day to 3 sets per day. I assume they are helping because the old bladder seems to be obeying my commands.
Finally, the surgeon also urged me to use a noseless saddle once I resume bike riding. Anticipating this, I recently replaced my very comfortable Selle SMP Lite 209 saddle with the ISM Adamo Peak (mountain bike version to the Adamo Road). This is a short-nosed split saddle that allows stable control for the sit bones, and with the saddle moved aft, allows one’s junk to hang off the front. I wont know whether this will really work for me for a few months, but I think it will. Any thoughts?
Hi Marco… So glad to hear all this prostate business is in the past and you’re making a great recovery.
I don’t have any experience with a “noseless saddle,” although I have talked with a couple of guys who swear by them. There’s certainly no harm in giving it a try. I’d be interested to know how it works for mountain biking. Good luck!
Marco & Gene,
Thanks for the stories. I’m 57 and scheduled for da Vinci surgery the middle of June, PSA 9.13 Gleason 3+4 and one 4+4. I road ride 4 days a week about 200 miles each week, 22-24 mph average. The anxiety of the recovery process seems to be formost in my mind and your stories help me understand what to be prepared for after surgery. I have a couple of questions. I was wondering if you have any suggestions for pre-surgery ride routine. Is there any reason to cut back or slow down before surgery? Secondly, I work from home and sit in front of a computer almost all day, how should I prepare for post surgery discomfort and for how long can I expect it? Thanks so much for your input.
Marco: I am also a mtn biker and its been 5 weeks. Same procedure and stories as I’ve read here. Anyway, have you tried out the ISM Adamo Peak seat yet? I’m anxious to get back riding, but nervous.
Hi CJ,
Yes, I have been riding on my Adamo Peak about 3 times per week for the last 3 weeks now. I got a little saddle sore in the sit-bone areas but otherwise no issues at all in the sensitive perineum area. I expect the soreness to go away as the saddle gets broken in. Because my urologist advised me to use a “noseless” saddle, I set the Adamo all the way back on its rails so that I could hang off the front a little further. I also dropped the nose a teeny bit for easier moving around during the ride.
Please note that Adamo replaced the Peak model with a newer model that looks identical, but without the camo-looking trim on the sides. I recommend the saddle. But as you know, saddle fitting is a very personal choice.
I hope your recovery is going smoothly. Please keep us posted on your progress. Time is on your side now that surgery is over!
You should be okay maintaining your regular riding schedule before surgery up to a day or two before, and then rest a day or two to build up energy reserves. Obviously, try not to crash and injure yourself, but being physically fit helps recovery.
It would be a good idea to purchase a small supply of Depend Fit-Flex for men underwear. This is in preparation for after the catheter is removed. I recommend buying online through Amazon for convenience and to save embarrassment. I needed these for a couple weeks and then switched over to Depend for men Guards – pads that fit inside your regular cotton briefs. A close friend of mine had the same surgery a couple years ago with the same surgeon. He had no incontinence issues at all. Not me. It has been 7 weeks since my catheter was removed and, although mostly dry, I still have occasional small leaks throughout the day.
After da vinci surgery one tends to underestimate that prostatectomy is major surgery because the incisions are so small. Just heed your doctor’s instructions. They will want you up and walking soon, but not jogging or weightlifting.
Stay ahead of the pain with pain medication. There were a few times I forgot to medicate on schedule and experienced random unfocused achiness until hospital strength ibuprofen eased it away. Drink lots of prune juice to keep regular and counteract constipation caused by any opiates you may be taking.
You will probably not feel like sitting in front of a computer or dinner table or anywhere else for long stretches at a time. I was often more comfortable walking around the house or backyard than sitting in a chair and feeling pressure pushing into my groin. Occasionally shifting weight sideways onto one buttock would help for a while. It was also helpful to focus attention on some mindless project like a coloring book, for example, as a pleasurable distraction. My pain stopped week 4 post-op and I could sit comfortably for long periods at about week 6 post-op.
Like I said earlier, my expectations for a super-quick recovery were unrealistic. Allow yourself the time to heal. I have to keep reminding myself that I had prostate cancer a few weeks ago, and now I don’t.
Thanks to everyone for their helpful and encouraging posts.
Hope the following adds further encouragement:
I’m 70 and have been riding about 6,500 miles per year.
da Vinci surgery on 12 April 2016. Histopathology upgraded stage from T2c to stage T3b (bummer!). Apprehensive but hopeful. Catheter was miserable and kept me mainly housebound for a week. Everything else has been brilliant. In hospital for only one night. Not much pain. Only needed 4 paracetamols in total since discharge. 95% continent on catheter removal and pad free after 3 weeks.
Walking 4 miles a few days after catheter removal and up to pre-surgery speed about 2 weeks later. In the gym 4 weeks after surgery using weights at about 80% of pre-surgery levels. Very stiff for a few days afterwards but up to about 90% of pre-surgery weights on second gym visit without much stiffness.
Now for the cycling! Gave the Colnago a deep clean in week 3 and re-taped the bars and changed the saddle from a Fizik Arione to a Selle Italia Flow (with a cut-out). This took hours and was very therapeutic. Perineal area still a bit sensitive, especially when sitting on hard chair, so was apprehensive about getting back on the bike. But did it today, five weeks and five days post op. Really no problem. Mildly sensitive at first then didn’t notice much. Cut out in new saddle helped. Rode 15 hilly miles slower than usual and pleasantly surprised that a little fitness still remained. The real pain comes on in a few weeks when I resume riding with my fellow geriatric ex-racer friends.
Hints:
Use a saddle with a cut out and make sure your weight is on your sit bones and not on your perineum. Move the saddle forward a little if necessary to achieve this. NB The Selle Italia Flite Flow works for me but saddles are a very personal choice so I’m not recommending it.
Avoid potholes! If you cannot avoid a pothole, stand on the pedals so your perineum is not endangered.
Reduce tyre pressures by about 10% to provide some cushioning.
Take your doctor’s advice!
Hi Brian, just wondering how you are doing today. It’s been 6 years since your surgery and you said your report was worse than first expected. Just wants to see if you are cancer free. I pray you are…. I had robotic surgery July 5th and they found one lymph node that had cancer. I go November 14th for my pea and then ill know how mine went. I’m 72 …
Thanks, Perry
Brian
Very helpful information. My surgery has been moved up to next Tuesday May 31st. Glad to get an opening in my Doc’s schedule so I can begin the recovery process sooner. Thanks again for the comments.
Hello Jeff
Hope everything went well on Tuesday and that your recovery will be as quick as mine. Yesterday, I completed a a 60 mile ride over a hilly course in strong winds only 7 weeks and 2 days after the operation. While I hope this is encouraging, it’s important to recognize everyone is different and you should listen to your body and your doctor. I’d give it around 6 weeks before getting back on the bike and stop immediately if you experience anything more than mild discomfort. Also, I forgot to mention in my previous post that, initially, I’d recommend using slightly higher gears to transfer weight from the perineum to the pedals. Very best of luck!
Here is an update on my progress since da vinci robotic surgery 3 months ago. I went on my first regular Saturday mountain bike ride with my mountain bike group yesterday (12 weeks + 4 days post-op). No problems aside from being a little out of shape from the 3 month hiatus. My bike is a hardtail, so standing slightly off the saddle when going downhill is highly recommended to avoid saddle soreness – a habit I got into years earlier.
As for the dreaded side effects…
Incontinence is about over. I still wear pads for insurance, but urine drip seems to be just about gone. I’m still doing kegel exercises 2 to 3 times daily. My urologist was pretty confident that incontinence would only be temporary.
Impotence is under control thanks to Cialis daily. Unfortunately, my prescription insurance does not cover this drug. The best deal I found was ordering online through Online Pharmacies Canada to get the actual brand name. If you go this route, allow about a 3 week lead time between ordering & delivery. It is also possible to get generic versions for much less (and without a prescription) elsewhere online – if you are a gambler.
Anyway, I’m back in the saddle!
Has anyone tried to ride their bike after surgery on a regular saddle. The reason I ask is that I rode several bikes before my surgery and don’t want to buy 3 new saddles. My surgery was on May 31st 2016 and I still have discomfort and pain on my sit bones.
Brian, Thanks for post.I’m in my easy chair recovering from same surgery eight days ago reading all this great info.I’m going to take it easy till catheter comes out in four days.MY goal is four to five weeks from now to be riding again! Looking at a Selle italia seat with cut-out.Thanks again to you and all posts that have me excited to get ridding again.Jeff
I had no idea that only one of the small incisions that were made requires stitches. I can see why this would be a good thing for someone who doesn’t want a big scar from the surgery. If someone I know needs this surgery, I’ll definitely refer them to this article. Thanks!
Thanks for sharing your story. Everyone’s experience is a little different but here is my RP/Cycling story:
About me: 59 years old. Very enthusiastic road cyclist. I ride upwards of 5K miles per year.
Regarding the effect of cycling on PSA:
The medical advice seems to be “keep off the bike for 48 hours before a test”. I can’t suggest an exact interval but I can relate my personal experience: cycling definitely affected my PSA tests.
Example 1: PSA of 5.0. Stopped riding bike for a week. Repeated test. PSA of 3.5 (whew!)
Example 2 (year later): PSA of 12. Stopped riding bike for a week. Repeated test. PSA of 10.3 (bummer…still very elevated).
Had a robotic prostatectomy at Mayo clinic. Had an unusual amount of pain for the first 4 weeks after surgery (could not sit at all and could not even stand for long periods) but sometime at week 5/6 the pain subsided.
I was very anxious to get back on my bike. Asked my urologist and 2 other urologists for opinions regarding when it was safe to get back on the bike. All of them told me 6-7 weeks. I was still feeling some soreness at 6 weeks so I decided to start gentle. I bought a spiderflex saddle (very funky seat that does not touch the perineum at all: http://www.spiderflex.com/). The seat allowed me to ride but I did not enjoy it. It is very awkward for road biking. However, at least it was riding. A couple weeks past and I felt good enough to try something closer to normal: a Selle SMP saddle (http://www.sellesmp.net/smp4bike/). This company make a huge selection of ergo saddles. Very impressive. I tried a “dynamic”. This was much better than the spiderflex idea and I enjoyed riding again. ALL of the weight is put on the sits bones so it takes some time to adjust. At 11 weeks post surgery I decided to try my old saddle and I was pleasantly surprised. No pain. Biking is good again. :-)
Thanks! You guys inspire me, and right now I need it. BITD, I commuted 16M daily, nearly year-round, for a decade. And, in the distant past, did a century and a short triathlon. But a year post-op, biking was still internally painful at what felt like the surgical site, even with a saddle designed to minimize the problem. A month or two ago I joined a bike riding Facebook group and now I’m consumed with jealousy! “I Love Road Cycling-VIP” is luring me back and I’m determined to remember RULE 4! (Rule 4: TTFU”) (“Toughen the ef Up!)
Did any riders try an elliptical type road bike while recovering? I’m looking at an ElliptiGO as an alternative. Never rode one before, but standing and riding seems like it might be a good alternative to filling the gap between surgery and being fully back up to speed.
Follow-up to prior question. Actually got back on the bike 19 days after robotic prostatectomy and rode 10.4 miles on my first outing and 24 the next day. To me clear, I am simply a recreational rider but I had my surgeon’s full support. I normally ride 25-60 miles a weekend, and commute about 10 miles to work about once a week. Actually, he said to walk a lot immediately following surgery (as long as I was comfortable) and I strapped on the catheter and hoofed it 4.5 miles 2 days after surgery, and never walked less per day until the day I rode again. As far as bike seats go, this may surprise some – I rode on a Brooks saddle. The support was perfect, and I even wrote to Brooks thanking them for making such a great saddle. Had PSA jump from 1, 2, 3, 6.8 in annual physicals. Gleason 4+3. Couple of decent sized tumors in overdrive. I’m 56 years old, and don’t consider myself a cancer survivor. More like just a small detour on this road called life.
Riding a short route in the Hotter than Hell 100 in Wichita Falls, Texas this weekend, less than 60 days after surgery. You can do this…
Thank you all so much for all this information. I will be having surgery soon. I’m a cyclists and have done the Houston to Austin MS150 for over 23 years. I love cycling and I’m concern that I won’t be able to continue after my surgery. Thank you all for giving me hope. Thank you Lord.
Thanks for all the information about your experience about your prostate cancer and cycling. I’m a 68 year old cyclist. I’ve been cycling and have done the MS150 cycling ride from Houston to Austin for over 22 years. Your inspiration has given me hope again. I will be having prostate surgery in the near future.
I was looking through the web site hoping that I would find some inspiration and I did.
God Blessing to all.
Chale
Hi Guys,
Had Robotic Surgery 9 weeks ago July 2018 , All went good . Gleason 3+4 high grade cancer but contained to prostate and starting to spread but margins and lymph glands clear , So got it just in time .
As you all know its no fun during the recovering stage but things have been getting better . Leakage nearly under control ..Erections possible with Viagra …Pain hasnt been too bad mostly uncomfortable.
All along ive been asking my Dr when can I get back on my Bike .. Each time he would stress not too hurry and wait at least 10 weeks or longer , I now know why . Last week (9) i went into garage , not to ride but to sit on my bike seat to see if it was uncomfortable…what a mistake , I sat on the seat for only a couple of seconds and got straight off ..It hurt.
That night I noticed Week Blood in my urine with dark grainy material that looks like cracked pepper in it . Contacted Dr and he said the bleeding was from getting back on the bike too soon and that it should resolve itself. ..% days on and its still bleeding.
He said the Material in the blood could be old scabs from Surgery . any one else experienced this ? ..It has been a bit scary tbh .
So im finally going to take my doctors advice and take it easy for quite a bit longer ….Also he stressed no weight lifting …..I just want to get better .
Listen to your doctor! Have patience for the healing process to run its course. My healing seemed to take an eternity. I got back on the mountain bike about 3 months post op. At 6 months post op I went to Moab and rode a couple days on a rented bike, and experienced some blood in my urine. Stopped riding again for a while. My surgery was 2 1/2 years ago. I ride 3 times per week just like the good old days except now my favorite recreational drug is Viagra.
had my prostate removed via robotic on 01/08 /2018. done at 8 in the morning and up walking that evening. wore pads for 2 days as insurance, but no leakage, have been doing lots of walking some distances around 8 km, and about to get back on the bike, urologist urged to get a bike seat that did not put pressure on the delicate area where the uthera had been rejoined. although it is easy to say, my only advice is, to stay positive, worrying does not do any help, it plays with your mind and can take you to places that are no good to you. place your faith in your doctors and heed their advice. i am 65 years young and looking forward to getting back on the freedom machine.
It’s great to read about so many positive experiences. I had Da Vinci surgery 4 months ago under the UK NHS. Gleason 3+4 T2C. Like many contributors I was up and about the next day and walking up hills to 1000m by the third week. Had to wear pads for 6 weeks. Back swimming, windsurfing and running but have deliberately avoided the bike. The surgeon has done a fantastic job preserving the erectile nerves that I didn’t want to risk it. Did a short ride today with my new noseless ISM saddle. It will take a bit of getting used to and I miss my old Brooks but I didn’t feel any pressure on my perineum. We are so lucky having access to this technology and the surgeons with skill to use it.
I too had the Da Vinci prostate surgery. I was fortunate enough to have cancer contained to the prostate. I really enjoyed the comments as I too ride 3 different bikes and didn’t want to buy 3 seats. Hearing what other riders have been doing is encouraging. You guys getting ready for this surgery, keep the faith, you’ll be fine just listen to the DoDoc!!D
Glad to hear about your good prognosis and continued cycling!
Radical prostatectomy January 12th 2019. Completely dry at night and sometimes able to sleep right through to seven hours. This feat is not consistent and I do suffer from urgency and frequency, I am able to control my bladder but come to a point where ‘I have to go!’
Bladder content is also inconsistent, I’ve measured my output and it ranges between 200 ml and a half litre!
Like most others on here started walking with the catheter. Post catheter began steadily excercising. Saw the urologist at 6 weeks and asked about cycling and he said it would be fine. I asked if I should have a special saddle and he said that he didn’t think it was necessary.
I was reunited with my bicycle this week and went for a short ride, it felt sensative in the area where my urethra has been reattached to my bladder (perineum) no pain, but a peculiar feeling.
I feel perhaps that an alternative cycle seat might help, but Iam prepared to persevere with the one I’ve got.
I don’t know if anyone else has had similar issues as me where going to the toilet is concerned? I feel that bladder and bowel are all vying for the exit, it would be indelicate to go into specifics!
Glad to hear that you’re able to return to cycling. One thing I’ve learned from all this is that everyone’s recovery is different.
During my recovery and early bicycle rides, I remember much tenderness down below and preparing for rides that never strayed too far from rest stations or porta-potties.
All that is a distant memory now.
Thanks Gene for sharing, and thanks to all who commented. I read them all. Doctor called me yesterday with the news that my biopsy showed cancer in all 12 samples, however my PSA is only 5.2. I am 50. I go in Tuesday for a full review of my options with my doctor. I am really thinking this DaVinci method is the way to go, but I don’t think my Dr./Hospital offers it. I really like my Urologist, and the surgery staff at the hospital where i had my biopsy was terrific.
Anyway, I plan to get out on my road bike this weekend with my lady for what could be my last ride for awhile (depending on how soon I get treatment).
It is a scary prospect, but reading all these stories is very helpful to keep things in perspective and prepare for whats ahead.
Update! My urologist actually suggested that I get DaVinci robotic despite the local hospital not offering it. I went to Johns Hopkins with my 5.2 psa and 4+3 Gleason.
Had surgery this past Tuesday and stayed one night in the hospital. I really had hard time getting out of bed and walking because of the abdominal pain. I had lymph nodes and seminal Vesticles removed along with the prostate.
I was still having hard time with pain and walking 2 days later- but kept drinking fluids and doing short walks anyway. Then on 3rd day things started drastically improving. Was able to get by with no oxycodone and single 500mg Tylonol.
Morale much better and did a 1 mile walk this morning!
Waiting for results of the prostate margins.
Reading these posts has really been helpful to me.
2019 – April 19th. That’s the day I had my robotic surgery. Today is June 14, 2019 I’m 66 but feel like 46. I’ve been a cyclist for as long as I can remember and have always been very fit. So my first question to my surgeon prior to surgery was, “When will I be able to get back on the bike?”. My surgeon was awesome. Got all of the cancer since it was contained within the prostate and he told me that I should probably wait at least 6 weeks. Which I have. I’ve got pretty much the same story as most others that are posting here. Walking helped a great deal. I was walking 2 days after I got home with the catheter. Uncomfortable at best. A week later the catheter was removed. Thank god! I’ve been walking between 4-6 miles each day. It is now been almost 8 weeks, I’ve been back to work 2 weeks, and I got out for the first time just a couple of days ago and rode for about 45 minutes. I still used a pad under my cycling shorts since I still have some incontinence issues. (Kegel exercises also help a lot with the incontinence.) So my first ride was a little tender but not bad. I’m actually going out tomorrow for my second ride (planning on doing 10-20 miles). I typically ride a Fizik Arione saddle, but am going to experiment with a couple of different ones. Looking at the Specialized Power Expert, Terry Fly Ti and a Selle Italia Boost TI Superflow since I think I want a shorter nose. At least in the short term while I am just getting back to biking. So there is hope. Keep walking, doing kegels and you’ll also be back on the bike soon. I’m still working on the incontinence issue and it seems to get better each day. So after 8 weeks I think I am doing ok. I am not going to push things but if I can ride a 10-20 miler without issues then I think I’ll be doing ok. If not I’ll back off a little. Taking it easy and not pushing the pace. Not going to ride consecutive days yet until I feel I’m really ready. So that’s about it for now. 8 weeks ago I had cancer . Now I don’t. Yea .
Congrats to you, Francis! It’s good that you have a doc who recognizes your need to get back on the bicycle. I’m sure that in a few more months the surgery will be a non-factor in your riding. Over time, I have mostly forgotten that I ever had prostate surgery and once had a tender time riding on a bike saddle. Thanks for the comment. It’s good for everyone to hear from fellow prostate surgery patients!
First, Gene, thanks for starting this thread; we can see lots of guys wondering exactly what the new plumbing in the nethers is all about.
Apparently, I was one of the rare to ask my surgeon about that new plumbing. His answer, along with some anatomy studies, show that daVinci prostatectomy brings the bladder down into the vacancy of the removed prostate. Resection of the urethra to the bladder happens right above the perineum. THAT’s got to be the principal reason to stay clear of pressures in that area. The sphincter shutting off urine flow is right there as well; probably the reason that I’ve noticed more dribbling after my short ride (2.5miles) to the Y for a swim.
For background, I was PSA 9, gleason 3+4. After surgery, pain relieved with just 2 days of Tylenol. Pathology showed no extra-prostatic extensions and clear lymph nodes. Follow-up PSA will be at 3 months. I’m now at 7 wks post-surg. 1-2 light pads per day, no erections. 5mi ride/1mi swim every other day, but the ride is on an old beach cruiser, while I stare longingly at my road bike.
I had my RP/PND just over a year ago (laparoscopic, not robotic). It was a long time before I even tried to get back in the saddle (combination of laziness and dread). When I finally did try to ride, it wasn’t great. A few additional rides were slightly better, but not much. Would love to regain some fitness. I have an old Liberator on the road bike–I still get significant post-ride soreness, and I think it’s starting to affect urinary function.
I want to play around with the saddle position–thinking moving saddle forward might get me further back on the saddle, maybe take some load off. Wonder if you have any pointers on what to try next.
I had a radical prostatectomy 4 months ago now, I’m a 46yo male who was a keen mountain biker before, so as you could imagine this was a huge shock to the mental health, however it was better than the alternative.
I googled so many things . I was just trying to work out when I could get back on the saddle, I researched a few saddles and in the end I chose the ISM 30 looks like a double ended dildo however, it’s the most comfortable seat I’ve ridden on. Pardon the punt.
I followed my Drs orders and rode on the flats at 8 week mark and then full downhill on the 12th week mark.
Surprisingly I hadn’t lost to much fitness as I walk from the 1 week mark working up to ten klms a day by the 8 week.
It was a hard slog however where I have come from and where I am now, surprisingly it was fine.
Hey Gene,
Thanks so much for your article and for all the details… And for all your thoughtful responses to people’s comments. I’m 61 and was just diagnosed and will undergo the procedure shortly, I’ll keep the rest of the group posted on my recovery. I ride about 5000 miles a year …Being off the bike for 4 to 8 weeks doesn’t sound that great, But sure beats dying of cancer!
I don’t know where you’re located, but I would think this is a good time of year for recovery. Good luck. As much as you ride, I’m sure your rehab will go smoothly.
Hey Gene – Please look this over and post this if you think it might be helpful, Feel free to edit as you see fit.
Cycling after Radical Prostatectomy
• In the case of radical prostatectomy surgery, the path back to cycling begins after you leave the hospital, and there is a lot that needs to be done well before you even think about getting on the bike. The discussion here is chronological, and is only for the first 4 weeks post surgery. I am a scientist (geophysicist) by training, and a geek by nature, so you might find more detail here then you want. On vocabulary, instead of using penis, I use “spear”, not because of some Puritan hang-up about the word, but “spear” just seemed more entertaining. By the way, keeping a light heart and being willing to talk about all this stuff makes its better (thanks again for this blog!) than being isolated and depressed. Not that prostate cancer is a laughing matter, but given that my attitude is the one thing I can control, I choose to be positive!
• I am 61 years old, and retired in 2018. I road cycle year round ~5000 miles a year with ~400,000 ft of climbing (I live in Colorado). I do 2 -3 weight and stretching workouts a week to maintain my core strength and flexibility. I have a replaced left hip (2017), right rotator cuff repair (2017 – cycling accident), scoliosis and L4 nerve compression (steroid injection treatment in 2017), AFIB (only one incident – cardioversion after a century ride in 2017), and a left ACL repair (1996). I am 5’ 7.5’’ and weigh 145 lbs. Resting heart rate 48, and blood pressure 100/70. My two favorite quotes are 1) Anything worth doing is worth overdoing (Mick Jagger), and 2) There is no such thing as bad weather, only bad clothing (Norwegian)!
My Prostate and Diagnosis
• My PSA score had risen from 2.5 to 5.0 over 24 months, so I got a prostate biopsy. Biopsy (12 samples) showed >50% cancer (Gleason 3+4) in all 6 samples on the left side, and >20% cancer (Gleason 4+3) in 1 sample in the center on the right side. Left side was a full-blown tumor, and its increasing size was creating some issues with urinating, both frequency and flow rate.
The Decision…. Radiation or Surgery
• Do your homework on the treatment; certainly not one size fits all. In my decision the downside of conventional radiation was the combined hormone therapy. I need the Testosterone for muscle recovery and mental health, based on a bad experience with induced testosterone deficiency while using Diclofenac (anti-inflammatory) for back issues. Proton therapy (new form of radiation) might be worth a look since typically it does not require hormone therapy, but not widely available and you need to check whether insurance will cover the cost. I landed on the Da Vinci robot assisted laparoscopic surgery at a Center of Excellence hospital in my area.
Very happy with the surgery and the result. Nerves on the right side were spared, cancer had escaped the prostate capsule on the left side, so the surgeon removed those nerves. No cancer in surrounding lymph nodes or other tissue outside the prostate based on pathology. Will need a follow-up high sensitivity PSA test after 2 months to confirm that the cancer is gone, but overall I feel very lucky!
• If you are in good physical condition, and specifically if you have low blood pressure, be sure to hydrate as much as you are allowed prior to surgery. They tend to dehydrate you pre-surgery, as they want your bladder to be empty. If you have low blood pressure, then dehydration exacerbates that problem. I had to be given Epinephrine during and after surgery to get my blood pressure up, as my blood pressure dropped to 70 / 40. This also kept me from getting pain meds immediately after surgery (which also lower blood pressure). The bladder cramps post-op were the worst pain I have ever experienced. My post-op nurse said they are just like uterine contractions (labor pains) and that I should stop whining, suck it up and “be a woman” (note – she made this comment after the pain subsided). This made me laugh, which also hurts by the way.
Post –Surgery (Week 1 – The Catheter!)
• 6 one inch incisions across the waste line from the Da Vinci procedure were not really that painful, feels like you overdid a core workout (like crunches). Bladder cramps went away after I left the hospital (only there one night). I started walking 1/2 mile on the first day and built up to 2 miles at the end of week. I started slow, avoided hills and took small steps and built up from there. I did not take any pain medication other than Tylenol at night to help me sleep.
The catheter allows you to stay in bed at night, since you do not have to get up and go to the bathroom, which for most of us older guys represents a big change in your night-time routine! I found it hard to manage the catheter in any position other than my back. The downside here is that without the normal change of positions while you sleep, back, shoulders and legs get stiff staying in one position… so I generally slept 4 hours in bed and another 3-4 hours in a recliner downstairs, switching in the middle of the night. Catheter care and cleanliness is something you need to focus on. I did the whole bag cleaning process, even though cleaning the area of the “spear” where the tube is inserted was the only recommendation for catheter care from my doctor. I was concerned about back-wash from the bag flowing back into my bladder (for example when getting into a recliner with the bad strapped to your leg, so I opted to clean the bag). Abundance of caution on my part. I also took some cranberry powder supplements, as a chemical component in cranberry juice has been shown to decrease the ability of bacteria to stick to your bladder and urethra. Note this was NOT recommended by my doctor, so please check with yours before starting. This recommendation came from friends who had a son who used a catheter for years and had chronic UTIs until they put him on the cranberry supplements. I wanted to avoid a UTI at all costs, as I had concerns about getting an infection in my replaced hip.
Post –Surgery (Week 2 – Back to Diapers)
• While getting the catheter removed was liberating (and not really as painful as I expected), my bladder was confused about suddenly not getting to pee continuously. I found that the women’s large volume Poise pads were better than the men’s Depends pads (perhaps because I am a smaller frame person or woman are just better at designing these products?). Once again, I just needed to “woman-up” and live with the pink packaging. I found that tight fitting briefs or boxer briefs that were snug around the crotch were a necessity. Thinner, looser fitting boxer briefs allowed the “spear” to sag to the side and get outside the pad, resulting in leakage and wet pants. I also had a lot of burning 3-4 days after the catheter was removed. Because the pad stays moist from all the dribbling, it becomes a perfect breeding ground for yeast. This is also compounded by all the antibiotics they give you during surgery (and when the catheter is removed), which kills off many of the good bacteria that keep the yeast in check. So I ended up with a yeast infection on the “tip of the spear and down the shaft”. I called the PA and she recommended using Monistat cream, which is convenient to purchase as it is right next to the pink women’s Poise pads in the grocery store isle! I also took some probiotics… again, check with your doctor prior to doing any of these interventions. I really felt like I had gotten more in touch with my feminine side having basically experienced labor pains, bought maxi pads, and Monistat cream. So on that note, just another reminder… take all this lightly, it gets better and getting stressed about it does not help. I even started saying to my family and friends, “Hey, if I get a bit fussy, I probably just need a diaper change, so just remind me”. What are you going to do, feel sorry for yourself or treat it lightly? Highly recommend the latter!
I also found that sitting in a hard, unpadded chair (if it was not a recliner) was more comfortable than sitting on a padded chair. I am lean and have pointy sit bones that are accustomed to a bike seat, so that may explain why straight back padded chairs (that press into your swollen perineum) are less comfortable. I also found rolling a towel and putting it right behind your knees, also worked better. Basically in this position you are creating a bridge over your perineum, resting on your sit bones in the back and the rolled towel behind your knees at the front. Same dynamic works for driving; I found reclining the seat back and lifting the front edge of the seat up (if you have that ability) made it more comfortable.
Post –Surgery (Weeks 3 and 4 – Better – Worse – Better)
• The other downside of the catheter is that it allows your bladder to shrink. Your bladder is like a balloon, and it stretches as it fills. With the catheter, it has no reason to fill up completely, and you lose the sensation of a full bladder and needing to pee. So, when the catheter comes out, your bladder capacity is small. In addition, the muscles and nerves around your bladder and prostate have been repositioned and/or removed, so the mechanics of starting and stopping the flow of urine are different post surgery, hence the focus on building up strength in the pelvic floor and sphincter muscles to control the flow. This gets better, and eventually (beginning at the end of the second week). I started feeling that sensation that my bladder was “full” and I needed to pee. The information on this blog and other sites that says your continence is first recovered while sleeping (I never had any dribbling in bed), then while sitting in a recliner, than while sitting in a straight back chair – this was also my experience. Standing from a sitting position, brisk walking and stair climbing were the hardest to do without dribbling. Gravity is not your friend, so standing and sitting upright for an extended period is challenging at first. Though once I got the exercise program for my pelvic floor dialed in, I made much better progress (see discussion below). There was also definitely a correlation between incontinence and a) being tired (from walking or standing or too many Kegels), b) drinking coffee, and c) drinking carbonated beverages or alcohol. No big shocker – widely reported and validated by others in post prostate surgery recovery!
On Kegel exercises, I differ with the typical doctor recommendation based on my own personal experience. Their recommendation was to do 3 sets of 10, 3 times, every day, starting in Week 2, after the catheter was removed. This is where I started and my pelvic floor soon felt tired and sore, like your quads feel after a riding a Century. I would have good days, and bad days with respect to incontinence, based mostly on how tired my pelvic floor muscles were feeling.
One of the lessons I have learned as I have gotten older is that I need more rest days between workouts. Would you do back to back 80% effort hard rides and expect to get faster? Would you do core workouts several days in a row? Maybe that would have worked for me when I was 20, but not at 60! I found taking a day off between “Kegel days” helped strengthen my pelvic floor, helped the muscles get stronger and diminished the level of incontinence faster than doing them everyday. I also found that doing them on my back with my knees bent, rather than sitting or standing was better (easier to isolate the right muscles and not fight gravity). You can check your form by seeing if the base of the “spear” is pulling in. I also found long, slow contractions, 10 seconds on (contract) and 10+ seconds off (relax) doing 3 sets of 10 -12 reps once a day was better than short rapid ones. In my experience, rest and recovery is as important as exercise in rebuilding muscle strength, and I found this to be true for Kegels just like cycling, core, or strength workouts.
Another discovery was a paper (reference attached), which demonstrates that exercising the associated hip extensors (which include glutes, hamstrings and especially hip adductors and abductors) in addition to pelvic floor muscles seemed to help patients recover continence faster. This paper is a worth a read and a chat with your doctor about type of exercises you should do, and how often to exercise and to rest!
I checked with my doctor and got the green light on doing this exercise program. I believe that part of why he was OK with this is that I had good core strength prior to surgery (I could do a 5 minute plank). Note VERY IMPORTANT that you talk to your doctor about any and all exercise. You could tear sutures or get a hernia if you go too hard too fast! Doing this set broader set of exercises described in Figure 1 of the paper every other day along with a long walk, and taking a rest day in between (2 mile slow walk or light activities) created a real turning point in recovering my continence, and by the end of week 4, my only dribbling was happening at the end of long walks (3-4 miles), or after a bowel movement.
That’s the update for now – I write so more at the end of Week 8. Sincerely hope this helps others…. And wish all of you a swift recovery!
Mark….. Glad to hear that your surgery went well and that you’re on the mend. By all means, let us know your progress after 8 weeks.
Thanks for staying in touch,
Gene
Hi everyone. I’m not much for posting on blogs, but feel like it would be encouraging for everyone. I was diagnosed with prostate cancer Gleason 8 in March 2019, and subsequently underwent radical prostatectomy May 6, 2019. Negative margins, negative seminal vesicles and negative Lymph node. Pathology revealed extra prostatic extension, and PSA came in at 0.7 months later, with radiation commencing 10/19 and ending 12/24.
The encouragement in finding this site motivated me to begin rehab and training for the RSVP, a two day 200 mile bike trip from Seattle to Vancouver August 23-4, 2019. Like Gene, I started walking just days after the surgery up to 5 miles with no elevation gain. Then I started cycling 5 weeks post-op…(June 15), with just short trips around the neighborhood, and using my indoor trainer. Little by little the tenderness began to subside and I increased my distance to 22 miles in early July with 50 mile trip in early August, adding in trips with elevation gain throughout.
By August 23 I was ready. The first day was great with exception of some chafing, and rode into Bellingham to stay the night, 108 miles from the starting line. The second day was even more breathtaking, with scenery unrivaled anywhere. I rolled into Vancouver BC and crossed the finish line at about 1:30pm that day. My body held up well and while tired, wasn’t exhausted.
I’m a very active 66 year old,185 lb. 6’4” and stay active through cycling, swimming, tennis and fitness activities regularly. I went in to the surgery as fit as I could be, and that really helped my rehab and training for this event.
So Gene, thank you for the encouragement here. It helped. My plans are to repeat the RSVP again this year. Best Regards,
I just had my surgery last Thursday, but not cancerous. Just enlarged prostate. Sounds like we had the same kind of surgery. Basically, my surgeon took out the inside of the prostate and left me with the shell, like a tangerine as he explained it. But I have the same issues I’m sure. Tomorrow, I have the cath removed and go from there.
My cycling is 100-150+ per week. Long distances. 5k for the past three years. Pretty good shape. Lost 40 lbs since Sept 2019 without the knowledge of this surgery until Jan 2020. I’m sure that “loss” will be my “gain” in recovery.
Thanks for your notes. This has helped me to ask a lot of questions tomorrow when I meet with my dr.
Post –Surgery (Weeks 5 and 6 – Getting Back to Bike Riding!)
So at the end of week 4 (beginning of week 5), I got the green light from my doctor to return to full activity (no restrictions) but to go slow! I began to integrate more pre-surgery core and strength training exercises at the gym, starting at about 50% on weight and reps and worked my way up to about 80% by the end of week 6. In week 5, I made my first attempt at riding on an indoor Life Cycle at the gym, rode for 2 miles, and about 7 minutes and definitely felt a bit of pressure in my pelvic floor, and some twingy pains around my bladder, but no side effects the net day. 2 days later I rode the Life Cycle for 1 hour (16 miles) at a high cadence (90-105); a bit tired the next day, but no other side effects. In week 6, another ride on the Life Cycle for 1 hour (16 miles). Felt great the next day so two days later did a 2-hour ride outdoors on my gravel bike (32mm tires for Colorado winter road riding, patchy snow, mud and sand). Rode 30 miles with 1400’ of climbing at average of 15 mph! Perineum and sit bones a bit sore the next day. But not really unexpected given I had not ridden outdoors in 7 weeks! No other side effects, and BEST part, no incontinence while riding. My only lingering incontinence was immediately after a bowel movement, sneezing, or coughing… typical stress incontinence, which has continued, but can be stopped by tightening your pelvic floor in advance of the event!
Post –Surgery (Weeks 7 and 8 – Home Improvement in Mexico)
Did another outdoor ride (same 30 mile route) and a couple more 1 hour indoor rides in weeks 7 and 8, then winter returned to Colorado, and outdoor bike riding became pretty miserable (unless you had an ice bike with studded snow tires, and even then no bike works well in slush). My wife and I headed to Mexico to visit some friends, and helped with some painting and home improvement projects at their home on the beach. I found that after a hard day of manual labor that my perineum and pelvic floor muscles had sort of a dull ache. Bending and lifting seems to be even more stressful than bike riding, but all is good the next day after a good nights sleep. I have continued my core and strength workouts at the gym and am now ay 100% of pre-surgery weight and reps, expect for my hip adductors, which remain weak, and seem to be subject to cramps. I have integrated Kegels into my gym routine, though they are my least favorite. Since outdoor riding is out, I have started some home improvement projects at our house, cleaning out 15 boxes from the attic, replacing cabinet doors in the bathroom, painting the interior, and hanging 13 new doors (in progress). Again, tired pelvic floor muscles at the end of the day, but recovery overnight.
Post Surgery Check Up and Summary (Week 9 – Things That Shall Not be Named)
So had my follow-up PSA test and I scored a 0.014. My doctor is NOT doing pre-emptive radiation post-surgery any more if guys score below 0.2. So I will return for a follow-up high sensitivity PSA test every 3 months, but at this point I seem to be in the clear with respect to more prostate cancer, and more treatment. Overall, the surgery was great choice for me! Here is a list of pluses and minuses …including some comments about things that guys normally don’t talk about!
Pluses
• Surgery seems to have gotten rid of the cancer, and unless there is some change in my PSA going forward, my treatment is done!
• Surgery was minimally invasive, fast recovery with minimal side effects. Stopped wearing pads after 4 weeks (incontinence ended – except for stress events, see notes above)
• Was able to stay active and see real progress in recovery. Could exercise (walk) immediately, do pelvic floor / core rehab exercises after 2 weeks, do 50% effort weights, core and cardio workouts after 4 weeks, and bike riding (30 miles – 2 hours) after 6 weeks. After 8 weeks back to full effort on core, strength and cardio, and relatively normal bike riding (can’t be 100% sure due to winter weather restrictions).
• Urination post surgery is amazing, I can empty my full bladder in • I did not have to do the hormone therapy (associated with radiation) which based on my previous experience with drugs that suppressed my testosterone was not good for me with respect to building and maintaining strength and cardiovascular fitness. I did not have to have any subsequent work done on my urethra post treatment (typical when you are having trouble urinating prior to radiation, be sure to ask about this before going down the radiation path).
• Most surprising, I can still have an orgasm, even though I cannot yet have an erection. I did some reading on this and ejaculation, erection, and orgasm, while related are actually independent. Yeah, it’s weird and requires more general stimulation (gentle, but rapid rubbing by your partner) of your testicles and penis, but the overall sensation is remarkably similar. It starts out feeling like you might urinate, but you don’t, so just keep going! Obviously, also requires a partner willing to try some different approaches to sexual intimacy. Reminding yourself and your partner that you were not killed by cancer sort of puts things in the right perspective!
Minuses
• Surgery is well, surgery. You have to spend time in the hospital, you have to get general anesthesia and be intubated. There are risks of complications like bleeding and infections. You have to have a catheter for 10 days, and put up with the exercise restrictions, incontinence, and erectile dysfunction (see below), which is a longer-term effect.
• I have not had an erection (at 9 weeks), and this is something that takes a while to recover. My doctor has me on daily Viagra (20 mg), and now wants me to try stronger doses to see if I can move toward getting an erection. I am beginning to get “soft erections” at night. This is normal for males (spontaneous erections while sleeping), and is the first sign of nerve recovery (remember I lost 50% of the nerves in the surgery). When I had ACL surgery, it took well over a year for skin over my kneecap to not feel dead / numb and for some sensation to return. Patience is required to recover from nerve damage. In the meantime, creativity with your partner and/or penile injections can bridge the gap with respect to sexual function.
Wishing you all the best!
Mark
I am 65 and have been an active road and mt bike cyclist for years.
Recently diagnosed with prostate cancer I was very concerned about still be able to ride again. Your article has made me feel very hopeful about my future riding adventures. Thank you so much for it, I am sure many other cyclists have found it to be of immense help and comfort.
Your fellow brother in cycling,
Pete Hepler
Thanks, Gene, for this forum. I love cycling but don’t log as many miles as many of you here. Impressive. Maybe in retirement. I hope to be back in the saddle again soon.
57 years old. I just had RALP (DaVinci) done mid-June of 2020. What an awful year, right? Procedure done at University of Chicago with Dr. Eggener, who is wonderful. Father had prostate cancer. So I had been monitoring my situation for about 10 years. MRI showed PRADs 5 and the biopsy revealed significant Gleason 3+4 in one sample. PSA spiked to 18 but dropped back down to 11 day of surgery. I waited a few months before making a decision and did look into other alternatives. Radiation can create other problems for surgery later if any scar tissue is created as a result of treatment. HIFU seems like just a stop gap and is not covered by most insurance plans. It would have been over 35K out of pocket. Other ablation procedures were presumably not an option with Gleason 7 samples.
I’m pleased with my decision and the process of recovery has been pretty good thus far. Very little leakage, which usually occurs if I’ve been stationary too long or have had a few drinks. I haven’t been using pads or Depends for weeks now (6). No erections yet (7 weeks post-op). I am taking Cialis (generic) to keep blood flowing. Even without an erection or ejaculate, however, I can still climax.
I wish all of you going through this the best!
I’m glad I can provide a place where guys can discuss their results with prostate treatments. Overall, my impression is that treatments are getting better and resulting in fewer side effects. It pays to do some research and determine what’s best for your individual case. Good luck to everyone!
It’s good to hear that the time feels short looking back even though it seemed like it would never end at the time. I’m helping my brother do research because he just found out he’ll need to get surgery for prostate cancer. Maybe I’ll share your story with him because I think your perspective would help give him hope during this hard time.
Thanks so much to everyone on this – so supportive. I am a week away from my surgery and all your shared experience has helped me.Finding it hard to take everything in but will keep reading as I go through it
Thank you all again
Nick
I cant believe I stumbled onto this thread. So helpful. Thank you.
I was recently diagnosed and have a consult with the surgeon this thursday. I had my radiology appointment this past friday. Its been caught early and risk is intermediate but favorable.
This thread seems to be about biking but Im more a runner and trail runner though I do try and do a century each year on bike,. (Side note: all part of 2020, but Im recovering from rotator cuff surgery (11/10), fell hard while trail) so at this point Im looking to just take care of both issues and be ready for running and riding late spring.
Has anyone had experience with the impact on running?
The side effects seem reasonable and Im trying to balance over treatment vs waiting vs side effects. Does sound like a tough first week after the surgery. My instinct is to just have the prostate removed and be done with it as long as its contained in prostate. I believe that’s the case.
I live in Montgomery County Maryland and if anyone is from here and can offer any advice on doctors, I’d appreciate that too. Im working with Chesapeake Urology and Ive been comfortable with them so far.
Good luck, Andy. My surgery was 13 years ago (hard to believe now), and prostate treatment has made great strides since then. Very good idea to be checking all your options.
Thanks to everyone and Gene in advance for any insights. I’m a 56yr old newbie to this 2 weeks out after simple prostatectomy. BPH with a big 166cc prostate. Catheter out today, so that’s good but I am extremely worried about getting back to training. My surgeon is great but doesn’t get cycling at an elite masters level.
I’ve raced for 35+ years, and was riding 8-12hrs/week with 2-3 intensity days each week right up to surgery. I use a Specialized Power saddle (short nose and cut-out) but also have a Bontrager Aeleous and ISM Adamo laying around I could try. I showed my doc the Bontrager saddle and he was like – no, no, no.
My plan is to heal this month with light walking/easy stretching, start swimming in 4 weeks and not think about the bike until 8-10 weeks post-op – as I am so afraid of riding with some pain, and the mental spiral that will cause. So any tips on my fears or re-entry?
– Wait how long?
– Try my current saddle or Adamo?
– Will I get back to prior levels? 6mo? ever?
Thanks again,
Jake
Hey Jake! Glad to hear your operation went well. I think all your cycling strengthened your pelvic floor to the extent that you should have a good recovery. I wish I was more of an expert on this. I’m a recreational and touring rider, so I’ve never pushed myself like you have. In my case, I listened to my body and waited for the tenderness to go away before I started putting in miles. My operation was in late September — 13 years ago — so I didn’t have too many sunny days that encouraged me outdoors for a ride. I remember riding, adjusting the seat, riding, repeat. After I had a good foundation, I trained for the Seattle to Portland ride through the spring and early summer and did that big ride in July. At the time, it didn’t seem like a big deal. I had pretty much picked up where I left off. I think you’ll be back to your prior levels, just give it a little time.
Thanks again Gene for the encouraging words. For anyone reading and worried about getting back on the bike from a simple prostatectomy it can be done! Patience is of course key. I was cleared to ride at 6 weeks post op, with the chief concern prior being shear forces where urethra connects to bladder. I walked 2mi per day for a month prior. I’m now 8 weeks post op and just finished two weeks of riding, 6 and 7 hours respectively, including a 3 hour ride this weekend at 17.5mph and 2000’ of gain. I still have some tenderness in pubic area below incisions after an hour but resolves quickly. Arguably cycling easier than swimming. I anticipate being able to ride with some real effort in another 8 weeks. Hard to imagine I’d be here just a month ago. All other urinating functions working better than ever too. Again thanks for this forum and stay positive all.
Thanks so much for starting this thread and sharing your experiences along with encouraging others to do so.
I was diagnosed with prostate cancer in November. 4 of 14 samples showed cancer. Gleason score of 7 on 3 samples and 8 on one. I’ve decided to move ahead with the robotic surgery for removal of my prostate, which will happen in February.
I’ve been very active my entire life, ( I’m 63 )mountain biking for the last 40 years. The thought of not being able to continue has haunted me since I was diagnosed.
All the people here have helped me tremendously with their stories. I will hope for the best outcome and post again after the surgery.
Thank you guys for the posts, and great information. I just turned 65, and in early December, had the robotic prostatectomy, and a tag team double hernia surgery. It was rough going for a while, but my recovery is apace with most of what I am reading here. My doctor said no cycling for three months, and since it is winter here in Michigan, I can live with that. I have been working out on the elliptical, treadmill, and weight lifting with the elastic bands. My question is, the prostate surgeon used a Hem-O-Lock to connect my urethra to my bladder. I will ask him during my next visit, but I am trying to ascertain if this will cause additional problems while sitting on the saddle, or is using this more the rule, than the exception, and should cause no positional problems on the saddle. Did any of you gentlemen have this used to connect your urethra to your bladder? I’m trying to picture the exact placement, and where it is positioned relative to the perineal area. Thank you all again for your posts, and encouragement. Safe and cancer free riding to all.
Wow, this site and all of these comments are a pretty inspiring and welcome thing to find in these harrowing days of the Google Search! Thank you everybody for sharing all of your stories. I’m 62 and have been riding with avid consistency since I was 14. I definitely identify myself as a rider. Over the 4 decades I’ve been riding, I’ve come to accept that not all years are created equal, and some years the fitness comes easily and I’m strong, and others are maybe not so much…but this was going to be different than the normal cycle of good or better years. My surgery was on Feb 2, 2021. After being diagnosed with prostate cancer, I was more concerned about how my riding was going to be affected than with the other potential side anti-benefits. A bit irrational I know, but who is really rational when talking about one’s cancer? My doc told me that for the first 30 days I was to not lift more than 10 lbs, and to get in daily walks, increasing in duration as my body felt it could. After the 30 days, his opinion was that I had no physical restrictions but I probably wouldn’t feel like riding for at least another couple weeks to maybe a month after that. I’ve been feeling pretty great lately, primarily only getting a bit extra tired toward the end of the day. Most of the swollen parts have subsided except for the belly button incision, which is still more inflamed and sensitive than I would like. My surgeon thought it was a reaction to the dissolvable sutures melting away and getting assimilated into the surrounding tissue. He said it was not uncommon for some men to react to this. Just sitting on the stairs I could feel that odd feeling of awareness in the perineum that probably only lucky folks like us get to experience. Even so, at 32 days after surgery, I chanced a short spin around the neighborhood. I had installed a Selle SMP Composit saddle, which still had not yet been adjusted. Even so, the first settling onto the saddle was pain and discomfort free! After a number of adjustments, the saddle feels great (!) and I’m going to begin a slow and consistent program next week. I would imagine that every one of our cases is different, and that if your doc told you to wait a specific time before riding, you should definitely wait. My surgeon said 30 days, and there were only so many times I could re-build my bike after the surgery before I was going to go crazy without riding it. Although the first riding test felt almost as if I had not had any surgery, I am still going to take it slowly out on the road. A few rolls around the block is a far cry from our country roads here in northern California, I know. I’m grateful to my surgeon for his skill and care, and to the folks who make that amazing robotics device. Thank you for this space to just tell your story to guys who share the same problems, questions, and anxieties around what can be a pretty scary life event. I wish everyone on the blog who has recently undergone the surgery a speedy recovery, and for all of us, long term, cancer free health. Stay safe out there and happy riding!
Here’s to a speedy recovery to you too, Stirling, but it sounds like you are well on your way already!
Two vivid memories I have from my surgery — almost 14 years ago now — is the last ride before my operation and my first one afterwards. Sometimes it’s good to remember those rides when I start feeling overwhelmed by little stuff.
