RALP Recovery Duration

I am almost 7 weeks post-op and am trying to figure out when I am going to be 100% recovered from the surgery. Most of the threads and doctor instructions focus on the first weeks after surgery and then discuss the long term issues with ED and incontinence, skipping the in-between period. I am not asking about ED or continence as these are covered in depth but the general after-effects of RALP surgery (the part they don't talk about).

My basic question is: When does the pelvic area feel like nothing has been done to it? or is it forever compromised? There are little aches and odd feelings around the groin/penis/rectum area as well as that uncomfortable feeling when sitting down that is not completely gone yet. Will I be able to get up and sit down with reckless abandon at some point as I am still tentative now?

I just want to make sure it is not just me as I know everyone has a different experience and I would like to be just average in this case. Just wondering what others experienced for the 1-6 months after surgery.

Mumbo,

At seven weeks, I would say what you are describing is pretty good progress. Unless something went wrong with your surgery, and it does happen (infections, hernia, etc.), I cannot imagine you will be "forever compromised", so get that off your plate. You would very likely know already if you were one of those unfortunate souls.

Mine was six years ago (April 2012). But what I remember, I was back to light elliptical, light weights, within couple months. Back to biking that summer, maybe 45 min. rides with wife. Now, I did have some PNE (pudendal nerve entrapment) even before the surgery, and it kept bothering me enough that by that fall, I was ordering special bike seats for discomfort. Maybe a little of that was post-RALP pain, but mostly the PNE. Eventually found a chiro exercise that fixed it almost immediately (praise be, because PNE is really a gnawing ordeal, like migraines...)

I think "the shape you are in going into" RALP determines how fast you recover coming out. I did have significant bruising around abdomen (took photos, ha ha), and scars still today. But what would we expect? I'll bet by the 3-6 month period, you will be coming around really well and the RALP will be mostly in rear view mirror.

Know you did not ask about this part for now -- but you really need to think about getting a 2nd path from Epstein soon. You need to find out the true gleason at your +margin and verify the EPE deal. Also, I just found out I cannot get gene testing now, since the path tissues are only good for about three years after RALP. So if you or docs are interested in gene testing, keep that in mind. If you do get a PSA rise down the road, and I hope not, it will require monitoring and some assumptions/guesses as to whether it is benign tissue, clinically insignificant relapse, or some thing that needs more attention. The more info you have gathered, the better--it's still an inexact science.

All in all, seems u are doing fine. Hope you continue good healing and a fine recovery in new year.

Robert

Mumbo, I think a lot of it has to do with your age and your condition going into the surgery. we are the same age and I had mine last March. I feel that I was in pretty good shape going in because I'd trained to run a half-marathon which I missed while recovering. I walked but kept thing low-key for about 3 months. 2 months later my long runs were back up to 8 miles.

For a while I had the weird abdominal sensations but didn't really have noticeable bruising except from the daily Heparin shots I received in the abdomen for about 3 weeks.

I would say that it was about 7 months before I quit feeling sensitivity in the perineal area so that it didn't matter what kind of chair I sat in. I also kept lifting anything to what my body said was OK for about 6 months? I do accept that things are different down there and will never be the same as they were. that alone helps moving forward. Luckily, I am done with treatment and only have the periodic PSA tests for which I have very little anxiety over.

Great question, Mumbo. For me, it was 5-6 months. I developed a lymphocele — accumulation of fluid where a lymph node was removed— at 6-8 weeks that hampered me severely. For weeks, I walked with a cane, couldn’t find a comfortable position for sleep. Then it cleared up on its own and I was close to 100 percent at 5 months. By 8 months I was doing full workouts at the gym like nothing had happened.
If you have disabling groin or leg pain, you might want to get an ultrasound to check for lymphocele, which develops in 7-10 percent of RP patients post-op.
Short answer: you’re doing fine, just do the time.

As has been mentioned earlier, a lot has to do with your physical condition before surgery and if you are willing and able to be somewhat active after the surgery to promote blood flow and therefore quicker healing to the affected area.
After knee ligaments surgery 30+ years ago, the advice was to rest and therefor the healing process took many months before weight bearing. Nowadays, after the same operation, the patient is encouraged to move their knee the next day allowing for weight bearing and quicker healing in a relatively short period. Post prostate surgery movement to a point, can have a very positive result for the patient.

Had RP surgery late April/13. Started walking a few days after surgery every day. Starting June 1st, began riding my touring bike every day. July 4th, my wife and I flew over to Europe for a 2 month, very strenuous cycle tour with all of our gear, through the Alps, camping 55 days straight. Had no problems at all.

For me, moderate to vigorous activity helped me heal quicker than I thought I would.

Dave

My RALP was in mid-February in the midwest--middle of winter. I was in the hospital about 36 hrs, start to finish. 7 days with Mr. Cathy. I went back to work after 3 weeks, and if I had been left along and set my own pace, I probably would have been ok. But, I took a few more days off the next week. ED was a non-issue, as was leaking--night dry within 2 weeks, pad free by 2 months. At 3 months I took my first trip by air--spent a week in the Maine woods....I slept a lot while there, didn't try a lot of hard physical activity.

Overall, I probably didn't feel 100% for 6 months. I was in average shape--I could have (and still could) lose 30 pounds.

Remember, you've had major surgery, RALP is not an appendectomy. The weird twinges in your pelvis are normal.....a gap was created that needs to fill back up...your other parts are filling in the empty space. Healing takes time.

slapshot - Since I had ACL surgery in 1970 and torn achilles repair in 1987, I can appreciate the old way of rehab (full leg casts) and the pain in 1970 when the doctors were anti-pain meds like they are now again (Reefer Madness got us all in trouble back then). You must have a sturdy biker's butt from so much intense riding over the years. The thought of sitting on my bicycle seat was just not possible until recently. I did not get out and really walk much until the catheter was out. We had terrible weather for the week after my surgery with cold, snow, and ice that it was a lot of work to get ready then walk carefully for 3-4 blocks and back.

logo - Good to know that it took months. For some reason I think this should be going faster but I do not have a history of operations like this so nothing to compare to. My continence is ok and the ED is a work in progress but the nerves were saved so I am pretty sure it will get better. Did not feel like practicing much the first month since everything down there felt odd. Not sure how these "younger guys" get after it so quick.

halbert - Thanks, more good to know reference points. My surgery was approx. 24 hours home-hospital-home (10 min drive). They aim for this so that it meets the requirements of out-patient surgery per Medicare from what I am told. It almost seemed too fast to me after walking in the hospital and them saying I am good to go, sign here.

jim nyc - I had a lot of bowel and bladder spasm pain for the first day followed by nasty upper back gas pain for a couple of days. Once that was over, the recovery started. Getting the catheter out at 10 days was a glorious moment in the recovery process that permitted walking and driving at any time. I had a little bladder pain after the catheter was out and it was "full" but that went away after a week of getting up a lot at night to stop the ache.

Merry Christmas to All......

Mumbo

You need to be patient. I am 5 years post RALP. I can tell you that it took over three years to get to 100% of what I perceive to be my recovery. It can be frustrating and it is not linear. There are ups and downs along the way but just keep going, it will get better.