Prehab Tips and Tricks for "seamless" RP post-recovery

Hey guys, I'm looking for tips and tricks to be as prepared physically and emotionally as possible for a prostatectomy surgery (February/March) to make sure my body is ready beforehand (physically and emotionally) so that the outcome is smoother? Thanks for the help.

[dadzone43]

Three critical steps: (1) read a lot to be informed about treatment; (2) Kegel every day; (3) meditate every day about health and guide your thoughts deep into your pelvis to illuminate your prostate. Sounds silly, I know, but mobilizing your body's intrinsic self-healing powers costs nothing and had lots of evidence of efficacy.

[Hidden in reply to dadzone43]

The meditation is something I've been meaning to start for a long time. Now may be the time. Thanks for the tips.

[dadzone43 in reply to Hidden]

You are welcome. Any words work. Mine are I breathe in Love and breathe out Peace.

Also I have a full case of Willow brand briefs that I will happily ship to you. They are 😊 unused.

[Bachisgreat]

Exercise regularly, do Kegel's, have sex with your partner if you have one (it will never be the same after the surgery) get pads/diaper/underwear.

[Hidden in reply to Bachisgreat]

Thanks for sharing. Exercise and Kegals seem to be the primary theme here...I've been tryring to do those while i drive.

[Fairway]

Hi,

No particular tips. Just wish you the best of luck. I was tempted to try and recover without the pain meds because I don't like Oxy. It didn't work. I had no ill effects from them.

[cpcohen]

>>>

Exercise regularly, do Kegel's, have sex with your partner if you have one (it will never be the same after the surgery) get pads/diaper/underwear.

<<<

+1. "Sex" should include non-intercourse sex -- that's all you'll be able to do, for months after surgery. So both of you might want to explore it, in preparation.

After surgery, you should start a program of "penile rehabilitation" -- Viagra (or other oral drugs), intracavernosal injections, possibly vacuum pump (= VED).

IMHO, your probability of recovering "normal erectile function" (with using oral drugs) is probably less than 50%. So expect to need VED or injections or implant, if you want to have penis-in-vagina sex.

You didn't ask "Should I consider surgery?" -- that's a whole other discussion.

. Charles

[Seve]

As has been said, do the kegel exercises. After you heal, you may consider using a vibrator to stimulate your nerves in the pelvic region.

[Handdrummer777]

Are you absolutely certain that RP is your best course? Is it medically mandated vs RT?

Or are you really wanting to just "get the cancer out of there?"

Because there's a substantial (30+%) chance that you will need salvage radiation, often along with ADT, which comes with havoc-wreaking potential in a number of areas.

The actual percentage figure of penile recovery from surgery, with every advance and every experienced surgeon figured in, stands not at "less than 50%", but rather specifically, at 37%.

That, and the certainty of having to deal with immediate ED (with odds nearly 2-1 against penile recovery) and incontinence (hopefully temporary), some nerve damage, and likely penile atrophy unless a rigorous rehab program is introduced and successfully maintained, are some sobering reasons why I chose the 43 VMAT radiation treatments.

Find out about SBRT, which only uses 5 treatments. Tall_Allen is a great resource for that.

Just make damn sure you are, with the beat advice and info possible, choosing the best Qol-preservation-and-treatment option.

I urge you (again respecting your choice if mandated) to at least fully consider the RT path -- preserving nerves, erectile functioning, and avoiding incontinence -- with advanced RT.

Beat of luck!

[David1958]

How about telling us how old you are, your PSA, Gleason Score, PCA staging? How did you decide upon surgery as the treatment of choice? Kegals will definitely help with incontinence, ED is unavoidable and takes time for the nerves to recover. I would try to be as fit as possible before undergoing surgery, as it takes time to recover from it and you do not want to reintroduce the gym too soon. You will want loose fitting pants (sweats most likely). Take the pain meds! At least all the way until they take out the drain from your abdomen.

[Hidden in reply to David1958]

I'm 57, and the following is from the pathology report. I guess I should have put this up top. The recent PSA was 6. 5. I have not heard the term PCA Staging, I can ask about that today.

My understanding is that because of the prostate had cancer everywhere, and my relatively young age, my relatively good health, no family history of cancer of any type, the best solution was to just cut this out, recover/rehab. I have heard many stories of great outcomes from surgery. I have heard many stories of difficult outcomes as well as surgery.

Everyone here has been helpful and the common theme is exercise, do kegals, and meditate. And respect the recovery process.

PROSTATE BIOPSIES:

A. RIGHT BASE (TARGET LESION):

PROSTATIC ADENOCARCINOMA, GLEASON SCORE 3+3 = 6 (GRADE GROUP 1), INVOLVING 5% (0.7 MM) OF ONE OF 3 CORES.

ADJOINING HIGH-GRADE PIN.

FOCAL ACUTE PROSTATITIS, NONSPECIFIC.

B. LEFT APEX:

PROSTATIC ADENOCARCINOMA, GLEASON SCORE 3+3 = 6 (GRADE GROUP 1), INVOLVING 25% (3.5 MM) OF ONE OF 2 CORES.

C. RIGHT APEX:

PROSTATIC ADENOCARCINOMA, GLEASON SCORE 3+4 = 7 (GRADE GROUP 2, WITH 10% GLEASON PATTERN 4), INVOLVING 80% (9 MM) OF 2 OF 2 CORES.

PERINEURAL INVASION PRESENT

D. LEFT BASE:

BENIGN PROSTATE TISSUE

E. RIGHT BASE:

PROSTATIC ADENOCARCINOMA, GLEASON SCORE 3+ 3 = 6 (GRADE GROUP 1) INVOLVING 6% (0.9 MM) OF ONE OF 2 CORES.

F. LEFT MID:

BENIGN PROSTATE TISSUE.

G. RIGHT MID:

PROSTATIC ADENOCARCINOMA, GLEASON SCORE 3+3 = 6 (GRADE GROUP 1), DISCONTINUOUSLY INVOLVING 75% (10 MM) OF ONE CORE AND 65% (8 MM) OF A SECOND CORE.

FLORID GLANDULAR HYPERPLASIA, APPROACHING HIGH-GRADE PIN.