Before going into detail, my top tip is to talk to one of the Prostate Cancer nurses with a list of questions that you may have. (after seeing the hospital specialists first) I was unable to have any erections following treatment, despite having nerve-sparing on one side of the prostate gland. (I had no dysfunction prior to surgery). The size of my penis was reduced by 2 to 3 cms and I was unable to urinate standing up. I was prescribed with a vacuum pump which I used 3 or 4 times a week which helped return my penis to its normal size. Subsequently, after a few weeks of use of the pump, I was able to urinate standing up again. (I still do need to use the pump several times per week in order to maintain penis size). It was painful to use the pump at first and somewhat time-consuming. However, it's now part of my shower routine, so I've become used to it. It takes about 15 minutes extra time in the bathroom when using the pump. After a few weeks of use, the pump routine enabled limited, soft erections to occur naturally (for example during the night), but never hard. I was then prescribed medication and this has helped erections to return almost to what I was experiencing before. So therefore both penis size issue and erectile dysfunction, in my case, were adequately resolved. Although I did speak to hospital specialists at length about the side effects of radical prostatectomy, the issue of penis size reduction was never mentioned. It was only when speaking to one of the Prostate Cancer Nurses that I became aware of this issue. I would strongly recommend that all Prostate Cancer patients speak to the Prostate Cancer Nurses, at any stage of the process after diagnosis and irrespective of the treatment chosen. They were incredibly helpful to me and I am eternally grateful for their help.
The remaining problem is urinary incontinence. Penis size reduction and erectile dysfunction problems have been largely resolved with post-operative care. The urinary incontinence was MUCH better than I expected. I imagined having to change soaked pads several times a day. This never happened. After the catheter was removed, I did need to use 3 pads a day, and for several weeks I would leak each time I went to the toilet to urinate. I would also leak a tiny bit if I coughed or sneezed. I worked on daily pelvic floor exercises and this seems to have helped. So today, 9 months after my surgery, I use 2 pads per day, one during the day and one at night. The night pad is never wet nor damp, so I may decide to stop wearing one at night and see what happens. There are only two circumstances where I leak urine during the day; the first is if I am doing heavy physical work such as digging the garden or using power tools like drills, hedge-trimmers and have to use force in pushing or lifting. The second situation is if I wait too long before I need to urinate, then I occasionally start leaking over the toilet bowl. (By too long, I mean an hour , not minutes, after I first get the urge to urinate). So there's always enough time to find a toilet, even if stuck on the motorway. I've never wet my trousers as any leaked volume of urine is so small that the pad catches it every time. In summary, urinary incontinence is my biggest residual impact, but in my case, it is completely manageable.
Yes
I am delighted with my outcome as the side-effects of the treatment are being well managed. For a few days after the operation, my abdomen was very painful and wearing the catheter for two weeks was a hassle, particularly getting in and out of the shower. Catheter removal was not painful at all. These first few weeks did pass quickly. I will probably always need to wear pads but they are so thin that you hardly notice them. Erections are not as good as before (but are still OK) and penis size has to be managed through use of the pump. These are such small inconveniences.
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