10 recovery tips after prostate removal that genuinely help
The practical advice I give in clinic and repeat at the first follow-up. Small daily habits that make the weeks after a robotic prostatectomy easier, and the warning signs that mean you should call your team.
The 10 tips in this article
If you are reading this a few days after a radical prostatectomy, or a few days before one, you probably want the same thing most of my patients do: to know what actually makes the next few weeks easier.
Not the textbook version. The practical version. These are the tips I give in clinic and repeat at the first follow-up. None of them is complicated, but done consistently they make a real difference to how quickly you feel like yourself again. Recovery is something you can influence, and much of that influence sits in small daily habits rather than any single treatment.
Start walking early, but keep it gentle
The single best thing you can do in the first week is to move. Short, gentle walks around the house and garden, building to 10 or 15 minutes a few times a day, help your circulation, reduce the risk of blood clots in the legs and wake your bowels up after surgery.
Walking is not a workout. Stop before you feel tired, and never push through pain. If you feel light-headed, sit down and rest.
Drink plenty of water
It sounds obvious, and it is the tip most men skip. Aim for pale, straw-coloured urine. Good hydration keeps the urine dilute, which reduces irritation around the catheter and the healing join between your bladder and urethra, and it helps prevent constipation.
Spread your fluids across the day rather than drinking a large amount late at night, so you are not up repeatedly with the catheter bag.
Take fibre seriously
Constipation is one of the most common and most avoidable problems after a prostatectomy. Straining puts pressure on fresh surgical tissue, and painkillers can make your bowels sluggish.
Keep fruit, vegetables and wholegrains in your diet, drink enough fluid, and use the stool softener your team prescribes rather than waiting until you need it. If you have not opened your bowels within a few days of surgery, tell your team rather than simply waiting it out.
Do your pelvic floor exercises properly
Pelvic floor exercises are the closest thing to a silver bullet for continence after surgery. The men who do them well, before the operation and consistently afterwards, tend to regain control sooner.
The secret is technique, not effort. Squeeze as though you are stopping wind and urine at the same time, hold for a few seconds, then fully relax. Short, quick squeezes work a different set of muscle fibres, so do both. A specialist pelvic health physiotherapist is worth seeing if you can, and your team can point you to one.
What I expect: most of my patients are dry at night and using a single pad for safety by around six weeks. Over 90% of men having nerve-sparing robotic surgery in my practice are dry or leaking minimally at one year.
Learn to live with the catheter
Most men go home with a catheter for about a week, and it is usually the part patients worry about most. A few simple habits help. Keep the bag below the level of your bladder, never tug on the tubing, and wash your hands before and after emptying it. Use the larger night bag so you can sleep undisturbed.
Some pink tinge in the urine is normal, especially after you have been moving around. Fresh, bright red blood or clots is not, so call your team.
Stay ahead of the pain
You will heal better if you are comfortable enough to walk, breathe deeply and sleep. Take your pain relief on a regular schedule for the first few days rather than waiting for the pain to build. It is much harder to settle once it has taken hold.
Paracetamol and the medication your team has prescribed are usually enough. Follow the dosing instructions, and check with your team before adding anything else.
Keep wound and skin care simple
Shower as normal unless you have been told otherwise, pat the small keyhole wounds dry, and follow whatever dressing advice your team gave you. Gently wash the skin where the catheter enters with plain water, and check your wounds daily for redness, swelling or discharge.
Less is more here. You do not need antiseptics, powders or elaborate routines, and they can sometimes irritate healing skin.
Pace your return to driving, work and lifting
You should not drive while the catheter is in, and most men are advised to wait a little longer before getting back behind the wheel, particularly as you need to be able to brake hard in an emergency. Ask your team before you start again, and check with your car insurer.
Build back into work gradually if you can. Avoid heavy lifting and vigorous gym work for the period your surgeon advises, usually around six weeks. Pushing too hard too early is the most reliable way to set your recovery back.
Be patient with erections and intimacy
Nerve recovery after prostatectomy takes months, not weeks, and it often continues for a year or more. Early on, the goal is to keep blood flow to the penis healthy, which is why your team may recommend medication, a vacuum device or both while the nerves recover.
This is a conversation worth having openly, rather than assuming nothing can be done. There are effective options at every stage, and the right one depends on your surgery and your goals. I cover this in detail in erectile dysfunction after robotic prostate surgery.
Know when to pick up the phone
Most recoveries are uneventful, but a small number of problems need prompt attention.
Contact your team straight away if you have:
- a temperature over 38°C, or you feel shivery and unwell
- heavy bleeding or blood clots in your urine
- pain or swelling in your calf or leg
- breathlessness or chest pain
- no urine draining, or a catheter that will not drain
- increasing redness, swelling or discharge around a wound
If you have chest pain or severe breathlessness, call 999.
It is always better to ask than to wait and wonder. No one minds a phone call.
Putting it together
There is no trick to recovery after prostate removal. It is the accumulation of small, sensible things done consistently. Walk, drink, eat well, exercise your pelvic floor, stay on top of pain, and keep in touch with your team. Expect good days and slower days, and judge your progress by the week rather than the hour.
If you have a new diagnosis, a raised PSA, or you are weighing up surgery, focal therapy or a second opinion, the aim is that you never feel rushed or talked over. I see patients privately at four London hospitals with same-week appointments and no GP referral needed, and I am happy to talk you through every option.
