Peter’s Story: What I Learned After Prostatectomy and Wish I’d Known Ahead of Time

Peter shares the story of his treatment—and practical tips for other men

Prostatectomy, or the surgical removal of the prostate gland and seminal vesicles, is one of the main treatment options for prostate cancer. It offers a strong chance of controlling or even curing the disease, but recovery can present its own set of challenges.

Peter* knows this firsthand. In 2024, at age 63, his annual PSA screening blood test showed a concerning jump from 3 to nearly 7 in just one year. Biopsies revealed high-grade Gleason 9 (5+4) prostate cancer—a fast-growing form of the disease with a high risk of metastasis (spread to other places in the body). Peter was otherwise healthy, working full time, and had no obvious symptoms.

After weighing his treatment options with his urologist, Peter chose a robot-assisted prostatectomy. Eighteen months later, he’s sharing what he wishes he’d known before surgery—and how he managed the ups and downs of recovery.

Immediately After Surgery

Following surgery, you’ll most likely go home with a urinary catheter, a thin tube inserted in your urethra to drain urine into a small bag strapped to your leg. The bag needs to be emptied several times a day, and everything should be kept clean to prevent infection.

Peter advises men to follow discharge instructions closely and speak up if something doesn’t feel right. In his case, he started having severe pain when urinating with the catheter in place.

“I spent most of my career working in pain management, and felt I had a pretty strong pain tolerance,” he says. “But I called the urologist’s office three times because the pain was so bad.”

It turned out that the screen at his catheter’s tip was clogged with blood, causing a buildup of bladder pressure and severe pain, as he could only empty his bladder by leaking urine around the catheter. Once the clog was removed, Peter’s pain improved immediately. Being seen sooner would have spared him days of suffering.

“I should have been even more proactive about demanding to be seen,” he says now. If something doesn’t feel right or hurts more than you think it should, don’t wait to ask for help. If necessary, keep contacting your care team until you are seen.

“You’re going to leak—get ready for it.”

Once Peter’s catheter was removed, he found it helpful to return to his usual routine and social life as soon as he was ready. But to do so, he needed strategies to deal with urine leakage (incontinence), a common side effect of prostatectomy that can last for weeks or even longer.

“You’re going to leak,” Peter says. “Get ready for it.” He recommends stocking up on male “guards” (absorbent pads that go in your underwear) and incontinence underwear, starting with the “maximum hold” pads. To skip the awkwardness of purchasing them in a brick-and-mortar store, he orders online. He advises getting them before surgery—and buying more than you think you’ll need—to avoid uncomfortable last-minute trips.

It’s normal to feel self-conscious about these products, especially at first. But no one else can tell you’re wearing them, Peter stresses. He recommends wearing black pants to help hide any leaks and carrying extra pads when going out, just in case. He also used a penile incontinence clamp, a device that fits around the penis and applies gentle pressure to the urethra to help control leaking. Peter explored several different iterations of a so-called “Cunningham Clamp” before eventually pursuing a more circumferential cuff, the “Pacey Cuff”, that he found to be more comfortable. (Note: Talk to your doctor about whether an incontinence clamp might be right for you, and if so, which brands or types they may recommend. Make sure to carefully follow instructions for use to avoid injury. Learn more.)

Peter also shares this travel tip: If you’re flying, keep in mind that airport scanners might flag a clamp or even a wet pad. To avoid a pat-down, be sure your pad is dry and remove any devices before going through security.

Incontinence is a common part of recovery, but everyone’s experience is different. Post-surgery recommendations can vary. Pelvic floor exercises, called Kegels, can help many men and are sometimes recommended even before surgery. Learn more.

What to Do About Long-Term Incontinence

Eighteen months after surgery, Peter still experiences significant urinary incontinence—a reality for many men. In fact, 5–20% of men continue to have symptoms one to two years post-surgery.

To address the problem, he has opted for an artificial urinary sphincter. This is a small, surgically placed device that helps control urine flow by mimicking the function of a biological sphincter muscle. Looking back, he wishes he had acted sooner. “There’s no need to wait a year or longer to explore solutions,” he says. “Advocate for yourself.”

Since there are different types of urinary incontinence, it’s important to get a comprehensive evaluation for long-term symptoms. If the urologist treating your prostate cancer doesn’t specialize in managing incontinence, seek out a clinician who does. Non-surgical options include pelvic floor physical therapy and bladder training; lifestyle adjustments such as timed voiding and managing fluids and caffeine; and a range of products and external devices. Surgical options include a male sling or an artificial urinary sphincter. Explore options.

Talking about Sexual Health

“To not discuss sexual health and recovery is to not address the elephant in the room,” Peter says.

He encourages men to speak openly with a urologist who specializes in men’s sexual health. For erectile dysfunction, treatment options include medications, vacuum erection devices (pumps), injections, and penile implants. “Be an advocate—there are options out there,” Peter says. Learn more.

Sexual recovery takes time and varies for each person and relationship. Emotional intimacy and honest communication with your partner can help you navigate the changes together.

Beyond Physical Recovery, Reconnecting Socially

Recovery isn’t just physical, it’s emotional too. For Peter, one of the biggest surprises was how isolated he felt: Despite having a large and supportive social circle, “I was really surprised at how few people reached out to me.”

He explains that when you’re treated for cancer, even close friends may not know how to approach you. Some may not know what to say, while others may assume that you’re ‘fine now that the cancer is gone.’

This taught Peter an important lesson about how he supports others. Now, when a friend faces bad news, he doesn’t wait for them to contact him. He picks up the phone first, knowing how hard it can be to start that conversation.

Peter also recommends thinking about how to answer questions ahead of time—whether those pertain to your treatment, how you’re feeling, or next steps.

“For me, I’m pretty transparent with a lot of my guy buddies,” he shares. “Some people can deal with it, and some can’t. And you know, we often end up using humor in strange ways to help get around some of these awkward things—and that’s okay.”

In sharing his story, he hopes to break the stigma that often keeps men from talking about challenges after prostatectomy. “Be as transparent as you want to be,” he concludes. “Your friends are there to help you. They want to know how you’re doing, so don’t be afraid to share what’s going on. You’re not alone, you’re not less of a man, and you’re not a victim. You’re a survivor.”

“Millions of men have lived through this—and so will we. That said, don’t fail to advocate for yourself!”

* Name has been changed to protect privacy. Photo is a stock image and not of the individual.