Most people don’t walk into prostate cancer surgery feeling “ready.” They walk in carrying a diagnosis that may have started with one lab value, one uneasy exam, or one “let’s just check” conversation.
Then suddenly it’s biopsy results, grade groups, scans, and a decision that can feel both lifesaving and deeply personal. Surgery is often framed as a finish line. In real life, it’s a starting gun: recovery is where you rebuild your body’s routine, your confidence, your intimacy, and your trust that you can feel like yourself again.
In the United States, prostate cancer remains one of the most common cancers in men. The American Cancer Society estimates that in 2026 alone, over 330,000 men will be diagnosed with prostate cancer.1
That’s the big picture. Your picture is more specific: What exactly is prostate cancer, how do doctors decide surgery is needed, and what does a strong recovery plan actually look like?
What is Prostate Cancer? (In Plain Language)
The prostate is a small gland below the bladder that helps make semen.2 It sits in a crowded neighborhood. The urethra (the tube that carries urine out of the body) passes through it, and nerves and muscles nearby help control urination and erections.2
That location matters because treating prostate cancer often affects urinary and sexual function, at least temporarily.2
Prostate cancer happens when cells in the prostate grow out of control. Many prostate cancers grow slowly, but some are aggressive and can spread beyond the prostate to lymph nodes or bones.2 Treatment decisions are based on how likely the cancer is to grow, spread, or return.2
How Diagnosis and Testing Usually Works
Even when the path feels chaotic, most workups follow a recognizable sequence. Knowing the steps helps you ask sharper questions and catch gaps in care.
Step 1: Screening signals (PSA and sometimes DRE)
A PSA (prostate-specific antigen) blood test measures a protein made by the prostate. Higher PSA levels can be caused by cancer, but also by benign enlargement, inflammation, infection, or even recent ejaculation or certain procedures. That’s why PSA alone does not diagnose cancer. Guidelines for patients emphasize PSA’s limits and why it is often paired with other evaluation tools.3
A digital rectal exam (DRE) may also be done to feel for nodules or asymmetry, but many cancers aren’t “feelable”.3
Step 2: Risk refinement (MRI and other tools)
If PSA is concerning or rising over time, clinicians may recommend a prostate MRI to look for suspicious areas and guide biopsy decisions.3 This step can reduce guesswork by helping target sampling.
Step 3: Biopsy (the diagnosis-maker)
A biopsy removes small tissue samples from the prostate. A pathologist looks under a microscope to confirm cancer and grade it.3
Step 4: Grading and staging (how aggressive, how far).
You’ll hear two key ideas:
- Grade Group / Gleason score: how abnormal the cancer cells look and how likely they are to grow/spread quickly.3
- Stage: how far the cancer has grown or spread. Prostate cancer staging commonly incorporates PSA level, Grade Group (based on Gleason), and TNM staging (tumor, nodes, metastasis).3
Some people also need imaging (CT, bone scan, or PSMA PET depending on risk level and local standards) to check for spread before deciding on surgery.3
When Surgery Is Recommended, and What it Actually Entails
Surgery for prostate cancer is most commonly a radical prostatectomy, which means removing the entire prostate (and often seminal vesicles) and reconnecting the bladder to the urethra. It can be done via open surgery or minimally invasive approaches (including robotic-assisted surgery). The goal is to remove the cancer completely when it appears confined to the prostate or still surgically curable.4
Because of the prostate’s location, surgeons work millimeters away from structures that affect quality of life. That’s why two side effects get so much attention:
- Urinary incontinence (leakage), especially early on.4
- Erectile dysfunction, especially if the nerves near the prostate can’t be spared.4
Major guidelines and academic urology resources are straightforward about this tradeoff: prostate cancer treatment often risks urinary and sexual function because critical structures sit right next to the prostate.4
After surgery, most people go home with a urinary catheter to keep the new connection healed and draining properly. Many reputable medical sources note catheter removal commonly happens around 7–14 days, depending on healing and surgeon preference.4
The 3-Step Post-Surgery Recovery Guide
This guide is built around what most people actually need: clear expectations, fewer surprises, and a structure you can follow even when you’re tired.
Step 1: The first 10–14 days
This is the “protect healing and prevent complications” phase. Right after surgery, your main jobs are to keep your body moving safely, manage pain without getting constipated into misery, and protect the bladder-urethra connection while the catheter is in place. Many institutions remove the catheter about 7–14 days after surgery.6
What to prioritize during this phase:
- Walking, early and often. Short walks reduce the risk of blood clots, help bowel function return, and reduce stiffness. You are not training for a marathon. You are reminding your body how to circulate and recover.6
- Catheter care like it’s your job. Expect discomfort, bladder spasms in some cases, and the awkward learning curve of managing tubing and a bag. Ask for written instructions before discharge and confirm who to call after hours if there’s blockage, fever, worsening pain, or no urine output.6
- Pain control with a constipation plan. Opioids can cause constipation; constipation can increase pelvic pressure and discomfort. Ask your care team what stool softener or laxative plan they recommend, and hydrate unless you were told otherwise.6
- Know the “call now” signs. Fever, shaking chills, sudden worsening pain, bright red urine with clots that block flow, calf swelling/pain, shortness of breath, chest pain, or inability to urinate through the catheter are urgent.6
Self-advocacy language for this phase (use it verbatim if helpful):
“I want to be proactive. Before I leave today, I need clear written instructions for catheter care, pain meds, bowel regimen, and exactly what symptoms mean I should call immediately or go to the ER.”
If you’re navigating insurance barriers, say this: “My recovery depends on avoiding complications. Please document why these supplies or follow-up visits are medically necessary, and help me submit the prior authorization today”.
Step 2: Weeks 2–6
This is the “rebuild control and stamina” phase.
After the catheter comes out, the most common emotional whiplash is urinary leakage.6 For many people it improves over time, but the early days can feel discouraging. Urology guidance emphasizes that incontinence after prostate treatment is a real, treatable issue and supports pelvic floor muscle training as a first-line approach.6
What to prioritize during this phase:
- Pelvic floor rehab, started the right way. “Kegels” are not always intuitive, and doing them incorrectly can backfire. Ask for referral to pelvic floor physical therapy if it’s available in your area and covered by insurance.6
- A realistic pad strategy. Pads are not a moral failure. They are a tool. Buy a few types and see what works for your leakage pattern. Many people need more protection during the day and less at night as they improve.6
- Gradual return to work and activity. Some people return to desk work in a few weeks, but jobs involving lifting or long periods on your feet may require longer. One major cancer center notes many patients return to work around 2–4 weeks, depending on job demands and recovery.6
- Protect the surgical area. Heavy lifting too early can increase discomfort and strain healing tissues. Ask your surgeon for the specific weight limit and timeline, because it varies. 6
Self-advocacy language for this phase:
“I’m having urinary leakage that affects my daily life. I want a pelvic floor physical therapy referral, and I want to understand what’s typical at this point and what would be considered a red flag.”
And if you’re being minimized, say this: “I hear you, but this is interfering with my ability to work and function. I need a documented recovery plan with clear next steps, not reassurance alone”.
Step 3: Months 2–12
This is the “long recovery, real life” phase. It’s where people often get less support even though they still need it.
Two things often unfold slowly after prostatectomy: urinary control and sexual function. A clinical review in the medical literature notes wide ranges in reported rates for urinary incontinence and erectile dysfunction after radical prostatectomy, reflecting differences in definitions, surgical technique, baseline function, and follow-up time.6
The point isn’t to scare you. It’s to normalize that recovery is not always linear, and you deserve follow-up that treats quality of life as part of cancer care, not a luxury add-on.
What to prioritize during this phase:
- PSA surveillance and “what does undetectable mean?” After prostate removal, PSA should usually drop to very low or undetectable levels. Your clinician will set a schedule (often every few months early on) to monitor for recurrence. Ask what number would trigger concern and what the next step would be.6
- Sexual rehabilitation as healthcare, not vanity. Nerve healing can take time. One leading cancer center notes that recovery of full erections can take up to years for some people, even with advanced techniques. Ask early about options: PDE5 inhibitors (like tadalafil), vacuum erection devices, injections, and counseling. The best time to start the conversation is before you feel desperate.6
- Mental health and relationship care. Anxiety, body changes, and intimacy stress are common. If you have a partner, bring them into a visit if you want. If you don’t, you still deserve support.6
- If leakage persists, escalate. If you still have significant incontinence months later, you’re not “stuck.” There are additional treatment options beyond exercises. The key is not disappearing from follow-up out of frustration.6
Self-advocacy language for this phase:
“I understand cancer control is the priority. I also need a plan for urinary and sexual recovery. Can we map out what we try first, what comes next if it doesn’t improve, and when we reassess?”
If you’re a Black or Brown patient navigating a system that sometimes listens less carefully, say this: “I want my symptoms documented today. I also want my referral options and timelines documented. I’m committed to recovery, and I need the same level of thoroughness in survivorship care as I received in cancer treatment.”
Why Knowing This Information Can Change Outcomes
When people don’t know what “normal recovery” looks like, they often delay calling for help. When they don’t understand how diagnosis and staging work, they can’t tell whether their care plan matches their risk level.
And when survivorship care isn’t structured, disparities widen because follow-up support becomes dependent on time, money, transportation, insurance literacy, and whether you feel safe pushing back.5
Having a recovery plan is not about being “high maintenance.” It’s about preventing avoidable complications and protecting your quality of life while you heal.
A Call to Action for the NOWINCLUDED Community
This week inside the NOWINCLUDED app, don’t recover in silence.
Share one thing in the community that would genuinely help someone else post-surgery: what you wish you had known about the catheter, what helped you manage leakage without shame, how you talked to your partner, what you said to your job, what supplies were actually worth buying, or how you advocated for pelvic floor therapy or sexual rehab support.
If you’re pre-surgery or newly diagnosed, post your biggest question. The goal here is not perfection. It’s shared clarity. And clarity is a form of care.
References
- ACS. (2026, January 13). Key Statistics for Prostate Cancer. Retrieved from American Cancer Society: https://www.cancer.org/cancer/types/prostate-cancer/about/key-statistics.html
- ACS. (2023, November 22). What Is Prostate Cancer? Retrieved from American Cancer Society: https://www.cancer.org/cancer/types/prostate-cancer/about/what-is-prostate-cancer.html
- ACS. (2025, March 21). Tests to Diagnose and Stage Prostate Cancer. Retrieved from American Cancer Society: https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/how-diagnosed.html
- ACS. (2023, November 22). Surgery for Prostate Cancer. Retrieved from American Cancer Society: https://www.cancer.org/cancer/types/prostate-cancer/treating/surgery.html
- Lowder, D., Rizwan, K., McColl, C., Paparella, A., & Ittmann, M. (2022). Racial disparities in prostate cancer: A complex interplay between socioeconomic inequities and genomics. Cancer Letters. doi:10.1016/j.canlet.2022.01.028
- Geng, C. (2025, April 24). What to expect during prostate cancer surgery recovery. Retrieved from Medical News Today: https://www.medicalnewstoday.com/articles/prostate-cancer-surgery-recovery
