Getting back on track: 10 steps to help with urinary and erectile problems after surgery

Whether you’re waiting to have surgery, in the early days of recovery, or several months down the line – there may be things you can do today to support your urinary and erectile function. 

You might not experience all the side effects we're going to talk about in this article – and the time it takes for you to recover from surgery might be different from someone else. But knowing what might happen, and what you can do about it, can help you stay positive.

Talking about these side effects can be difficult, too. Incontinence and erectile dysfunction are topics that might feel embarrassing or awkward to bring up – even with healthcare professionals. But they’re used to having these conversations. And they can support you through your treatment and beyond. 

Alongside your healthcare team, we’re also here to help you have more open conversations, sharing information you may find useful during your recovery. 

Before your surgery

1. Start pelvic floor muscle exercises 

These exercises strengthen the muscles that help you maintain erections and control when you wee. Try starting them in the weeks leading up to your surgery. This may help you recover your erections and bladder control sooner. 

2. Get ready to rest

Take a look at our tips for getting organised at home, so your daily chores are more manageable. It’s important to make time for rest in the days after you’ve had surgery. 

3. Look into treatment options for erection problems

Your doctor may suggest that you start taking PDE5 inhibitor tablets before surgery, or in the first few weeks afterwards. These tablets encourage blood flow to your penis, so the cells have a good supply of oxygen – which helps to keep it healthy.

Another treatment to start thinking about is the vacuum pump. You'll need to wait a few weeks after surgery before you can start using it, but it’s good to have ready.

Like tablets, it can play an important role in keeping your penis healthy by encouraging blood flow. You should be able to get one on prescription. But if not, you can buy one yourself – just be sure to ask your doctor, nurse or specialist for advice on choosing one that’s suitable.

Your recovery

4. Make time for rest 

In the first few days after surgery, make time for rest. Go easy on household chores and take a break from heavy exercise – or anything that feels like hard work.

But light exercise around the house, or taking a short walk every day, can help with your recovery. Try to make sure you’re eating a balanced and nutritious diet, too.

When it comes to having sex or masturbating again, the timing depends on the type of surgery you’ve had.

• If you’ve had keyhole or robot-assisted surgery, wait until your catheter is out (one to three weeks after surgery). 
  
  
• If you’ve had open surgery, wait until the wound has healed and it feels comfortable.
  
  
• If you receive anal sex, wait about six weeks to give the area time to heal.

5. Prepare for leakage 

Although some men regain their bladder control very quickly, it’s likely you’ll start leaking urine as soon as your catheter is removed. Remember to take incontinence products – like absorbent pads or pants – with you to the hospital, and some spare underwear and trousers just in case. The hospital might be able to give you pads, but it’s good to be prepared.

Our surgery support pack contains some samples. To order one, call 0800 074 8383 and choose option four. You can also get a discount on TENA Men products with their product selector tool.

There are other products available that may help with leakage too, including external catheters (sometimes called urinary sheaths), bed protectors and handheld urinals.

6. Drink a normal amount

You might be tempted to drink less to reduce leakage, but this can irritate your bladder and could cause an infection. Make sure you’re still drinking enough (three to four pints, or one-and-a-half to two litres a day). But try to avoid fizzy drinks, alcohol and caffeine, as they can irritate the bladder.

7. Restart pelvic floor muscle exercises

Once your catheter is removed, start doing pelvic floor muscle exercises again. These will help with controlling when you wee and maintaining your erections. 

For other types of exercise, stick to gentle physical activity for the first few weeks. After about six weeks, you should be able to start exercising normally again. If you cycle, it may take up to eight weeks before you can get back in the saddle – you could think about buying a padded cover to make the saddle more comfortable. 

8. Stick with the tablets

You’ll probably be offered PDE5 inhibitor tablets as a first treatment to help you get your erections back, and to keep your penis healthy. They usually work well, but it can take a few months to see the effects, as they work best when the nerves start to recover. Stick with them and try to stay positive. 

9. Start using the vacuum pump

Around four to six weeks after surgery – when you feel ready – it’ll be safe to start using the vacuum pump. Aim to use it every day, even if you don’t feel like having sex or masturbating, as it will make up for the natural erections that a healthy penis has while you’re asleep. 

10. Experiment with other treatments
If you’ve tried your first treatment options for as long as your doctor recommended but you’re still not getting on with them, speak to your doctor. There are several treatment options for urinary problems and sexual problems.

It’s a good idea to experiment so you can find out what works best for you. And keep in mind that you can re-visit some treatments later on. For example, the tablets may work better for you in the future, when your nerves have had more time to recover. 

It’s good to talk

There’s no denying the side effects of surgery can be tough. Discussing your challenges with specialists, and with other men who’ve been through it – or who are going through it now – will help you stay positive and informed. Whatever point you’re at in your prostate cancer journey, you’re not alone.

You can ask about anything related to sex, in confidence, via our Sexual Support service. Call 0800 074 8383 and ask to speak with a sexual support nurse, or fill in our form and we’ll call you back. 

Alternatively, you can connect with someone else who’s had surgery through our One-to-One Peer Support service, or head to our online community if you want to share an experience, get tips or ask questions.