05 March 2026
Written by:
Debra Ward, Clinical Nurse Manager – Telenursing & Supportive Care Programs, PCFA
Naomi Mutinda, Prostate Cancer Specialist Nurse
Just over half of men diagnosed with intermediate risk (Gleason 7 or Grade Group 2 and 3) and just under half of men diagnosed with high-risk disease (Gleason 8-10 or Grades 4 and 5) will choose surgery as their preferred treatment option in Australia.
There are many questions men ask to be best prepared for surgery. You can read more about this here.
General health and wellness are important in the lead up to radical prostatectomy. The prehabilitation info on the PCFA Survivorship toolkit can support you with this.
Common Pre-surgery questions
Should I see a pelvic floor physiotherapist before my surgery?
Yes, minimum of one visit to a specialist Men’s health pelvic floor physio is recommended for best outcomes with urinary leakage after surgery. With an individual assessment you can be provided with targeted exercises to practice prior to your surgery. This creates muscle memory to assist your recovery afterwards.
Obtaining a Chronic Disease Management Plan with your GP can assist with costs for these visits. You may be eligible to up to 5 subsidised visits per year.
Find more information here: GP chronic condition management plan - Health professionals - Services Australia.
Your specialist may suggest a particular physio for this purpose otherwise you can seek here Find a physio - Choose physio | Australian Physiotherapy Association.
Some men though may learn these exercises by seeing a local continence nurse, from your doctor or specialist nurse or at pre-admission clinic appointments.
What do I take to hospital? How long will I be in hospital?
1-3 nights is the standard stay in Hospital following Radical prostatectomy, this may depend on surgical type and general status of the patient. Basic toiletries and loose-fitting clothing/ sleepwear is all that is required. Most hospitals will supply all necessary equipment for your stay and discharge needs.
How long will I have a urinary catheter? Does it hurt when it is removed?
7-10 days is the average length of time you will require an indwelling urinary catheter after surgery. This is inserted whilst you are asleep during the operation. You will be provided education on catheter care and given all necessary new catheter bags prior to discharge from your hospital. Removal of your catheter should not be painful, and you should not require pain relief to have this removed.
How do I go about purchasing incontinence aids? How much do I need to purchase?
Following surgery, Incontinence or bladder leakage is common. Degree of severity varies from individual to individual. Most men are dry 3 to 6 months post-surgery. Continence aids will be required following surgery, and these are available in most supermarkets, chemists and online. Start with small to moderate purchase of a medium absorbency pads. Chances are you will have plenty of time to order or purchase more as needed.
You can order samples of pads from many suppliers:
https://tena.com.au/pages/for-men
Will surgery alone be enough to cure this cancer? What happens if it comes back?
For many men, surgery alone is enough to effective treat prostate cancer. Overall, in approximately one third of all men the PSA may become detectable again after surgery. This varies based on your grade and risk of the cancer. Small rises or fluctuations do not always mean the cancer has returned. PSA that persistently rises (e.g. to above 0.20ug/l), may indicate recurrent diseases and requires further investigation and management.
You can read more about a rising PSA in this booklet: https://www.prostate.org.au/wp-content/uploads/2024/01/02-Understanding-Surgery.pdf
Fear of incontinence and erectile dysfunction
How long will I experience urine leakage?
Incontinence after removal of the prostate for cancer can vary significantly among men. There are many factors that can affect recovery of bladder control. Recent Australian patient reported outcomes suggest around one third of men need to use one or more pads per day 12 months after radical prostatectomy.
Can I return to usual activities when I still have urinary incontinence?
Yes. Use of male pads control urine leakage well and can be worn discretely under clothing. Other devices such as penile clamp and urinary sheaths may be options also. Many men find The Toilet Map app is useful in locating public toilets across Australia to assist you whilst you have some urgency after surgery https://toiletmap.gov.au/
Will I be fertile after surgery?
For some couples, prostatectomy means that they can safely discontinue birth control measures.
For men planning to have children, infertility will occur after prostatectomy. Discuss with your partner and healthcare team regarding options such as sperm banking. A government program helps many cancer patients who need to preserve their fertility. You can read more about this here: https://www.health.gov.au/our-work/assisted-reproductive-technology-art-storage-funding-program
Can I become dependent on penile rehabilitation drugs? How long will I have to stay on ED Drug?
Many men continue to take these drugs until there is spontaneous return of erections. Some men stop using them because the drugs didn’t seem to help anymore.
Have a discussion with your treating team about continuing or discontinuing these drugs to understand what options you have should you wish to regain you erections and sexual function.
What happens if my incontinence persists over many months?
Severe incontinence that persists beyond 12 months after prostatectomy may require surgical intervention to manage. This may be in the form of a male sling or an artificial urinary sphincter.
You may also be eligible for a Continence aids payment should your incontinence persist beyond 12 months.
Recovery expectations vs reality
Recovery after surgery can be different for each person. Some will find that talking to others will provide input about their own story. Sometimes this is not helpful or supportive but can provide increased distress. Speaking with your healthcare team can assist you to understand your own recovery timeline in a personalised and caring way. It is best to refer to trusted sources to provide reassurance and guidance for your individual situation. Your local prostate cancer specialist nurse, the PCFA telenurse team, GP or your surgeon can provide you with realistic time frames and understanding of your surgery and recovery.
Recovering at home
Most men will be discharged from hospital a day or two after surgery. Pain relief medications may be provided in case of pain during recovery at home.
Education regarding catheter management at home will be provided by the hospital as well as extra supplies if needed. A leg bag attached to the catheter is secured to the leg and you can mobilise with this bag. During nighttime a larger overnight bag will be provided which holds a large amount, so there is no need to get up and empty the bag through the night.
Eat healthy nutritious diet and drink plenty of fluids. Manage constipation with a high fibre diet or laxatives to avoid straining or bearing down after surgery.
Monitor wound sites for signs of infection such as redness, swelling, pain or fever. Contact hospital if needed.
When can I resume my usual physical activities?
Until the catheter is removed, take it easy. Avoid strenuous exercises and heavy lifting. Gentle walks are generally okay, and you may take as many trips up and down the stairs as you can. It is a good idea to wait for your first follow-up with specialist usually around 6-8 weeks after surgery to discuss resuming usual exercises and activities.
Emotional preparation
Who can I talk to for support?
Starting with the PCFA telenurse team can provide support and distress screening as well as referral to any local prostate specialist nurse that may be available in your area. Call us on 1800 22 00 99 or email telenurse@pcfa.org.au
https://www.pcfa.org.au/prostate-cancer-specialist-telenursing-service/
Consider Joining one of the more than 100 local support groups across Australia or connecting to a Virtual Facebook Group, PCFA new Online Community. These are all great ways to feel connected and supported through whatever difficulty you are facing.
Questions men forget to ask
When can I return to my usual activities?
Most men will have a review with their surgeon 6-8 weeks after radical prostatectomy. This review may include a PSA blood test. It will also provide an opportunity for the urologist to assess your recovery and timeline for your return to ‘normal’ activities. It is best to avoid heavy lifting and strenuous exercise prior to your surgical review appointment.
What support can my partner receive?
Partners can be affected also with any cancer diagnosis of their loved one as well as the side effects of treatments after radical prostatectomy. Open and honest communication is helpful amongst couples to assist understanding of the changes and recovery experienced after surgery. Professional counselling with your local specialist team or referral to a local practitioner can be helpful in this situation. Access to free PCFA counselling is available for any adult associated with prostate cancer. To learn more or request support visit https://www.pcfa.org.au/support/prostate-cancer-counselling-service/
How long do I continue with pelvic floor exercises?
Penile rehabilitation exercises are exercises that all adults should be doing, but especially important after radical prostatectomy. Following surgery, a physiotherapist may provide a pelvic floor exercise regime and once continence is restored frequency of exercises reduces. As you age, when you are ill and when you may drink excess alcohol you may place extra stress on your pelvic floor, continuing exercise throughout your post prostatectomy life may be beneficial in limit the impact of further leakage.
How frequent do I need to do PSA after surgery?
Your urologist will do a PSA blood test 6-8 weeks after surgery, then 3-6 monthly for the first year then 6 monthly to annually for consequent years. This forms part of your ongoing care and surveillance after surgery.
A final word and where to get help
Prostate cancer foundation (PCFA) can help with Specialist Nurses, a free and confidential Telenursing and Counselling service, peer support networks, reliable and guidance on next steps. Reach out to PCFA to connect with expert support and community.
For more information about prostate cancer, or to find a support group, visit www.prostate.org.au or phone 1800 22 00 99 to speak with a Prostate Cancer Specialist Nurse.
