Reporting in on my experience returning to cycling after a radical robot-assisted laparoscopic prostatectomy (RALP).
Prior to surgery 14 weeks ago, cycling was one of my passions as a 74 y/o. I’d done it all – mountain biking, multi-day trips, including across the USA, down the west coast, through mountains of BC, OR, WA, tandem riding with my wife and kids, commuting 20 miles round trip, and twenty + years of triathlons, including 35 Ironman races. So potentially losing it was probably as big a deal to me as penile dysfunction.
All the surgeons I consulted (3) said “no cycling for at least 3 months” after the RALP. The risk: the urethra needs to be sewn back together, and the perineum (between the scrotum and the anus) is where that repair is. It needs time to heal to prevent scarring up and causing problems.
For the past twenty years, all of my bike seats have had center cut-outs, useful to prevent numbness and infertility. The perineum has minimal pressure on it while riding as a result. The weight is carried on the “sit bones”, the ischial tuberosities. Still, I was leery of getting back on, worried about pain. I started with 15 minutes indoors, on a bike trainer. Next day, 45 minutes, then one hour 15 minutes outside, and then a 45 minute ride indoors, working harder. After this first week, I felt ready to go out riding with my weekly group, who tackle the mountains here in Washington. First ride: two hours biking on the road up up Mt. Rainier. Still no pain (except on those sit bones.) I was gruesomely tired, but did not have any soreness in my legs or pelvis.
I’m now starting my third week back, going a little harder each ride. Second road bike ride in the mountains was 2 hours 40 minutes, aiming for a bit more each week.
I’m a retired surgeon myself, and I knew better than to second guess the guy who was re-arranging my innards. I tried not to think about riding during the hiatus. Luckily, being a triathlete, I could still swim and run, so exercise was not a problem. My message to any serious cyclists who find this post: not cycling for 3 months is a significant side effect of the RALP. But given the proper equipment – a saddle which puts no pressure on the perineum – you should be able to get back out on the road. So far, I’m able to ride in the drops for minutes at a time, and on the trainer as well. I have yet to try my new pelvis off-road, which might be a bit more demanding, I want to get most of my fitness back before then. Right now, I’d say I’m at 65-70% of my pre-surgery level.