Post Prostatectomy Incontinence & Bicycling

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I am 66 and had my RALP in August 2022. I have experienced progress with my incontinence and am at 2 light shields and one pull up brief (for security) per 24 hours period. I am doing kegals daily and supported by a physical therapist.

Prior to my surgery I was an avid cyclist bicycling each day for transport and/or recreation. I had to stop for the surgery and have not been on the bike since. I realize this is a queston for my urologist but am curious to know if anyone with my history has ridden bicycles and suffered any ill effects. My obvious concern is not doing harm to my "plumbing" which may still be healing and may interupt progress toward reaching continence.
 
I'm 70 RP in Nov 22. I find that I have no leakage riding my bike. Getting on/off and lifting the bike into the shed poses some challenges but not during riding. I'm on one light pad per day. I waited 6 weeks before trying because of healing etc.
 
Once healed, my surgeon gave me no restrictions. About 6-8 weeks from surgery. I’v been on stationary bike for 20 minute stints this winter. No issues. No leaking while on the saddle.
 
Riding my road bike after my prostatectomy, in 2011, caused numbness, something you don't want for the reasons mentioned by the poster. I tried a number of saddles over the years but couldn't find one that didn't create numbness off and on. Then, I had a Artificial Urinary Sphincter implanted about 12 weeks ago and activated after 6 weeks. I've been reluctant to even try the "wedgie" since that operation because of the plumbing involved. I'll ask my surgeon about it but I have a feeling that it will be a no-go.

My theory is that, with the prostate removed, the saddle wedges deeper into the perineum area, agitating the now more exposed nerves and blood vessels. Hence, the dreaded numbness.

So, I've gone to "The Dark Side" and ride a recumbent. Best move I've ever made cycling-wise. No back pain, numbness, or general body discomfort. And, damn fast on the flats and down hill. Up hill? Not so much.
 
I ride a stationary cycle for exercise per doctors advice to get some exercise being a diabetic. Cycled for many years before surgery in Aug 2019. I stopped cycling for about 4 months post surgery. Did mostly walking during that time. My mind wasn't in a good place dealing with leakage. Also was gaining weight...not good. Decided I needed to cycle no matter what. I don't know if it helped with the leakage, but over time it has reduced. I was not much for kegels. Lost about 20 pounds. I cycle daily (almost) for an hour...miss a day rarely. I still use a small pad daily since occasional heavy lifting, coughing or sneezing will still get me. At 73, I've accepted where I'm at. I see cycling as an overall benefit to my recovery.
 
@bcarr All of the men I know who are 60 or older and were avid bicyclists have ended up with prostate cancer.
 
I'm 74 and had my prostate removed 2 years ago. Prior to my surgery I did sprint biking for 10-15 miles per day, 5 days a week and participated in long distance races. About 6 months post surgery, I started to ride my bike again. During the 6 months after surgery I started a walking regimen of 3-4 miles a day to keep my legs in shape. I started out biking every other day and after a month or so went to 5 days weekly. I do not have ED and am about 95% continent (wear one mini-pad a day)and I've encountered no problems with my plumbing or experience any muscle or joint pain.

Biking is my favorite exercise and I feel my best both physically and mentally when I'm able to ride. So my recommendation is to go for it.
 
It's working very well, especially considering how much incontinence I was experiencing before. The plus side: Almost NO leakage no matter how much I may need to pee. No more thick pads that I was going through at the rate of up to 6-8/day, no more surprise releases of urine, filling the pad and running down my leg, no more hoping I had enough back-up pads stashed through my home, cars, work, briefcase, tool box... Well, you get the idea! It's a god-send!

The problem I'm having is making sure I allow the cuff to open completely before I urinate. Otherwise it hurts! It seems that, in my case, it may be closing much too fast rather than staying open for the 2 minutes indicated in the user's booklet. That causes pain as the flow is restricted by the too small opening.

Also, the compression bulb is located in the scrotum and is a slippery little sucker! So, it takes practice to trap it in such a way that you can squeeze it enough to get the proper release of the cuff without it escaping. "Ha ha, catch me if you can!"

Would I do it again? Absolutely!!!

FYI, I'm a month away from 75.
 
@snow I know plenty of older cyclists who do not have prostate cancer. I know of no study that links prostate cancer to cycling.
 
There are many.

www.ncbi.nlm.nih.gov

Long Distance Bicycle Riding Causes Prostate-Specific Antigen to Increase in Men Aged 50 Years and Over

To investigate whether bicycle riding alters total prostate-specific antigen (tPSA) serum concentrations in healthy older men.129 male participants, ranging in age from 50 to 71 years (mean 55 years), rode in a recreational group bicycle ride of between ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov


 
Re: your first reference, there is debate re: whether biking can push up PSA, i.e. you get a high PSA that is a result of sitting on a bike saddle and irritating the prostate. That is possible. PSA can be elevated due to inflammation. But it doesn’t bear on causing cancer.

The second study is 10 years old, is a survey with no control group, and the number of cancers is very small. Your third reference debunks this study.

So I guess there is a study linking cycling to prostate cancer. You are correct on that.
 
Thank you to everyone who has responded! I am pleased to see that many returned to cycling and did not suffer any ill effects. In fact, in some cases, it appeared to help with incontinence! These responses are helpful but in the end I will listen to my surgeon and urologists to determine when I feel safe to return to bicycling.

@snow Thank you for your article links. The first deals with increased PSA linked to cycling which is already understood. Sex increases PSA also. I couldnt access the WP article but found the third article to be interesting. It begins with observations from recent headlines that cycling increases cancer risk while sex with multiple women reduces risks ... if I only knew :) The remainder of the article is insightful but also includes limitations of the study. Anyway, thanks for the links.
 
Hi Bcarr
Avid cyclist myself at 65. I have five bikes myself for various different types of riding. Keep on biking.
I know this is an older post. I have heard of the links of prostate and testicular issues and cycling as Snow pointed out. Remember Armstrong.
My younger brother is a full on competition road racer cyclist.
He has a special seat on some of his bikes designed just for men to provide protection for this.
I’ll look for a link and image on this bike seat if you’re not aware of it.
Be safe
Joe
 
I am riding 11 months post prostatectomy. No prostate, no problem! I am somewhat incontinent, but I wear a light pad inside my bike shorts, which suffices. Plus the padding in the shorts absorbs any leakage beyond the light pad. I use a short saddle with a generous cut-out to take pressure off the perineum. Fizik Boost is the name. My rides are 15-40 miles. The days of century rides are done, but I’m almost 75. I’m lucky overall.
 
This is an interesting topic..... My PSA levels have always been quite low, for many years. Last year, at my annual check, they spiked up. Enough that the doc had a second PSA done the next week. The second PSA test was again low, as usual for me.

I asked the doc what could have caused the jump in the previous PSA test.... He told me several things could cause a temporary PSA rise, including bike riding, sex, even masturbation. I thought "Wow, what would happen if I combined all 3 at the same time! 😂🤣😆
 
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