After prostate surgery, most men spend one to four days in the hospital, go home with a urinary catheter, and gradually return to normal activity over several weeks. The two biggest long-term concerns are urinary leakage and changes in sexual function, both of which improve significantly over the first year for most men. Here’s what the recovery actually looks like, from the first hours after surgery through the months that follow.
The First Days in the Hospital
You’ll likely be encouraged to sip clear liquids within a couple of hours after surgery and eat light food within four hours. Most hospitals want you sitting up or standing at the bedside within four to eight hours. This early movement helps your gut wake back up and lowers the risk of blood clots. Your first bowel movement typically happens within the first day or so.
Hospital stays have gotten dramatically shorter over the past decade, especially with robotic and laparoscopic approaches. Under modern recovery protocols, men without complications go home in about three to four days. Some high-volume centers discharge patients even sooner. During your stay, the medical team monitors for nausea, fever, signs of infection at the incision sites, and any issues with the catheter or surgical drain.
Managing Pain at Home
Pain after prostate surgery is generally moderate, especially with robotic procedures that use smaller incisions. The standard approach combines acetaminophen with an anti-inflammatory like ibuprofen, which together control pain well enough that many men need little or no opioid medication. If you had robotic or laparoscopic surgery, your surgeon may have used a nerve block in your abdominal wall during the procedure, which keeps you comfortable for the first several hours and reduces the need for stronger painkillers early on.
Most men describe the discomfort as soreness around the incision sites and a feeling of pressure or irritation from the catheter rather than sharp surgical pain. This tends to ease considerably within the first week.
Living With the Catheter
You’ll go home with a urinary catheter, a thin tube draining urine from your bladder into a collection bag. Depending on your surgeon’s approach, it stays in for roughly three to nine days after surgery. Some surgeons remove it as early as day three or four if imaging confirms the surgical connection between the bladder and urethra has healed properly. Others prefer to leave it closer to a week or longer.
During the day, the catheter connects to a small leg bag you can strap under your pants. At night, you switch to a larger bedside bag so you can sleep without interruption. Many men find wearing a pull-up style undergarment over the catheter helps prevent any leakage from soiling clothes or bedding. Keep the area around the catheter clean, drink plenty of water, and avoid tugging on the tube.
Activity Restrictions in the First Weeks
For the first two to four weeks, you should avoid lifting anything heavier than about 10 to 15 pounds. That rules out grocery bags, laundry baskets, and young children. Most surgeons clear you to drive once you’re off narcotic pain medication and can comfortably check your mirrors and hit the brakes, which is usually one to two weeks after surgery.
Walking is encouraged from the start and is the best thing you can do during early recovery. It helps prevent blood clots, eases constipation (a common complaint in the first week), and supports healing. Vigorous exercise, cycling, and heavy lifting are typically off limits for four to six weeks. Your surgeon will give you a specific timeline at your follow-up visit.
Urinary Leakage and How It Improves
Almost every man experiences some degree of urinary leakage after the catheter comes out. This is normal. The surgery disrupts the muscles and nerves that control the flow of urine, and your body needs time to compensate. In the first few weeks, leakage can happen when you cough, sneeze, stand up, or move quickly. Many men wear absorbent pads during this phase.
The good news is that continence improves steadily. By about four months, roughly half of men are fully dry. By 12 months, studies report continence rates between 68% and 97%, with improvement continuing for some men up to two years after surgery. The wide range reflects differences in surgical technique, a man’s age, and how continence is defined across different studies.
Pelvic floor exercises (Kegels) are the single most effective thing you can do to speed your recovery. Start them as soon as the catheter comes out. The goal is 10 to 20 repetitions, three to four times a day. To find the right muscles, imagine you’re trying to stop the flow of urine midstream, then squeeze and hold for a few seconds before releasing. It takes about six weeks of consistent practice to notice meaningful strengthening, so patience matters. Starting Kegels before surgery, if you have the lead time, gives you an even bigger head start.
Sexual Function and Recovery
Changes in sexual function are the other major adjustment after prostate surgery. The nerves that control erections run along the surface of the prostate, and even with the most careful nerve-sparing technique, they are bruised or stretched during removal. This means most men experience erectile dysfunction immediately after surgery, even when the nerves are fully preserved.
Recovery depends heavily on whether the surgeon was able to spare those nerves on one or both sides. Men who had both nerve bundles preserved recover erections at a rate of about 60%. When only one side is spared, that drops to around 47%. Age matters too: men under 60 at the time of surgery have significantly better outcomes. Recovery is slow, often taking 12 to 24 months, with studies showing modestly higher rates of return at 18 months and beyond compared to earlier time points.
Many surgeons recommend starting a rehabilitation program early, sometimes within weeks of surgery. This typically involves taking a low-dose erection medication on a regular schedule (nightly or several times per week) to promote blood flow to the penis while the nerves heal. Some men also use a vacuum erection device. The idea is that keeping the erectile tissue healthy during the healing window improves the chances of natural function returning later. Starting sooner rather than later appears to produce better results, though the research is still evolving on the ideal protocol.
One permanent change: you will no longer ejaculate fluid during orgasm. The prostate and seminal vesicles, which produce most of the ejaculate, are removed during surgery. Orgasm is still possible and can feel similar, but it will be “dry.” This also means natural conception is no longer possible, something to discuss before surgery if it’s relevant to you.
PSA Monitoring After Surgery
After a successful prostatectomy, your PSA level should drop to essentially zero, since the organ that produces PSA has been removed. Your doctor will check your PSA with a blood test every 6 to 12 months for the first five years, then annually after that. This is the primary way to detect whether any cancer cells remain or have returned. A PSA that starts rising from undetectable levels is the earliest sign of recurrence and triggers further evaluation, often long before any symptoms appear.
What the First Year Looks Like
The overall arc of recovery follows a predictable pattern, even though individual timelines vary. The first two weeks are about healing from the surgery itself: managing discomfort, caring for the catheter, and getting mobile. Weeks two through six are a transition period where the catheter comes out, leakage is at its worst, and you’re gradually resuming light activities. From months two through six, urinary control steadily improves and you’re back to most normal activities. Months six through twelve bring continued gains in both continence and sexual function.
The symptoms to watch for during recovery include fever or chills, increasing redness or swelling at your incision sites, persistent nausea or vomiting, significant leg swelling (which could signal a blood clot), or an inability to urinate after the catheter is removed. Any of these warrant a prompt call to your surgeon’s office.