Life After Prostate Cancer Surgery

Prostate cancer treatment deals with the cancer, but it can leave you with changes to bladder control and sexual function that nobody prepared you for. The Life After Prostate Surgery (LAPS) Clinic in London exists to treat that side of things properly — with a plan that ideally starts before your operation, and that is still worth addressing even months or years afterwards. This page explains what recovery usually looks like, what can be done about the common urinary and sexual after-effects, and when to be seen.

The Life After Prostate Surgery (LAPS) Clinic

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Treatment for prostate cancer does its job. What it also does, for most men, is change the way the bladder and the penis work afterwards — sometimes for a few months, sometimes for a good deal longer. The Life After Prostate Surgery (LAPS) Clinic exists to manage these aspects proactively and properly, rather than leaving it as an afterthought once the cancer has been treated.

The clinic was developed by Mr Maj Shabbir and Mr Arun Sahai, Consultant Urologists at Guy’s Hospital who work in andrology and functional urology. It grew out of their award-winning Post Prostate Surgery (PPS) Project, launched at Guy’s in 2019, which reshaped the way men are looked after following robotic radical prostatectomy. The principle is straightforward: start before the operation wherever possible, and treat functional recovery as something to be actively worked on rather than waited for. The aim is to help you return to as normal a life as possible after prostate cancer treatment, using evidence-based therapy.

You do not need to have had your surgery with us to be seen. Many of the men who come to the clinic were operated on elsewhere.

What recovery usually looks like

Most men take around six weeks to get over the operation itself — the tiredness, the wound, the return to ordinary activity. Recovery of urinary control and of sexual function runs on a much longer timescale, and the two do not move at the same pace. Knowing that at the outset spares a good deal of worry, because it is easy to assume everything should have settled once the catheter is out and the histology is back.

Every recovery is different. Some men need very little input. Others need real support with bladder control, with sexual function, or with the emotional side of what they have been through — and it is common to feel flat, irritable or oddly detached in the months after cancer treatment, even when the surgery has gone well. None of that means recovery is going badly. What does make a difference is being proactive rather than waiting to see what happens.

Sexual effects of prostate cancer treatment

All prostate cancer treatments can affect sexual function, in different ways and to different degrees. At the LAPS Clinic we can give you independent advice on what your particular treatment is likely to mean for you, and explore ways of managing it proactively — including before your cancer treatment begins.

Erectile dysfunction attracts most of the attention, but it is only one of the possible consequences. Others include:

• Loss of penile length
• A curvature developing in the penis (Peyronie’s disease)
• Loss of ejaculation
• Loss of the ability to father children through intercourse
• Painful ejaculation
• Climacturia — a leak of urine at the time of orgasm

Not every one of these needs treating. Some men are entirely untroubled by a dry orgasm, and if it does not bother you and your partner, nothing has to be done about it. Where something does matter to you, there is almost always an option — from medical therapy and traction devices through to reconstructive or penile implant surgery for the most complex problems. Some aspects of sexual function are permanently different after prostate surgery, but in our experience men are able to return to sexual activity with one form of treatment or another.

If having children is, or might become, important to you, please raise it early. Preserving fertility is far more straightforward to arrange before treatment than afterwards.

Urinary control after prostate cancer treatment

Every treatment for prostate cancer has the potential to change how you pass urine, and bladder control in particular. Leakage of urine — incontinence — is the concern men raise most often.

Starting before surgery where we can, the team identifies the aspects of your body and general health that make problems more likely, and builds a plan that changes as your needs change. Most men regain a good deal of control over the first few months with pelvic floor training and physiotherapy. For those who need more input, we can provide:

• Physiotherapy and biofeedback for pelvic floor exercises
• Surgical treatment for urethral strictures and bladder neck stenosis, including the latest technology and reconstructive techniques
• Artificial urinary sphincters (AUS) and male slings for significant urine leaks
• Botox or neuromodulation for bladder symptoms
• Laser treatment of radiation-induced haematuria (blood in the urine)

Mild leakage when you cough, lift or stand up is common in the early weeks and often settles without any surgical treatment. It is worth reporting, but it is not in itself a sign that something has gone wrong.

Seek urgent medical help if you find you cannot pass urine at all, if you pass visible blood or clots, if you develop a fever with pain or burning when passing urine, or if you have a swollen, painful calf or become breathless. Contact your surgical team, call NHS 111, or attend your nearest emergency department. Do not wait for a routine appointment.

Our post-surgery support services

We offer support across recovery, so side effects are managed rather than endured.

Physiotherapy and pelvic floor exercises

Specialist physiotherapy to strengthen the pelvic floor muscles, improving urinary control and supporting sexual function. Technique matters more than effort, which is why supervised training and biofeedback tend to work better than a leaflet.

Counselling and emotional support

One-to-one counselling for men and, where they want it, their families, to help with the emotional side of prostate cancer recovery. Partners are welcome at appointments.

Treatments for sexual dysfunction

We will guide you through traction devices and medical therapies intended to support the recovery of sexual function. Psychosexual counsellors are on hand to help with the effect surgery has on confidence and intimacy, which is often as significant as the physical change.

Treatments for ongoing urinary symptoms

From surgery for persistent incontinence or strictures through to therapies for bladder dysfunction, the team can guide you to the treatment most appropriate for your problem.

When to be seen

The best time to see us is before your surgery, so that you start on the right path from day one. If that is not possible, the evidence points clearly to being seen early — ideally within four weeks of your operation — and starting proactive treatment then.

If more time has already passed, it is still well worth being seen. Men who come to us months or years after surgery can usually still improve their function, and there may be evidence-based treatments they have never been offered.

The team looking after you

Our multi-disciplinary team are internationally recognised specialists who work alongside prostate cancer surgeons and oncologists, and include:

• Consultant urologists with a specialist interest in andrology — men’s health, including the medical and surgical management of erectile and ejaculatory dysfunction, Peyronie’s disease, urethral strictures and infertility
• A consultant urologist with a specialist interest in functional urology — bladder function and incontinence, including the surgical management of these conditions
• A consultant with a specialist interest in prostate surgery and bladder cancer surgery
• Clinical nurse specialists, physiotherapists and psychosexual counsellors

You may be seen by Mr Maj Shabbir, Consultant Urological Surgeon and Clinical Lead of The Andrology Centre, and past National Chair for Andrology at BAUS; Mr Arun Sahai, Consultant Urologist and National Chair of the BAUS Section of Functional Urology; Ms Raveen Kaur Sandher, Consultant Urological Surgeon; or Ms Elsie Mensah, Urology Specialist, whose work covers bladder cancer, BPH and prostate diagnostics. All four practise at Guy’s & St Thomas’, named by Newsweek in 2025 as the number one urology service in Europe.

Appointments, locations and referrals

We consult at three HCA locations in London: HCA at The Shard (SE1 9BS), HCA at Canary Wharf (E14 5NR) and HCA at Guy’s Hospital (SE1 9RT). You can be seen at whichever is easiest for you to reach.

If you are paying for your own care, you do not need a GP referral — you can book directly. If you are using private medical insurance, your insurer will usually require a referral letter from your GP or treating consultant, so check with them before you book. Bring any operation notes, histology results and recent PSA readings if you have them.

To arrange an appointment, call +44 7889 318584, Monday to Friday, 8am to 4pm, or email contact@theandrologycentre.co.uk. There is no need to have finished your cancer treatment before you come.

Frequently asked questions

References and further reading