rectal pain after prostate surgery

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Regular Member

Date Joined Oct 2008
Total Posts : 56
   Posted 10/14/2008 8:29 AM (GMT -6)   
 I know that this topic has been talked about before, but I would like to ask for some help from others. I am having a lot of rectal as well as pain when passing urine. I have bought a donut and it helps a little. My surgery was Sept 18. My gleason was 3+3. My lymph nodes were clear but a few specs of cancer escaped just outside of the capsule. My doctor is waiting till my first PSA score on Nov 12 to see if I need radiation. My Dr. is very hard to get in touch with and get answers from. I found this forum and see there are many others in the same situation.
  Any help or input on these problems that I have mentioned would be greatly appreciated
Thanks Fred

Regular Member

Date Joined Aug 2008
Total Posts : 328
   Posted 10/14/2008 9:03 AM (GMT -6)   
My Doctor is also tough to get in touch with. My suggestion is if you have any questions for your Doctor, either schedule an appointment to discuss. Or what I have done is give the Nurse my questions and my # to call, and he calls me after he is done. Dont hesistate to call with your concerns, my opinion its your health and your Doctor should answer your questions. Regarding your pain I have talked to people who had the rectal pain, not sure about the urine pain. I didnt have either.

Good Luck, and LIVESTRONG
Age Dx 37, 7/2008
First PSA : 4.17 5/2008
Second PSA After 2 weeks of antibiotics : 3.9 6/2008
DRE: Negative 5/2008
Biopsy : 6 out 12 Postive all on right side, Gleason 7 (3+4).
Bone Scan/CAT Scan: Clear 7/2008
Cystoscope: Normal 7/2008
Prostate MRI: Normal 7/2008
Da Vinci Surgery 7/2008
PostOp: T2c (On Both sides), margins clear, seminal clear, nodes, clear. Gleason 6(3+3).
First PostOp PSA 9/2008: <0.01
2nd PSA 12/2008: Praying for <0.01

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4849
   Posted 10/14/2008 9:09 AM (GMT -6)   
How long ago was your catheter removed?
I had "discomfort" when passing urine for several weeks after my cath was removed.
Age 53   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Gleason - 6
(biopsy done March 4, 2008-> 2 of 12)
06/25/08 - Da Vinci robotic laparoscopy
10/03/08 - 1st Quarter PSA -> less then .01

Surgeon - Keith A. Waguespack, M.D.

Las Colinas and Plano Offices


Regular Member

Date Joined Oct 2008
Total Posts : 56
   Posted 10/14/2008 9:41 AM (GMT -6)   
My catheter was removed 10 days ago. Also I get up very frequently 5 times a night to pass urine.

(age 55)

Regular Member

Date Joined Sep 2008
Total Posts : 72
   Posted 10/14/2008 10:34 AM (GMT -6)   

Hi Krep....

I too had pain when urinating and in the rectal/perineal area. What exactly "pain" do you have? I had a bladder infection that did not follow the norm. When I would urinate, I could empty very easily but it was like I had not real control. Out it would come with great force and then done. At that point I would then get a pain or slight burning effect for a few minutes. (I had a bladder infection about 7 years ago and it burnt badly so I didn't think this was the same thing.)

The pain in the rectal area went away a few weeks after the bladder infection was cured. I do not know if they were connected actually or not, but the doc felt it probably was. Anyway it has been not quite three months and I basically have no incontinence and no pain and no ED.

Do try to leave the messasge with the nurse as suggested in another post. My doctor is terribly busy in this research/training hospital so I would leave the message and someone would call back with the answers. You need to know what is hapening.


Don't get discouraged!!
Diagnosed Feb 2008  54 years old
3+4=7 gleason
7.5 PSA
4 out of 20 biopsies were cancerous
daVinci Robotic surgery July 24, 2008
Univ of Calif San Francisco Med Center  Dr Peter Carroll
In hospital 2 nights altho I had option of leaving the next day but stayed due to distance home.
Contained in prostate, not spread
Six weeks post surgery PSA less than .01

Regular Member

Date Joined Oct 2008
Total Posts : 56
   Posted 10/14/2008 10:58 AM (GMT -6)   
Wow thats great no pain, no incontinence and no ED in 3 months. I hope I`m that lucky. Do you feel you were just lucky, or did you do anything to help it along?

My streams are slow and I have to push at the end of the stream to get all the urine out and I think thats were some of the pain starts. I`m going to pick up a copy of my pathologists report today.


Regular Member

Date Joined Oct 2008
Total Posts : 46
   Posted 10/14/2008 11:24 AM (GMT -6)   
Hello Krep,
I'll think you'll find that you are not alone in the rectal pain deptartment. I wound up seeing a butt dr about 6 months after surgery. He told me I had internal hemoroids and an anal fissure, which is a small tear in the colon. He gave me some cream, stool softener, told me to eat fiber and take warm baths. His advice did work, although as I recall it took a couple of weeks.
As for the urinary pain, I had pain (and still do) in my abdomen when I try to hold it for too long. I never had trouble with pain while peeing, although I have heard others complain about it.
Good luck
Age: 43
Diagnosed at 41 by routine blood test
PSA at diagnosis: 5.1
Pre-op Gleason: 3+4=7
Post-op Gleason: 6 (different labs?)
No luck finding local experience with DaVinci
Scheduled RP at Vanderbilt: 8/06
Insurance trouble, rescheduled at Centennial Hospital, Nashville
Prostate removed 9/06
Robotic, nerves spared, no positive margins
PSA since RP: good (less than .05)
Currently suffer ED

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 10/14/2008 11:28 AM (GMT -6)   

I had my surgery on Sept 18 too.   Yes had a little burning sensation when urinating like you mentioned.  My doc says it's normal and will subside within a few more weeks.   It is caused by the catheter unless you have an infection as mentioned earlier.

The rectal pain varies depending on individual because the prostate is actually peeled away from the rectal wall.  Like taking a bandaid off the skin..sometimes it sticks really good and will hurt some..other times it just comes right off.  It will pass with time and healing.

My incontinence and ED is about the same level as yours and getting better all the time.

Good luck and hang in there, it will get better!

Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base)
Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1,2008
Gleason 7 (4+3) Staged pT2c NO MX
Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
14 tumors in prostate - largest being 6 cm 

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 10/14/2008 3:19 PM (GMT -6)   
Few of us will share the exact experiences, nor do we have the same conditions/bodies/surgeries, etc.  It was uncomfortable for me to sit when I had the catheter in - a pain in the butt - but once the device was removed I've had no pains . . . urinating or sitting.  Did your Urologist prescribe Cipro or another antibiotic for you to take when the catheter came out?

Age:  59 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (19 days post-op)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)


Regular Member

Date Joined Oct 2008
Total Posts : 56
   Posted 10/14/2008 3:36 PM (GMT -6)   
No my Doctor only said if you get any spasms , to take buscopan which is an anti spasm drug. He didn`t prescribe any cipro or other antibiotic

New Member

Date Joined Mar 2008
Total Posts : 19
   Posted 10/14/2008 8:02 PM (GMT -6)   

I had pain in the rear (rectal area), to the extent I used a "donut" for a month or so when seated.  I even modified a seat pad for my car (cut a hole in it) so I would not agitate the area while driving.  All evidence of the problem dissappeared completely, so I threw away my devices at week 6.

With regard to the stinging while urinating; I suffered similar sensations for about six weeks.  It may have been due to excessive walking (4 miles a day) while the catheter was in place (8 days).  My pain was near the end of my penis, where the cath's tube entered.

Age 55
PSA 6.7
Needle biopsy: T1c Gleason 3+4=7...2 of 10 cores
Non-Robotic laparoscopic RP on 3/4/2008
Specimen pathology: T2C organ confined with clear margins. GS lowered to 6!
100% urinary continence since cath removal on 3/11/2008
ED resolved with Levitra within 3 weeks
4/18/2008  1st PSA undetectable
7/25/2008  2nd PSA undetectable

Regular Member

Date Joined Oct 2008
Total Posts : 56
   Posted 10/14/2008 8:38 PM (GMT -6)   
My pain sounds as though it was similar to yours. Did you use any pain killer or anti inflamatory to lessen the pain ?

Regular Member

Date Joined Oct 2008
Total Posts : 29
   Posted 10/14/2008 8:57 PM (GMT -6)   
I stayed on antibotics while the cath was in (two weeks). the pain in the butt got better for me, but it took 3-4 months until having a bowel movement was not painful. Used a lot of fiber and lived in fear of constipation. Like many things time makes it better.
Age 51
Father died of prostate cancer at 73
Yearly PSA testing.
Biopsy after PSA went up .75 in one year
6 of 12 in needle biopsy where cancerous
DaVinci surgery 4/15/2008
Last PSA .008

New Member

Date Joined Mar 2008
Total Posts : 19
   Posted 10/15/2008 11:36 AM (GMT -6)   
kreplerfp said...
My pain sounds as though it was similar to yours. Did you use any pain killer or anti inflamatory to lessen the pain ?
I didn't use pain killers after day 5 (post-op).  The rear-end pain wasn't was dull and annoying, leaving me with the feeling that things were still healing inside.  I felt no pain there except when I didn't sit much, and when I did, it was on my trusty donut.

Age 55
PSA 6.7
Needle biopsy: T1c Gleason 3+4=7...2 of 10 cores
Non-Robotic laparoscopic RP on 3/4/2008
Specimen pathology: T2C organ confined with clear margins. GS lowered to 6!
100% urinary continence since cath removal on 3/11/2008
ED resolved with Levitra within 3 weeks
4/18/2008  1st PSA undetectable
7/25/2008  2nd PSA undetectable

Patrick Ledwidge
New Member

Date Joined Aug 2009
Total Posts : 2
   Posted 8/6/2009 11:16 AM (GMT -6)   
I had prostate surgery on 6/9/2009. My biggest problem is rectal pain deep inside. It is worse when I am active for a long time or standing for a long time. It seems to be letting up as time goes by, but for a while it  had me worried.  My incontanance is almost gone but I can still not get an erection. I hope my desire for sex returns because my wife still turns me on. Please let me know if you have experienced the same problems?

My surgery was open

Heart of Florida Hospital, Davenport, Fl.

PSA was4.7 went up to 5.3 in one month

Biopsy cancer in right apex 1 core

right lat mid 2 cores of cancer.

doctor says we caught it early.

Gleason score3+3=6

My surgery was open here in Davenport Fl. My PSA went from 4.7 to 5.2 in one month.
Gleason 3+3=6.
One core in my right apex contained cancer.
My right lat Mid contained 2 cores of cancer.
I am 67 years old and other than this good health.
Doctor says we got it early.

Post Edited (Patrick Ledwidge) : 8/6/2009 3:17:16 PM (GMT-6)

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 8/6/2009 11:42 AM (GMT -6)   
Patrick, let me welcome you first to HW Prostate Cancer group. This is a great place to be and you will make new friends quickly and get loads of good information.

You are less than 2 months out of surgery, the pain you described is one of the biggest and most normal complaints that soon after surgery. You didn't say if you had open surgery or robotic. I had open, and felt pains in that area for a good 6 months after my surgery, my dr. said it was normal and eventually it abated. I still get some pain there if I over do things physically.

Glad you are doing well on the incontinence part, that is a big deal to most men. The ED part, well, that varies as much as the weather here. You and your wife can still be intimate in other ways, good time to use your imagination while you are healing, and then there are all kinds of way to deal with ED and the men here are very experienced with all of the methods.

Keep us posted, and it would help if you put some stats on yourself at the bottom of your postings so we can understand and help get to know you and your case better.

Welcome to the brotherhood of PC survivors.

David in South Carolina
Age 57, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
 Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
2009 PSA   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, scarring closed up bladder neck, corrective laser surgery scheduled for 8/18

Patrick Ledwidge
New Member

Date Joined Aug 2009
Total Posts : 2
   Posted 8/6/2009 4:35 PM (GMT -6)   
David thanks for your reply, and good luck with your laser surgery. I had a problem with my catheter also, they could not get it out! Doctor said we may have to remove it surgicaly. My jaw dropped. Hear I just got out of surgery 1 wk ago. Finnally he said go home we will wait one week because sometimes a stitch might have been wrapped around the catheter or he may have stitched through it and since they dissolve it might come out at home. Ayway it came out that evening, thank God. My next appointment is in late september. I feel great except for that nagging pain in my rectal area which is letting up. Please keep in touch. Pat

My surgery was open here in Davenport Fl. My PSA went from 4.7 to 5.2 in one month.
Gleason 3+3=6.
One core in my right apex contained cancer.
My right lat Mid contained 2 cores of cancer.
I am 67 years old and other than this good health.
Doctor says we got it early.

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 8/6/2009 4:48 PM (GMT -6)   

Greetings, Patrick.  Ditto to what David in S.C. said.  The rectal pain is very normal and if you are gaining continence in less than two months you are doing great.  ED is an issue we all deal with from time to time and have various ways to deal with it.  I would encourage you to make your wife a part of the solution.  This affects her to and if she is anything like my wife, she wants to be as helpful as she can be in getting things back to normal. 

Quick story that I thought was funny - several years ago my wife complained that she could never buy me anything because as a CPA I was always looking online at our credit cards and our online activity and we always had joint checking and savings accounts which I also monitored online.  Also, I did all the reconciliations and I decided she needed to be able to handle all those kinds of things if something ever happened to me.  So we got her a Mastercard and her own checking account that she is totally responsible for.  We have an AMEX card that I monitor and reconcile.  The last time I ordered ED drugs from ADC they were having problems with credit cards and no longer took AMEX.  She had to go get a money order and so she ended up paying for my ED drugs from her account.  I told her I thought that was appropriate since she received the benefit of those drugs.   Oh well, we thought it was funny. 

Sounds as if you are right on target with your progress.  Please keep us posted on how things are going.  David 

Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me

Veteran Member

Date Joined Dec 2008
Total Posts : 673
   Posted 8/6/2009 5:02 PM (GMT -6)   

Hi, and welcome to HW Patrick,

I agree with the others. It is normal. I've had a lot of rectal pain since surgery. Some of it, a day stopper. It does get better and is, for me. I was told that due to multiple bouts of prostatitis, I had a fair bit of scar tissue. Since the prostate has connective tissue to the rectum that has to be scraped away from the rectum, there was some damage done during the prostatectomy. Better than a temporary colostomy.

It does get better.

Good luck on your recovery.


-Hernia, mesh and large scar, surgery early 2006
-Nov/Dec 07, March 08 and Dec 08: Severe perineum pain . Septra/Bactrim for 8 months for diagnosed prostatitis.
-PSA start of 2008: 5.3..... PSA June of 2008: 7.3
-14 DRE all benign or nothing felt
-TRUS Biopsy Nov 08: 5 of 8 cores positive GS 3+3 or 6. Perineural invasion.
-General Health: pretty good, 5' 10", 180 lbs, slim.
-Bone scan Dec 08: Negative
-Barium enema X-ray March 09: Small diverticulosis
-MRI with endorectal coil (April 09 as part of a study)
-3D advanced TRUS (April 09 as part of a study)
-CT (April 09 as part of a study)
-Open RP surgery: May 09 both nerve bundles spared. Bilateral lymph node dissection performed. Discharged 48 hours after surgery.
-Post Surgery Pathology: pT3a N0 MX, extraprostatic extension (EPE), stage III prostate cancer, lymph nodes clear, seminal vesicles clear, Gleason upraded to 3+4 GS 7. EPE within surgical margins. Other than prostate and EPE, all tissue removed negative for cancer involvement.

New Member

Date Joined Sep 2010
Total Posts : 10
   Posted 9/8/2010 11:41 AM (GMT -6)   
I had prostrate surgery 4 weeks ago and still have discomfort while urinating. Thanks to this site I am not alone and that it will go away soon I hope. Did have robotic and was home the next day and never took a pain pill other than Ibuprofen (800 mg). They work very well. Was given a large prescription so assume it was to last for several weeks. Absulutly no pain when I get up several times duing the nite. Seems to be only when active. Am very fortunate that I only use 2 pads a day and nothing at nite.Had leakage before surgery so guess I was partially trained. Go back to Doc in 2 weeks and may have to have some radiation. My lymph nodes were clean, but might of had some microscopic invasion into the blood stream. Did have nerve sparing surgery even though i suffer from slight ED. Time will tell on that but all in all life is good yeah

Regular Member

Date Joined Aug 2010
Total Posts : 245
   Posted 9/8/2010 7:35 PM (GMT -6)   
Fred, Patrick, about the rectal pain: This is the issue that drove me to a survivors site to relieve my husband's anxiety!  Up til then I'd been using hospital or medpage sites and books for research and info but my husband was experiencing so much rectal pain that I was up half the night reading survivors' sites to find some answers (HW was the BEST).  His surgery was July 6 and it was his biggest complaint after the catheter's inconvenience.  He couldn't sit on many surfaces, reclining was the easiest and hard chairs were completely out of the question.  Bowel movements were a real pain in the @#$%.  Pain killers (initially oxycodone) relieved some discomfort but he was worried about the constipating side effects. Tylenol initially, then some advil later was somewhat helpful.  The doc said it was "referred pain" from the surgery.  The prostate was 95 grams (normal is 20) and he had no symptoms since it had been growing out towards the rectum - another reason we assumed there was some stretching and thinning out along the rectal wall.  His surgeon advised no colonoscopy for him, although he is due, for 9 months so obviously there is some thinning there.  And as far as the doc's answers to your questions - we always get the nurse practioner in reply, and it's always "no problem, this is normal"  It's very difficult for us to get the doc to reply to questions post surg. Anyway, the pain is nearly gone now, and aches rarely - usually after a long day on his feet.  Each guy is different, but I hope this helps you.

New Member

Date Joined Sep 2010
Total Posts : 9
   Posted 9/10/2010 11:46 AM (GMT -6)   
Hi Folks,
I'm new to the forum but familiar with the rectal discomfort/heaviness/pain issue. I had
laproscopic surgery about 3 weeks ago and have trouble with constipation, and that seems to aggrivate the rectum discomfort. They say it will pass in time but in the meantime it is rather worrisome. I am on stool softners and metamucil 2x daily but things are still slow moving. Also makes it hard to do the kegel exercises. Any suggestions or help is most appreciated.

New Member

Date Joined Sep 2010
Total Posts : 10
   Posted 9/10/2010 5:53 PM (GMT -6)   
I know the feeling Been 4 weeks for me but am doing fine. Am on stool softeners and they seem to be doing the job. Still have pain but maybe more uncomfortable than pain. Don't know what to do after the prescription runs out. Have to go back to Doc on the 16th of Sept so will ask him how long I have to be on them. I'm sure it will be ok but we get alittle gun shy as to we might harm ourselves. Still have discomfort urinating as if it is restricted. Night time is no problem as I am laying down and I think less pressure on everything. My understanding is that this will get better as time goes by. I do take Ibufrofyn once a day. Other than that I am working full time at my partime job at a campground. One more thing I beleive that plenty of water helps along with soft foods "ex" eggs,pudding ,soups etc etc. Anyways welcome aboard and maybe other will reply to you. So hang in there with the rest of us. Good group here and they make you feel welcome
you have the right to look down on someone when you are helping them up

New Member

Date Joined Sep 2010
Total Posts : 9
   Posted 9/11/2010 1:24 PM (GMT -6)   
My surgeon thinks I may have internal hemmerhoids
as well as normal healing discomfort.  I see my family doctor
on Sept. 14th and will ask for his advice/suggestions.
It sure can be alarming and I keep wondering, is this
normal and when will it pass?
I am supposed to keep the water and fibre intake high
(which I thought I was doing) but will keep taking stool
softners, sennakot  and some tylanol for pain.
I am wrestling with depression ( 3 months prior to surgery)
so that really affects my outlook at this time.
You are doing amazingly well to be back at work so
soon after your surgery. Congrats.
Don ( pcr7)

New Member

Date Joined Sep 2010
Total Posts : 10
   Posted 9/12/2010 8:50 AM (GMT -6)   
I know the depression feeling as I have been there. Did'nt have time for it on this as this came on to fast ,but I have recurrant Stage 3 advanced Melanoma and was diagnoised terminal with 6 to 8 months. That was 7 years ago this October. So hang in there and know things will get better with atitude. I try not to worry about this to much and thank the Good Lord for every day. This site really helped me and only been on it for a few weeks. Everyone understands as they are there or have been. It's just nice to have someone to talk to about it . Hav.nt posted my numbers yet but will when I see the Doc at Norris Cotton Cancer Center. Prior to Surgery I had a PSA of 16.8 and a Gleason score of 7. Lymph nodes were clear but some invasion of bloodstream. will see come Sept 16th. Ok for now and don't forget "attitude" is the best and knowing you are not alone.
you have the right to look down on someone when you are helping them up
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