perineal pain after surgery

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Regular Member

Date Joined Feb 2007
Total Posts : 122
   Posted 4/17/2007 3:53 PM (GMT -6)   
Is it common to have perineal pain after robotic surgery, how to combat it?

Regular Member

Date Joined Feb 2007
Total Posts : 242
   Posted 4/17/2007 4:02 PM (GMT -6)   
Kurt sat on a doughnut pillow. That seemed to help him. I have heard others say to lay down when the pain starts. Sorry I can't be more help. Courtney
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Live in OK
Da Vinci scheduled 3-14-07 in Austin
Post-Op  Gleason 6, Stage t2c nx mx  YAAAAA HOOOOOO! 

Veteran Member

Date Joined Jul 2006
Total Posts : 686
   Posted 4/17/2007 7:36 PM (GMT -6)   


You didn't mention where you are in your healing process.  How long ago was your surgery?  If you are just a few weeks past, then a bit of pain of all sorts is a regular companion.  My doctor told me I shouldn't to sit in a chair for any longer than a few minutes for the first few weeks.  I relocated my computer to the side of a "lounge chair" to avoid sitting at a desk.

So, if you have pain...don't sit on it.  Cushion it.  Avoid long car rides. etc...lay down for a while. Take some tylenol (not aspirin).

If you are months past surgery and pain still persists, then I would suggest consulting with your urologist.


I just checked your older posts and see you still have your catheter in place.  So, Yes you will feel some discomfort.  Even after your catheter is removed you will be uncomfortable for days, even weeks.  I remember that the tip of my penis was quite sore for at least three weeks after I got my catheter out.

This is going to be a time when you wonder every single day what your body is doing, and why. You will keep asking, "Is this normal pain?", "Is that the usual drip?" , "Am I healing ok?".

All I can say is, we all went through this.  Once in a while, things arn't usual. but so far, it seems that you are going in the right direction.  Keep on healing 









Biopsy 10/16/06
T2A,  PSA 4.7
Gleason 4+4=8 right side
adrenocarcinoma of prostate
DaVinci Surgery 01/16/07
Post op report,confirms Gleason4+4=8
no extra extension/invasion identified
age 65
Back on the golf course...

Regular Member

Date Joined May 2006
Total Posts : 31
   Posted 4/17/2007 10:15 PM (GMT -6)   
Hi. The pain is probably from the catheter. You'll soon know as you will soon be getting it out.

I had pain after my cath was out. It was a burning type pain in the perineum like someone stuck me with a hot poker. It turned out to be a bladder infection.

Yours probably is the cath though, although I'm just a PCa patient not a doctor. Let us know how it goes after the cath comes out.


Regular Member

Date Joined Apr 2007
Total Posts : 31
   Posted 4/17/2007 11:21 PM (GMT -6)   

Yes It is normal to have pain in the perineaum. Im 4 weeks post op and 2 weeks post catheter and the pain is still off and on with me. It just started getting to where I feel sort of normal a fe w days ago. It still comes and goes. Sometimes it hurts all the way from the anus to the penis ( including testicles) Feel like a bad bruise when you press on it so suggest you keep the pressure off it as much as possible. I have a ring pillow that helps but makes the boney part the buttocks sore if I sit on it too much. It will SLOWY subside so be patient. Just try not to disturb it as much as possible. WALK WALK and Walk some more as it exercises the area too and help the pain go down. Take tylonol for the pain as well. At first when you walk it may seem to cause slightly more pain but is bearable and after a few days it will get better and better. Also pain increases with coughing sneezing and passing gas. But all is normal according to my uro doc. You will find many different things hurt some start hurting after a while and not right after surger some come out of nowhere but usually pass quickly. I have to remind myself and now I say to you dont forget a lot of cutting and damage was done internally due to the surgery robotis as well as radical. I was told to forget the 6 week healing standard as it is different for us all. Some of us got lucky and in 6 weeks did good. BUT I dont belive any one was fully normal at 6 weeks. My uro doc says it may be 6 months or so before I will really seem to be back to my normal self and will have many  good days and a few bad ones before I get there. Just dont get too caught up in a quick cure as it will probably not happen, Unless your one of the lucky ones. Your next big battle will be incontenance so get ready for the fun and games...  Do your keagels and keep youself dry to prevent rashing etc. God bless and hang in there it will pass.


Veteran Member

Date Joined Oct 2006
Total Posts : 626
   Posted 4/18/2007 7:14 AM (GMT -6)   
My experience with perineum aching was much like Telstar. It went away after about six weeks post op only to come back at about four months. When it came back I also started leaking again. The aching lasted about three to four weeks the second time and then disappeared. When it went away the second time I became fully continent and now feel from a bladder view point exactly as I did before surgery. There is a lot of trauma in the area where the prostate was and it takes a while for everything to settle down.

Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
Catheter out on 11/13/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07

Regular Member

Date Joined Feb 2007
Total Posts : 122
   Posted 4/18/2007 9:08 AM (GMT -6)   
I'm 9 days out of surgery
Gleason 3+4=7
nodes and surrounding tissue negative

Veteran Member

Date Joined Oct 2006
Total Posts : 626
   Posted 4/18/2007 12:33 PM (GMT -6)   

Sounds like the surgery was a succes. Take it easy for the healing takes a while even though you feel fairly good. Walk a lot as it helps everything. The perineum aching will be with you for a while.

Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
Catheter out on 11/13/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07

Regular Member

Date Joined Feb 2007
Total Posts : 122
   Posted 4/18/2007 2:00 PM (GMT -6)   

thanks Tamu


Regular Member

Date Joined Feb 2007
Total Posts : 365
   Posted 4/18/2007 6:44 PM (GMT -6)   
Amen Tamu:  I agree.  I'm just over three months out and once in a while get sensations and some aching (not pain) in the perenial area.  You and I have had very common post-surgery symptoms.  Some days I've felt like I never had surgery.  Others, I get these sensations down there like the Addams' Family's "Cousin Itt" is moving around and poking at me from the inside.  Then, the dripping starts again, not bad, but a pain in the you-know-what.
My theory is that the nerve bundles are healing at their normal pace and playing tricks on me.  Now that they don't have a prostate to deal with, they're sending signals out in other ways, ala Cousin Itt.
mgl -- From what I've read in this forum, the Da Vinci surgery can create all kinds of aching etc. for a while.  In my case, my right testicle ached like hell; was highly sensitive to touch, and felt like it weighed about 10 pounds for many weeks -- with no swelling!!  I began to wonder if I would just have to live with it forever, but eventually it disappeared.  However, I did consult my doctors -- all of whom kinda shrugged and said it was something to be expected after surgery.  I had testicular ultrasound, physical exams for hernias etc. and all came up negative.
So stay in touch with your doc(s) regarding all your symptoms.  I'm sure it's just your own body's reaction to the surgery though.
Time heals all wounds, they say.  AND  -- even though we had the so-called "non-invasive" surgery - we should remember that we essentially got stabbed six times through skin, muscle etc., plus chopped up pretty well inside.  All that stuff takes time to heal.
Most veterans of prostatectomy that I've talked to say you can't judge the results of your surgery till you're about a year out.
All I can tell you is hang in there my friend.  The tide always turns.  It'll pass.
Best to ya!

54 years old

PSA = First ever was 9.8 in late Oct. ‘06, two weeks later, 10.1

DRE: Negative

Biopsy results 11/22/06 (6 out of 8 cores positive), both lobes, Gleason 3+3 = 6

Da Vinci Robotic RP surgery, City of Hope, Jan 12, 2007

Post surgery pathology – Organ confined, Gleason still 6, margins clear.

First post-surgery PSA -- Undetectable, 2/20/07


Courage is fear holding on a minute longer.”

George S. Patton

American Soldier and General

Post Edited (PianoMan) : 4/18/2007 5:50:18 PM (GMT-6)

Rick 1
New Member

Date Joined Mar 2008
Total Posts : 3
   Posted 3/1/2008 3:47 PM (GMT -6)   
Hello All. I am new to this board.
I only heard the term perineal pain for the first time yesterday while searching the Net and trying with your help to confirm that's what i have.
I am 53 YO and had a radical prostatectomy and lymph nodes removed Fe 6th. went home with a catheter Feb 9th and catheter removed Feb 19th. about a week after the surgery i started to get significant pain/pressure in what i thought was my rectal area but since then I think I have pinpointed it  to the area between the rectum and scrotum and when really bad the pain would radiate into my buttocks. to be blunt it felt like someone was shoving a baseball bat up my you know what, when i would sit it felt like I was sitting on a balloon and the only way to get relief was to take painkillers and lie down. after lying down the area would throb for about an hour.
I mentioned this to my doc/surgeon who said my bladder was spasming and was inflamed and swollen from the surgery and catheter. he said it would be better when the catheter was removed.
well the  catheter was removed Feb 19 and pain stayed the rest of that day and next day went away for about 3/4 of a day and then came back. it is much reduced from what it was and seems to have stabilized at a moderate uncomfortable level but does not seem to be improving after a week and a half without the catheter. the doc again talks about spasms, possible infection so has put me on strong antibiotics and just says for some it takes longer to recover. he has never mentioned perineal pain.
the symptoms i'm experiencing:
-the balloon like feeling is the least first thing in the morning and seems to get larger as the day goes on
-walking relieves the pain/ache
-lieing down "        "      "
-the pain is the worst and comes on the fastest when standing in one spot such as when shaving or standing under the shower.
-seems to also come on when i feel a bowel movement coming on and is temporarily relieved like 10 or 15 minutes with the movement.
i mentioned all of this to the doc this past Thursday and he has booked me for a cysytoscopy for Tuesday if i am not improving. I'm sure you can all appreciate that after having a catheter for 2 weeks i certainly want to avoid having more things shoved up there if i can avoid it.
I am hoping the gentlemen in this forum who have been through this can tell me that all the symptoms are normal and will go away.
I look forward to your reponses and thanks to all in advance.

Regular Member

Date Joined Jan 2008
Total Posts : 276
   Posted 3/1/2008 5:20 PM (GMT -6)   
I also had some pain in the lower pelvic area, which I attribute to the prostate being shaved away from the anterior rectal wall, which has over time thinned out as it relied on the prostate for structural support, and naturally once the prostate is no longer there the rectal wall has to strengthen AND recover from the localized trauma of surgery. Mine lasted on and off for 3 to 4 mos, more notable prior to a BM, the stool softener (ducosate) 200 mg daily helped a lot. As everyone who has been there knows, it is different for all of us, and takes significant time to recover, even though we "look fine", which I got sick of hearing. Good Luck and hang in there.

Veteran Member

Date Joined Nov 2006
Total Posts : 883
   Posted 3/1/2008 5:36 PM (GMT -6)   
Although I had RRP, the pains all seem about the same. Although the Robotic guys do not get the "zipper" in front, we all get all the trauma and repair from the work done inside. I was unfortunate enough to have to get a bladder scan done about two weeks post op. I was able to see the screen when the radiologist was looking at it. I saw a bunch of black squiggly lines on the screen and I asked what those were. The radiologist said that was all the suituring. I though WOW! Much more than I would have ever imagined. I think the Doctors (especially the Robotic Guys) should let everyone know that the only thing less invasive about the Robotic is the puncture wounds. Overall my "invasive" RRP incision did not bother me much at all.
After having my AdVance Male Sling done just a week ago I have a new kind of perineal pain! For it I have been using an ice pack on the area to numb things up and to help the swelling go down. I do not remember doing this after my RRP you might try it.

Good Luck, KW
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second opinion Doctor at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 4th, 2008 - Appointment with Original Dr. to discuss options and recomendation for surgical fix for incontinance.
    Feb. 22nd, 2008 - Surgery to install the AMS AdVance Male Sling.

Veteran Member

Date Joined Nov 2007
Total Posts : 598
   Posted 3/1/2008 7:00 PM (GMT -6)   
Frankly, I'm amazed that your doc isn't telling you that this pain is perfectly normal. It is listed in every post op instruction I read anyplace. Everyone has it to some degree.

It is truly a pain in the butt! It hurts to sit - and yes, is surprisingly intense. As you know, it only inflames the area. Sit in a recliner. If you must sit, use the do-nut cushion - not the balloon donut. Rock back onto your tail bone if you must sit. I was told the lengthy sitting will cause nerve damage from the pressure on the swelling.
Painkillers might help, but the fact is, don't irritate it. If you are at home, lie on the sofa, or in a recliner. There is simply no need to sit for long periods of time...or stand for that matter! Yes a bowel movement will add to the pressure, but will feel so much better after it is done.
Please be kind to your body.
47 at Diagnosis.
Father died of Pca 4/07 at 86.
1/06 PSA 3.15
1/07 PSA 4.6      (Biopsy 3/07 just suspicious)
10/07 PSA 5.06   (Biopsy 11/07  1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC
Saved both nerve bundles.
Path Report:  Stage T2cNxMx
-Gleason (3+3)6
-totally contained to prostate,
-10% involvement in L & R Mid lobes

Veteran Member

Date Joined Apr 2006
Total Posts : 818
   Posted 3/1/2008 7:13 PM (GMT -6)   
Hello mgl,

Ditto everyone else's comments; as for me the aching gradually subsided after 3 months. You may also find that for the first few weeks you will become fatigued in the middle of the day. So rest-up while you can, and eat protein to help your body heal & rebuild.

I hope you have a speedy recovery.

Diagnosed at age 60
PSA went from 2.2 to 3.8 in 14 months
2 of 14 cores positive at 10%
Gleason 6(3+3), negative DRE, neg. margins
DaVinci surgery on 02/23/06
Last PSA 02/26/08 @ 24 months "0"

Rick 1
New Member

Date Joined Mar 2008
Total Posts : 3
   Posted 3/2/2008 3:06 PM (GMT -6)   

Just wanted to thank everyone for their posts in response to mine. it has eased my mind a lot that the pain I'm having is perfectly normal.


New Member

Date Joined Mar 2008
Total Posts : 9
   Posted 3/9/2008 12:51 PM (GMT -6)   

Hello All:

I am so relieved to find this discussion group.  I had the Da Vinci radical prostatectomy almost six weeks ago and I still have significant perineal pain.  This is the first site that has given me the assurance that this is not out of the ordinary.  Thanks.

Regular Member

Date Joined Oct 2007
Total Posts : 300
   Posted 3/9/2008 1:58 PM (GMT -6)   
I'm about 3 weeks out from the cath and have the same pain. It was bad at first but now it comes and goes. At first I thought it was from the Kegels. Doc didn't tell me either. Sure glad I joined the forum awhile back before surgery. Everyone here, including myself, will help you through your journey mgl.

Take care,
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Gleason 7 (3+4)
1 positive margin (.3cm)

Rick 1
New Member

Date Joined Mar 2008
Total Posts : 3
   Posted 3/9/2008 3:15 PM (GMT -6)   
saw the surgeon on Friday and he is certain my perineal pain is from an inflammation of the bladder due to the acidity of the urine. after 3 weeks of this pain on and off he prescribed cortisone pills (prednisone) to reduce the inflammation and after only 4 doses they seem to be working well since my pain is noticeably less and went for 1 1/2 days with no pain at all. it seems to come back when the pill starts wearing off though. just started Kegels  2 days ago and my lower abdomen muscles are very achy.
FYI my PSA 4 weeks post surgery has gone down from 12.5 to .008. another test in 2-3 weeks and my docs thinks it will be down to .006 which he says is considered 0 and undetectable. I had a slight exceedance of margin on one side.

Regular Member

Date Joined Aug 2007
Total Posts : 120
   Posted 3/9/2008 10:33 PM (GMT -6)   
Several of the men here have suggested the donut cushion. I started out the first day with on that was inflatable, but it was uncomfortable at any pressure. I took it back and bought a sponge rubber with removable washable fabric cover for less money. It was like day and night difference. Worked well and just four weeks later I took a 3000 mile coach trip using it. I did not experience any problems on the trip. Right after the surgery I did have some pain and I think most it was due to bladder spasms. A couple of times they were close to unbearable. Hang in there and this too shall pass. God Bless, Uncle Dan
Age 68
DRE negative, 10 - 06 PSA 5.44, 01 - 07 PSA 6.47
5 - 07 CT and Bone scans negative, 05 - 07 Biopsies, 2 of 6 positive
Gleason Score (3+4) 7 Stage T1c
08 - 14 Da Vinci RAP, five hours surgery
Some right nerve and all left nerve removed,
8 -16 Negative margins, Encapsulated, 50% left side
Lymph nodes 2 R & 1 L - Negative, R & L seminal vesicles - Negative
Gleason changed (4+3) 7 so it was closer to 8 than 6
Sixth month PSA 0.04 Previous PSA 0.00 Occasional stress drip
Results are improving while using pump. Pills no help

New Member

Date Joined Mar 2008
Total Posts : 9
   Posted 3/16/2008 11:17 AM (GMT -6)   
An update to mgl on post op perineal pain.
Finally, after almost seven weeks, my perineal and testicular pain is starting to subside. I can sit for short periods without the donut cushion. I alternated heating pads and ice for several days and that seemed to help.
Routine physical 9/18/07 showed PSA to be 13.5.
Diagnosed PCA 11/14/07. Biopsy 2 positive cores out of 12.
Gleason scale 4+3=7.
Da Vinci prostatectomy on 1/30/08.
Negative lymph nodes, negative margins, positive seminal vesicles.
Post op Gleason 4+4=8.
Anastomotic leakage post op necessitated having the Jackson Pratt drain in for 2 weeks.
Incontinent leakage bad at first, but has greatly improved over past 3 weeks. Down to 1 Depends a day on 3/16/08.
Significant perineal pain for six weeks. Significant testicular pain for six weeks.  Both starting to taper off after almost seven weeks post op.
Awaiting post-op PSA.

Veteran Member

Date Joined Apr 2007
Total Posts : 823
   Posted 3/16/2008 3:48 PM (GMT -6)   
Hi mgl. My hospital (Duke) gave me a foam rubber horse shoe type cushion that I put inside a pillow case and used it every time I sat down in in restaurants and at work for the first six weeks. I had no other problems except for terrible gas pains. None of these pains caused me to take any pain meds and I did not have any bladder spasms either. Take care all and have a great recovery.

age at dx 54 now 55
psa at dx 4.3
got the bad news 1/29/07
open surgery Duke Medical Center 5-29-07
never more than 2 pads
wear one for insurance now
ED still a problem
last PSA undetectable

New Member

Date Joined Mar 2018
Total Posts : 3
   Posted 3/9/2018 3:10 PM (GMT -6)   
I am out surgery 5 weeks and still have same pain and I can only sit on the donut cushion or lay down. I hope it will be less pain soon. Anyone can tell me how long this pain will last?

Regular Member

Date Joined Nov 2016
Total Posts : 442
   Posted 3/9/2018 3:40 PM (GMT -6)   
That wasn't my experience. At 5 weeks I did not have the pain you report. Ask your surgeon what he thinks.
Age at diagnosis-66 Diagnosed 6/16
RALP 10/16 at U of Chicago, Dr. Shalhav. Experienced internal bleeding post op requiring transfusion of 2 units.
Pathology Gleason 3+4=7, tumor volume 15% Margins negative except for one focal margin, .1mm
PSA @ 6 wks <0.02;16 wks <0.02; 5/17 <0.02; 10/17 <0.02

Regular Member

Date Joined Sep 2017
Total Posts : 209
   Posted 3/9/2018 9:55 PM (GMT -6)   
Had PT immediately after the RP. She had me strengthen my AB muscles. Perinem stretch sit cross legged on floor with back to a wall.
76 very active. Physically fit. PSA 6.8 MRI Targeted biopsy 6/17 Gl 4+3 9%, Chose RP without consultation 7/28/17 RP ,16 lymph nodes & nerves removed, pT3a, pin, negative margins, EPE focal Total ED using bimix, still one pad a day, 9-18-17 psa <.1, 1-5-18 <.1 psa
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