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Could the Aftermathof side-effects be blamed on the Surgeon?

lion1
Posts: 239
Joined: May 2007

I guess I never dwelled on it too much, but as I deal with incontinence 6 years later, I don't believe it's all that critical of a question. Is the Doctor to Blame? The answer maybe Yes. When I was 46 and diagnosed with Cancer, I had Great Erections, never had incontinence isssues and was otherwise in great shape. After I had my prostate out , the cancer has not returned which I count ny blessing for, but obviously the surgery did result in me being incontinent and requiring Cialis for probably the rest of my life. I understood the risks,but the Doctor has to take some of the blame, because there are many men out there who came out of surgery, in much better shape---------------------Are we giving the Doctors too much credit?
Lion1

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Lion

I understand your second guessing. Maybe it was the doctor. Maybe it wasn't. I don't think there is any way you can know for sure. I am sure at the time you picked the best doctor available to you and one you had confidence in. Every patient is different. What may have worked for one may go south for another. It's not unusual for men who have had an RP to rely on Cialis or Viagra given the amount of nerves that had to be taken out with the prostate (even with the so-called "nerve sparing" technique).

Counting your blessings is always a good thing. I'm so sorry that you are still having continence issues and I hope you're talking to someone who might be able to help you with that.

In any event, what is the use of second guessing? You can't rewind this. You can only go forward. I think your post is a good one and men who are considering their options ought to consider very carefully the potential ramifications of their decisions. i do hope that you can find some improvement to your issues. Are you seeking help in this area?

Best,

K

Swingshiftworker
Posts: 620
Joined: Mar 2010

Sorry to hear about your travails in dealing w/the consequences of surgery. Unfortunately, at this late stage, you probably can't prove whether they were caused by the surgeon or not.

FWIW, when anyone undertakes surgery, it's a crap shoot. As you know, some men come out great but others are doomed to a lifetime of misery. You can have the best and most experienced surgeon in the world and still come out of PCa surgery impaired for life. Also, when surgery fails, as it often does, you still have to resort to radiation and other methods of treatment anyway.

So, why risk it?

Surgery for men w/early or intermediate stage PCa is really unnecessary because there are now equally effective methods of treating their cancer w/radiation w/o the risks of surgery. Late stage PCa patients where the cancer has likely metastasized also have no need for surgery because removal of the prostate will not solve that problem; hitting the prostate w/various forms of radiation & using hormone therapy w/the possibility of chemo for backup is the main recourse for such patient.

This is why I'm now such an ardent opponent of using surgery to treat PCa. It's too late to help you but it's an archaic treatment method which has been superseded by modern radiation technology. It's time to put surgery for PCa to an end. End of speech.

I hope your post-surgical problems are somehow resolved in the future. Good luck!

lion1
Posts: 239
Joined: May 2007

Thanks Guys....for adding such great perspective. All that you said is true, because there is just too many variables involved. I live a full life, but incontinence is challenging to say the least. I have tried all types of medication, botox injections, collagen, and nothing has worked. I have a great doctor now and he has suggested trying the interstim, but I am delaying it. Again there's no guarantees and I am not ready to have a pacemaker like device in my butt. I am very active and would probably knock it off course.My doctor says for my situation there are no effective cures right now. I have to believe that something is coming along to treat an overactive bladder--that's my main problem right now.

I wanted to bring the Surgeon aspect up , to see how others feel and share their experiences. I did pick a great doctor and have no ill-feelings. My decision in one aspect was a trade-off, the hope to be cancer-free and to roll the dice and hope I had no after-effects
Life goes on............Lion 1

VascodaGama's picture
VascodaGama
Posts: 1518
Joined: Nov 2010

Lion

I agree with you that guys should blame their doctors for incontinence and ED post a treatment for PCa. These two main aspects in surgery outcomes would not have a chance to happen would the surgeons take into higher consideration the side effects when cutting, more than the principal intent of their job in showing cure.
The same responsibility could be attributed to radiologists when bladder chronic cystitis or permanent rectal ulcerative colitis is caused due to their isodose-planning or deviations during treatment.

Cancer cannot be seen but judged to exist so, both, surgeons and radiologists tend to cut and reach closer to the limits. These are means only possible at the hands of highly expert physicians.
Treatment applied by trainees or mediocre doctors should have fixed protocols, lesser cutting and lesser limits in the isodose-planning. In other words it should be looking more into avoiding too much cut or radiate than looking at cure; particularly when the patient is young and with many years of survival to go. What good is there in being alive but handicapped?

I recall been given a “contract/agreement” which had to be signed by my wife and I before surgery. We took it home one week in advance so that we could read it in detail and never thing in blaming the physician for whatever he would cut on “S- day”. Those items were listed and so it was the argument of fathering. We had lots of interrogations in our minds but knew that the upmost would be cure, otherwise I shouldn’t be doing a treatment”.
And so it was. I signed for a “hypothetical cure”. All the rest was covered in the agreement.

When reading about guys that like you become permanent suffers, I see myself as one of the lucky group not affected to such extent. However, I really believe that the outcome was not totally due to luck. It was due to the efficiency and knowledge of my surgeon when cutting and during his “after-care services”.
He was careful at the bladder’s sphincter area and took focal X-rays of the area to certify the incision limits. After surgery he also checked for the healing process of the V-shaped neck before withdrawing the catheter and allowing my discharge from the hospital (12 days after surgery).

Physicians looking for quick cures to the wound with fast robotic cuts and short terms in hospital after-care, working like factories tend to precipitate the aspect of individual care and forget about what one most dare which is Cure but with Quality of Life.
Those should be blamed and prosecuted.

Best.
VGama

Beau2
Posts: 228
Joined: Sep 2010

Hey Lion 1,

You asked for others experiences and feelings.

I guess that I was luckier than you in that my side effects have not been as bad. I was continent from the moment the cath was removed and my ED is now workable with the pills and even seems to be continuing to improve (3 years out this coming April!). PSA remains undetectable so I'm happy.

I feel that I got real lucky in that my surgeon had completed a fellowship with the DaVinci (he said he had been involved in 250 procedures during the fellowship) but had only completed 35 DaVinci procedures after the fellowship, and before my surgery. Nice guy; however, if I knew then what I think I know now, I would have been a lot less accepting of his credentials.

When I read your comments on Surgeon credit/blame, I thought that it would have been nice if there had been a score card available where the surgeon's statistics (as reported by patients) were posted (like outside the office door). Maybe former patients could report on the following three items:
1.) Cancer Recurrrence
2.) Continent?
3.) ED?

Concerning your incontinence, would an AUS or sling improve your condition? I've talked to guys whose incontinence improved after these procedures.

Best wishes and good luck with your fight against PCa and the side effects.

lion1
Posts: 239
Joined: May 2007

Beau,

Not for a guy with an overactive bladder. Additionally, a sling or AUS I feel would be rolling the dice. For as many positive stories I have heard there seem to be more negative outcomes and Maybe again it comes down to the Surgeon. Could you imagine if a Surgeon screwed up a Sling or AUS operation? The pain and suffering could be catastophic. I just don't care to go down that road, it scares the heck out of me.

Lion 1

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