Had Robot Assisted Prostatectomy December 5

JDE3

I was diagnosed in early October with prostate cancer. My PSA was 5.5 and a DRE revealed a nodule. Subsequently, I had a biopsy - of the 12 samples, 3 were positive with one containing 40% "low volume cancer" and two others with a trace of cancer. I am 62 and my urologist outlined the options ranging from doing nothing ("watchful waiting") to removal, radiation, cryotherapy and HIFU. Because of my relatively young age, he did not advise me to do nothing. He emphasized that I had time to make an informed decision and was confident that the cancer was confined to the gland. I purchased several books on prostate cancer, spoke to quite a few men who have it and searched the internet. I did get a second opinion from a radio oncologist who said that radiation would be an effective treatment for my case and would have the same outcome (statistically) in 10 years. I elected to have the radical removal using the laparoscopic robot assisted technique. My urologist is also a surgeon and has been doing this procedure for 4 years. The way my mind works, I wanted to get the cancer out - and I liked the idea that if it had spread, there are options after the gland is removed for further treatment (external radiation). I had the procedure done Monday, December 5 - I had a one night stay in the hospital and was up and walking 4 1/2 hours after I woke up from surgery. The pain was very manageable - I did take pain medication for three days as needed, then stopped. The most annoying issue was the catheter, which stayed with me for 7 days. I was discharged with instructions and a bag that strapped to my leg during the day and a larger bag for use while I slept. The catheter was removed Monday, December 12 (along with the staples in my abdomen from the surgical wounds)- not at all painful. I was warned that incontinence would be an issue for some period of time - ranging from several months to a year. However, my doctor said that most patients regained full control although some continued to have stress incontinence when lifting something heavy. And, the second issue is the possibility of impotence. My doctor said if the nerves are spared (which they were) that I should regain the ability to have an erection. I am very pleased to say that after 4 days from the catheter removal, that incontinence issues are minimal - I am sleeping through the night without problems and really don't have much of a problem during the day. It is clear to me that I will regain full control over the next few weeks. I believe however, that I am somewhat of an exception. The impotence recovery remains to be seen at this stage. And, I am still waiting for the final pathology report which will determine if I need further treatment or not.

After determining that my cancer was in an early more treatable stage, that I am relatively young and in good health, I and my doctor believed I was a good candidate for radical removal. Given this, and the way my mind works, surgery seemed to be best option for me. Then it boils down to the skill of the surgeon - it was important to me (and confirmed by what I read) that the surgeon had at least 150 robot assisted surgeries under his/her belt - 300+ is preferable. In addition, my surgeon, who is 56, started with the "traditional" open surgery and had done maybe 1,000 of these - so my guy was very experienced.

Last comment: The decision for my treatment was left up to me - I asked my urologist what he would do in my shoes and he did say he would opt for removal. I asked the radio oncologist the same question and he refused to answer - all he would say is that both radiation (internal and external) and removal were all good and effective.

Kongo

Welcome
JDE,

Welcome to the forum and thanks for sharing your story. It sounds as if you've had a smooth journey so far and you did your homework up front. As you point out, the 10-year statistics for either active surveillance, RP, or radiation are all about the same and your decision was based on your individual priorities. I think you were very savvy to find an experienced surgeon and his skill is undoubtedly a key factor in your quick recovery.

Wishing you the best for a continued speedy and full recovery.

K

Imalive50

Questions about incontinence and erections
I had a radical prostitectomy on Oct. 10th with the DaVinci system. I had a gleason score of 3+3 with 4 out of 10 boipsies shown cancer. Pathologists report said cancer was contained within the nodule on the right side. All the margins were clear. He said no chemo or radiation. Good news there. Because I am very physically active yet my urologist suggested this procedure. My incontinence is doing pretty well with 2 pads a day if I'm real active at work. I keep doing my kegel exercises and I hope things continue to improve. I was advised to start on 5mg of Cieles a day to keep it from becoming atrophied. Did any of you guys urologist suggest this therapy? The urologist was able to save the nerve(s) on the one side. Of course, he told me I had a 50/50 chance of erections returning. I go in in 2 weeks for my first psa check. Just wondering if I have any chance of getting erections back naturally or not. I realize everybody's body is different and each is an individual. I would like to read some words of encouragement. Thanks for all the help and info.

hunter49

Imalive50 said:

Questions about incontinence and erections
I had a radical prostitectomy on Oct. 10th with the DaVinci system. I had a gleason score of 3+3 with 4 out of 10 boipsies shown cancer. Pathologists report said cancer was contained within the nodule on the right side. All the margins were clear. He said no chemo or radiation. Good news there. Because I am very physically active yet my urologist suggested this procedure. My incontinence is doing pretty well with 2 pads a day if I'm real active at work. I keep doing my kegel exercises and I hope things continue to improve. I was advised to start on 5mg of Cieles a day to keep it from becoming atrophied. Did any of you guys urologist suggest this therapy? The urologist was able to save the nerve(s) on the one side. Of course, he told me I had a 50/50 chance of erections returning. I go in in 2 weeks for my first psa check. Just wondering if I have any chance of getting erections back naturally or not. I realize everybody's body is different and each is an individual. I would like to read some words of encouragement. Thanks for all the help and info.

Yes, you should get it back.
Yes, you should get it back. I had the surgery on Novmeber 10th. My urologist stared me on a regiment as soon as the catheter came out a week after surgery on 5mg of cialis for 30 days then 4 days of these other pils and now back on cialis. I was also advised to use a pump at leats 2 times a day to stop atrophy. I had the nerves spared as there was no nodules felt only a jump in PSA then confirmed by a biopsy 3 cores out of 15 posative with 90%. My gleason was 3+4 but after surgery another small tumor was found in the other lobe which was a 4+3. No spread to seminal vessels, clear uretha no spread to lymph and no posative margins, was organ confined. I do get erections and had one only 2 weeks after surgery that was as good as before but not getting them consistant. Even though I had nerve sparing the nerves when moved or touched go into shiock and that can take up to 9 months to heal. Also, swelling can take up to a year to go away. I recomend letting you partner try to stimulate you to see what happens. It cannot hurt. I just had my first PSA and it was .006. I am sure you will be ok just let it happen. Believe it or not it is as much mental as physical. My wife is a good partner and always adds creativity to our "rehab" time. How old are you? Lastly, are you soaking pads or just drips?

Imalive50

hunter49 said:

Yes, you should get it back.
Yes, you should get it back. I had the surgery on Novmeber 10th. My urologist stared me on a regiment as soon as the catheter came out a week after surgery on 5mg of cialis for 30 days then 4 days of these other pils and now back on cialis. I was also advised to use a pump at leats 2 times a day to stop atrophy. I had the nerves spared as there was no nodules felt only a jump in PSA then confirmed by a biopsy 3 cores out of 15 posative with 90%. My gleason was 3+4 but after surgery another small tumor was found in the other lobe which was a 4+3. No spread to seminal vessels, clear uretha no spread to lymph and no posative margins, was organ confined. I do get erections and had one only 2 weeks after surgery that was as good as before but not getting them consistant. Even though I had nerve sparing the nerves when moved or touched go into shiock and that can take up to 9 months to heal. Also, swelling can take up to a year to go away. I recomend letting you partner try to stimulate you to see what happens. It cannot hurt. I just had my first PSA and it was .006. I am sure you will be ok just let it happen. Believe it or not it is as much mental as physical. My wife is a good partner and always adds creativity to our "rehab" time. How old are you? Lastly, are you soaking pads or just drips?

Thanks for your advice.
Thanks hunter49 for the words of incouragement. I'm 61 years old. If I'm doing alot of physical activity, eventually the pad will get soaked. This is over a 4 or 5 hour period. If I'm just hanging around the house, I sometimes get by with just one. I have not had an erection yet but it does get enlarged when I have to push for a bowel movement. My wife and I have not tried anything as yet as I think she is a little reluctant to do anything because of my dripping as yet. I'm still very active physically as I walk the lab 2 to 3 miles each day when I can and I'm going to start going to the fitness center again to get back in shape. I guess it's not the end of the world if I don't get it back but I'll take the wait and see approach for now. What else can I do????? Definately not going to do the shot thing.
I have an appointment with my urologist that did the surgery on Jan. 11th so guess I'll get the total lowdown as to what to and what to expect. Thanks again for the help. There really isn't any support group in the the area where I live and my urologist is 65 miles away and I can never get ahold of him to talk. I will be transfering to a urologist closer to home after this appointment. He's a good doctor that my wife, who is a nurse, works with. I didn't have him do the surgery here as they don't have a DaVinci machine at my hospital.
Thanks again Sir for your words of encourgement. I'm a Viet Nam Vet so I will get some compensation for this cancer. Agent orange you know. I feel kinda strange conversing with someone I don't even know but it sure is a relief to get things out when you don't have anyone to talk to. This is an excellent website.

hunter49

Imalive50 said:

Thanks for your advice.
Thanks hunter49 for the words of incouragement. I'm 61 years old. If I'm doing alot of physical activity, eventually the pad will get soaked. This is over a 4 or 5 hour period. If I'm just hanging around the house, I sometimes get by with just one. I have not had an erection yet but it does get enlarged when I have to push for a bowel movement. My wife and I have not tried anything as yet as I think she is a little reluctant to do anything because of my dripping as yet. I'm still very active physically as I walk the lab 2 to 3 miles each day when I can and I'm going to start going to the fitness center again to get back in shape. I guess it's not the end of the world if I don't get it back but I'll take the wait and see approach for now. What else can I do????? Definately not going to do the shot thing.
I have an appointment with my urologist that did the surgery on Jan. 11th so guess I'll get the total lowdown as to what to and what to expect. Thanks again for the help. There really isn't any support group in the the area where I live and my urologist is 65 miles away and I can never get ahold of him to talk. I will be transfering to a urologist closer to home after this appointment. He's a good doctor that my wife, who is a nurse, works with. I didn't have him do the surgery here as they don't have a DaVinci machine at my hospital.
Thanks again Sir for your words of encourgement. I'm a Viet Nam Vet so I will get some compensation for this cancer. Agent orange you know. I feel kinda strange conversing with someone I don't even know but it sure is a relief to get things out when you don't have anyone to talk to. This is an excellent website.

I have some good info on ED
I have some good info on ED rehad from Hopkins if you provide me your e-mail I will send it to you. You can down load it but it does cost about 45 dolars I believe. If I decicde to get it I will send it to you in pdf (no charge:)). I walk my lab as well good excercise. I would hold off weight training for at least 60 days. do your keegels daily they work and make sure u do them correctly and different ways (standing sitting lying down). I will see what else I can get for you. I started the same way when having a BM saw thickening. You are only 3 weeks out so take it slow. Age does come into play. You sound like my friend who had it at 62. Same thing he wore pads for about 5 weeks then it stopped got oak in about 7 months. It will get better but remember even with nerve sparing it can take 18 month to get back to normal. I agree with not shooting it that is what birds and ducks are for.

Imalive50

hunter49 said:

I have some good info on ED
I have some good info on ED rehad from Hopkins if you provide me your e-mail I will send it to you. You can down load it but it does cost about 45 dolars I believe. If I decicde to get it I will send it to you in pdf (no charge:)). I walk my lab as well good excercise. I would hold off weight training for at least 60 days. do your keegels daily they work and make sure u do them correctly and different ways (standing sitting lying down). I will see what else I can get for you. I started the same way when having a BM saw thickening. You are only 3 weeks out so take it slow. Age does come into play. You sound like my friend who had it at 62. Same thing he wore pads for about 5 weeks then it stopped got oak in about 7 months. It will get better but remember even with nerve sparing it can take 18 month to get back to normal. I agree with not shooting it that is what birds and ducks are for.

Thanks for your advice.
Hello again Hunter49 and thanks again for more info. I didn't even know you were suppose to do the keegels in different positions. I have been doing them only while standing up. Thanks for the heads-up. I am very fortunate that my margins were clear and so nothing spread. I do appreciate all the help and info you are giving. Guy down the street (another fellow hunter) had the cancer, went to the same urologist I had but his had spread. He had to do hormone therapy and is now doing radiation. He's only 51 so I feel fortunate.
I like your last sentence. My son and I hunt also. Had christmas goose and a duck on christmas day. What part of the country you from? I live in eastern/central Wisconsin, @ 10 miles west of Lake Michigan. 6 miles west of Sheboygan. My email address is: rtbluestreak@yahoo.com. Thanks again.

elkhunter

hunter49 said:

I have some good info on ED
I have some good info on ED rehad from Hopkins if you provide me your e-mail I will send it to you. You can down load it but it does cost about 45 dolars I believe. If I decicde to get it I will send it to you in pdf (no charge:)). I walk my lab as well good excercise. I would hold off weight training for at least 60 days. do your keegels daily they work and make sure u do them correctly and different ways (standing sitting lying down). I will see what else I can get for you. I started the same way when having a BM saw thickening. You are only 3 weeks out so take it slow. Age does come into play. You sound like my friend who had it at 62. Same thing he wore pads for about 5 weeks then it stopped got oak in about 7 months. It will get better but remember even with nerve sparing it can take 18 month to get back to normal. I agree with not shooting it that is what birds and ducks are for.

info
i just joined today, but already have learned alot. I am 6 weeks post sugery and have ED problems, would you send me link to Hopkins info. Any advise on what to do to get starded trying to have an erection? Does the Cialis daily work? Thanks

Beau2

elkhunter said:

info
i just joined today, but already have learned alot. I am 6 weeks post sugery and have ED problems, would you send me link to Hopkins info. Any advise on what to do to get starded trying to have an erection? Does the Cialis daily work? Thanks

ED advice
You may also want to look at the book by Dr. John Mulhall of Memorial Sloan Kettering entitled, "Saving Your Sex Life." It addresses treatment for ED in PCa patients.

hunter49

elkhunter said:

info
i just joined today, but already have learned alot. I am 6 weeks post sugery and have ED problems, would you send me link to Hopkins info. Any advise on what to do to get starded trying to have an erection? Does the Cialis daily work? Thanks

sure but I need an e-mail
sure but I need an e-mail address to send. 6 weeks post op is not a good indicator of ED. I sometimes get wood and sometimes do not. It can take a long time to return to normal as the nerves go into shock if touched or moved,

elkhunter

hunter49 said:

sure but I need an e-mail
sure but I need an e-mail address to send. 6 weeks post op is not a good indicator of ED. I sometimes get wood and sometimes do not. It can take a long time to return to normal as the nerves go into shock if touched or moved,

info
jdellos@bresnan.net

angela.barnes38

Welcome back from a tough
Welcome back from a tough journey which you made easy with your rational thinking. You are an inspiration for other sufferers; people need to learn from you.

littlemontana

robotic surgery
I like you had robotic surgery on Dec 6 2011 . I was in good physical shape at the age of 67. At this time no side effects except as most ed.
I would like to put this out there has anyone ever regained ed with out using Viagra or similar drug and therapy .

Tom13

littlemontana said:

robotic surgery
I like you had robotic surgery on Dec 6 2011 . I was in good physical shape at the age of 67. At this time no side effects except as most ed.
I would like to put this out there has anyone ever regained ed with out using Viagra or similar drug and therapy .

Injections
I tried cialis, Viagra, lavitra and they all made me sick with whole body aches? They where so bad I couldn't continue. I then tried injections and they worked VERY well! I only did that about 15 times over 45 days and after about six months after surgery it was back without any help. You may want to try a pump as I did that a few times and it does work but no very well. Hope that helps you!

Imalive50

elkhunter said:

info
i just joined today, but already have learned alot. I am 6 weeks post sugery and have ED problems, would you send me link to Hopkins info. Any advise on what to do to get starded trying to have an erection? Does the Cialis daily work? Thanks

My 2 cents worth
I had radical prostatectomy on Oct. 10th. I'm back to doing everything I used to do but still have some incontenance problems when I'm at work (standing for 4 hours a day) and when I do outdoors activities (ice fishing right now). If I'm sitting around the house I can get by without wearing a pad otherwise I use a light one during the day. Try to do my kegle exercise's when I think about it but am definately not consistent with that. Haven't had an erection yet but haven't tried anything yet other than taking cieles 5mg once a day. Don't know if I should buy a pump and try that or what and see. Haven't had any stimulation from the wife as yet. She say's wait until the leaking is better under control. There's my latest 2 cents worth. Any suggestions would be most helpful.