New Guy Reporting In

Gatorman

Greetings, Gentlemen.

 

New guy reporting aboard here, although I’ve been watching this forum for last couple months to learn as much as I can from the collective experience of all participants.

I’m 73, retired Navy, and in pretty good shape/health.  PSA for nearly 20 years was 0.4 to 0.5.  But it started climbing 5 years ago, going from 0.7 to 4.5.  DRE were all normal.  Urologist said maybe we needed to do biopsy and I said absolutely (I’m an engineer by training and a pilot by occupation – so data is always important to decision making).

 12 core Biopsy done just before Thanksgiving 2020.  First pathologist said Gleason 7 (4+3).  Second pathologist on review said Gleason 9 (4+5).

 This was at a Naval Hospital where follow on treatment, other than diagnostic scans, would have to be referred outside. I was able to schedule and complete a pelvic CT and bone scan in next couple weeks.  Then I was lucky to get an appointment in early Jan 2021 with a urologist who said either RALP or IMRT were options I should consider.  I chose RALP and elected non-nerve sparing option mainly because I thought I was dealing with a Gleason 9.  Two weeks later I met Mr. da Vinci.

Nine days later the catheter came out and I got the pathology report.  Gleason 7 (4+3) in 30% of 45 gm prostate. Margins all clear. 6 lymph nodes taken out and clear.  So it appeared there was no metastasis.  Just went back for 3 month follow up and PSA was <0.01.  So I will repeat every 3 months for a year.

 Obviously I’m feeling some relief at the outcome, but I do have questions for the group – and would appreciate the wisdom of your experiences.

1.     Perineal pain/discomfort – how long does this last?  I still need to use a donut to sit on any hard surface chair

2.     Incontinence – I was using two pads in day and a pair of briefs overnight.  Now down to 3 pads for 24 hours.  Mostly dry overnight, but still get up 2-3 times to pee.

3.     Flabby skin rolls – A lot of loose skin at bottom of pelvis right above penis.  Dr says this  is due to lymphatic system still figuring out how to operate with 6 missing nodes.  Also scrotum seems larger than before surgery.

4.     Fatigue – At 10 weeks post RALP I seemed to finally be getting some energy back.  Normal?  Remember, I’m 73.

5.     Bowel Movements – I’m still super cautious about ‘bearing down’ when going out of fear I’ll tear something.  But after 3 months I should be pretty much healed internally.

 Comments and advice welcome.  Thanks for listening.

 Florida Gator

 

 

Clevelandguy

Getting healed

Hi Gatorman.

1.     

Perineal pain/discomfort – how long does this last?  I still need to use a donut to sit on any hard surface chair 

Don't have an answer for this one, I had little or no pain after my Ralp. I would talk to your Surgeon about the pain.

 

2.     

Incontinence – I was using two pads in day and a pair of briefs overnight.  Now down to 3 pads for 24 hours.  Mostly dry overnight, but still get up 2-3 times to pee.

Sounds like your making progress, it takes some time to heal, pray for continued improvement, could take over a year to make good improvement.  I maxed out at about a year, still wear a light pad today just to catch the occasional drop or two

 

3.     

Flabby skin rolls – A lot of loose skin at bottom of pelvis right above penis.  Dr says this  is due to lymphatic system still figuring out how to operate with 6 missing nodes.  Also scrotum seems larger than before surgery.

Did not have that, don't know. Would not worry about a large scrotum unless it seems to be filled with fluid.  If it is talk to your surgeon. Ive got flabby skin in other areas due to aging and not surgery.

 

4.     

Fatigue – At 10 weeks post RALP I seemed to finally be getting some energy back.  Normal?  Remember, I’m 73.

Good, making progress is good after major surgery.

 

5.     

Bowel Movements – I’m still super cautious about ‘bearing down’ when going out of fear I’ll tear something.  But after 3 months I should be pretty much healed internally.

Bearing down can cause hemroids, not a good thing to do.

 

Dave 3+4

Old Salt

Patience

Congratulations on getting through the surgery; the path report and the post-surgery PSA both look (very) good. But your body went through a lot and will need time to heal. How much varies among patients.

Do continue to be careful and do not hesitate to contact your surgeon if necessary. 

Good luck with your ongoing recovery.