da Vinci robotic single port surgery using the Trendelenburg position

Niquels

Are there many prostrate cancer patient treated using this technique? How to you find doctors that can do this? Can anyone share their experience if they were treated like this?

Please forgive my rambling (see below) and thanks for listening (reading).

Greetings. This is my first post. I was diagnosed with a small (.3 cc) transition zone Gleason 6 (3+3) adenocarcinoma in December 2022. My urologist recommended active surveillance. Jump to today, last month the MRI showed two lesions, right and left side mid gland anterior transition zone both with hyperenhancement, restricted diffusion and indistinct margins. PI-RAD 4. I have not seen the biopsy report yet but I anticipate Gleason score of at least a 7. Bad stuff. My PSA is 2.7, but that's because I take finasteride. Pre-finasteride was 5.3. It's been seven days since the biopsy and I'm going nuts waiting.

The last biopsy was torture. The first one was easy, in the hospital and I was sedated. This one was in his office with a local and it was painful and uncomfortable. I bled a lot but it stopped by the time I got home. Peeing is painful. He really worked over my prostrate. I suspect now I'm suffering from prostatitis. I have BPH and the lesions are small and my prostrate is of normal size (was 28 cc it feels bigger now). I've been on finasteride for a couple of years, that's why my prostrate and lesions are small.

Enough complaining. I've been reading about prostrate cancer treatments and presently I'm focused on surgery. Particularly da Vinci robotic single port surgery using the Trendelenburg position.

Anyone that can shed some light on how to get this type of procedure done will be greatly appreciated.

Bill

Wheel

Bill,

I had the exact procedure one year ago. I was so happy to have had the Surgeon do nerve sparing, Retzius sparing, and Puboprostatic ligament sparing. I had total continence immediately after the catheter was removed. Also totally happy with the nerve sparing. My single port entry scar is hardly noticeable. My procedure was done in Southern California. I was Gleason 8, downgraded to Gleason 7 unfavorable after the surgery. The surgeon also sent the margin cuts to pathology while I was on the table to determine whether the margin was positive or negative.

Niquels

Thanks so much for the comment. That's reassuring. I'm glad your doing well.

Steve1961

I had salvage surgery done also in Southern of California UCLA, my doctor, Robert Reiter yes they used the da Vinci robot. they said to the margins out up and walking your holes all next day catheter out in a week and even with salvage surgery I go through one to two pads a day I can still get an erection. OK don’t listen to the horror stories. If your cancer is prostate just get it taken out specially at your age I regret doing radiation piece of advice you must this must have the biopsy sent out for decipher testing. You must make sure that is not Cribbiform . After six months of seeing doctors surgeon I waited for sent it out for this testing and mine came back aggressive Cribbiform they suggested take it out. Or i should do radiation. I chose radiation and it was the wrong decision ..four years still there The cribbiform I ended up having it removed by salvage surgery and right now I’m cancer free and I hope to God stay that way because I cannot do radiation three steps to prostrate cancer and you can look this up if you’re good health and you expect to live more than 10 years and the cancer is contained to prostate the gold standard is surgery Then if it happens to come back, you have a back up plan radiation and then the third option dreaded hormone treatment. I just thought I’d throw this out there because I experienced all of this and I don’t want somebody else to experience it. Make sure it’s not crib form. If it wasn’t cribbiform the radiation probably would’ve worked best of luck to you.

Niquels

Thanks for sharing Steve1961. Good to know.

I finally got my biopsy report and I'm relieved it's not an aggressive cancer. It showed two lesions both Gleason score 3+3, stage 1. I also got a message from my urologist saying the cancer is small and insignificant and we'll wait and watch with active surveillance for now.

The MRI description worried me and having to wait so long for the biopsy report didn't help. I'd do searches on prostrate cancer and use the lesion description and the results always reported an aggressive cancer that needed treatment. I think the finasteride makes the tumors smaller and denser and also affects the way they show up on the MRI.

Finally my prostrate is recovering. It swelled up to the point where I could just barely pee and it was painful. After the seventh day I started taking naproxen and got some relief. I should've started taking it sooner. It's better today but still not to the pre-biopsy condition.

Anyhow, I'm grateful I don't have to treat my prostrate cancer for now.

Wheel

great news! If your PSA rises, consider having your urologist order the ExoDx prior to another biopsy. It is a simple non-invasive urine test. It can determine the risk of aggressive cancer.