RRP followed by PSA Rise

Hi Cushions,

I'm leaning towards surgery, I'm a Gleason 4+3, what is your age and #? Was it robotic? My surgeon says I can stay two nights in the hospital, did you need two? What excecise prep did you do to help with surgery? Why will it take 6 weeks for the biopsy?

All the best,

Nick

Congratulations on pulling thru without complications. The constipation thing is always a problem. Give it three or four days. I've had three abdominal surgeries in the past year (two in recent weeks) and start with a stool softener immediately, first night add a stimulant and another the next morning. Increase the dose each day, morning and night. If by day four still nothing (including your post-op day) then do something drastic like magnesium citrate, double the normal dose. I always hate having to deal with this, but it is unavoidable.

BTW Lucky, my robotic involved only one overnight in the hospital.

 Cushions,

Thanks for the report. As you can see many guys are interested in your story and reading your posts. It is petty that you did not maintain them in a single thread. In any case for those interested, they can follow your story in these links;

https://csn.cancer.org/node/308573

https://csn.cancer.org/node/309415

https://csn.cancer.org/node/310010

https://csn.cancer.org/node/309464

So far all seem to be in your favour. The PSA in one month will verify the treatment success. It should be less than 0.06 ng/ml. The pathologist’s findings on the whole gland will be important for future interventions if needed. You should get a copy of the report.

Best wishes for a final good conclusion on this bad chapter in your life.

VG

Cushions,

I'm glad you are along the path toward sitting wheresoever you wish, on whatever you wish.

Two facts you shared intrigued me:

1. Why will the pathology report take 6 weeks ? In the US, men get a pathology summary in the recovery room when they wake up (if they ask).  I asked, and the doc shared that the tumor(s) size was different (larger) than thought, and had been adjusted to Stage II.   He gave a great deal of detail, which had come to him from the pathologist.  Why on earth six weeks ?  I got a surgeon's summary of the whole proceedure (per my request) within two weeks or so following discharge.  It is good to have this; questions will arise later that have not even occured to you yet.

2. You said nerve-sparing was successful on one side. What occured on the other side ?

Urinary: In the US, post-op hospitalization is usually over the next day.  Cath time is usually under one week, and because of when the weekend hit, I got mine removed by the RN on Day 4 post op.  Cath removal is painless.   I took a disposable adult male diaper per direction for cath removal, and wore it the remainder of that day. Uncertain how things were working, I wore a diaper most of the next day also, but by then I transitioned to a large pad, and never wore a diaper again.  I had relatively good urinary control by three days following cath removal. Pad use can easily last weeks, and sometimes much longer.  Pads and liners come in an assortment of sizes to tailor to your needs.    I have much better urinary contol post RP than I had before, and will never have stricture issues.

Sexual:  My pelvic region was TOTALLY numb for some time thereafter (well over a month), but I was having sex via injections by I believe within two months or less (this is from memories of 2.5 years ago).  Sex was not good prior to the surgery, due to the disease -- some particulars that the tumor caused that I do not feel ok sharing here.  Sex was encumbered post-surgery, but it was encumbered pre-surgery also, so how could I blame surgery ??

Pelvic sensation to touch can easily take several months to a year or more to return.  As I have written here many times, I was in ICU decades ago following massive trauma, mostly to my chest, but also had a surgical incision on the side of my hip a foot long for rod insertion of the femur and wiring together of the hip.  My pelvic region, including all of the genitilia, was totally devoid of sensation for  OVER A YEAR.  But sensation returned to normal.   The only doctor I was routinely seeing at that time was the orthopedic surgeon, and he said he did not know what had caused the loss of sensation (I was 30 years old then). 

I asked my urological surgeon about this history two years ago during an office visit following the RP, and he said his best guess was that it had been drug induced, since I was on a morphine and muscle relaxers IV (Darvon and others) for 24 days.   My point is that the pelvic region can be numb a long, long time and then recover, as mine fortunately did.

But what any given individual's does only time will reveal to them.  I simply suggest tht if you have no pelvic feeling for months, do not dispair.   Sex returns much more slowly than continence. Get on Cialias as soon as possible to maintain blood flow to the vascular tissue in the penis, this is critically important.

Wishing you well,

max

Maybe VdG meant to say it is a pity (???) and spell check changed it.  Glad to hear you made it through. I was also dealing with a GI infection during my RP. After what you want through, maybe it was a blessing that I did not recognize.  

Be patient, it took me longer than the expected three months of incontinence, but eventually this amazing creation of our bodies adapts. Sometimes it takes longer than usual.

Only an inch?

Partially continent already?

Mr. Happy is starting to smile?

That was fast... Here's some more positives to add to your RP list...

No more fingers up your keester. By the time I had a biopsy, I had had more fingers up my butt than Boston Pops has fingers playing instruments. 

No more Foley catheters. I had five Foleys inserted, occasionally in humiliating circumstances. I never got used to it. It is probably the most hated but necessary invention. Emergency room personnel often screwed it up, but the urologist office PAs were much more proficient. One time I had one male and two female ER nurses struggling to get one in while I laid there in naked misery, as I started bleeding all over them and myself since they couldn't get it past my ginormous prostate. After thirty some minutes they gave up and the head ER doctor called up Urol of Ind and said I was their problem and they better do something about it. And people wonder why I opted for RP. I

No more UTIs... I don't know if you had this problem, but mine are gone. The urinary tract always got inflamed when the prostate got infected. Much worse inflammation than an STD, which makes it all the harder to get any stream of it burns like hell. And with the inflamed UTIs, it makes the Foley, or worse the self catheter, feel like a hot poker going up your business. 

No more fingers in your butt, no more Foley catheters, no more inflamed UTIs...  No more Flomax either. No more prostate biopsy, that's supposed to feel like a little sting but the last six weren't numb yet and felt like Excalibur being run through your rectum.

That's a lot of "no mores" that are worth celebrating, come what may.

Cushions,

Something seems not right in your posts. I understand that all the fuse of the diagnosis and operation was a pain in the neck. The recovery is underway positively but your wording makes me think that you are not satisfied. Something in your mood is not right. You worry too much. Have you checked the testosterone levels? At low levels menopause sets in and the symptoms could be playing a trick without you noticing it.

I hope you recuperate fully the soonest and that you find a job.

Best,

VG

He's right... It could be a vitamin deficiency. You could try sublingual B12 and B complex vitamins. Often mood swings are B vitamin deficiency. Also you can eat foods with mood enhancers. Turkey has tryptophan which the body converts to serotonin. You should also avoid red meat. But you need certain vitamins and foods for your body to produce endorphins which improve your mood. And you want to avoid foods that have or will produce fear and flight hormones like adrenaline. Like red meat that hasn't been bled kosher style. 

Anytime you have mood swings that can't be explained environmentally, I would look at diet and vitamins first, and the resulting production of mood enhancing brain chemicals versus the trauma fear and flight hormones. And like VdG said, add lower T-levels just makes it worse. 

And then what Paul the Apostle said... Contentment with godliness is great gain.

Cushions,

Aaaa,  I don't know about the "no more fingers deal".  I had my RP in Dec. 2013.  Followed by 8 weeks of daily Radiation and two full years of Hormone Therapy.  At my yearly physical at Radiation Oncology, I still have to have a DRE to check that there is no swelling or lumps in the empty cavity.  They check because of the radiation treatments to the prostate cavity area, that was done as follow up.  I hope you don't have to have any more DRE's.  That would be great.  Again---we are all different and all of our cases are different so you might avoid the further exams.

The hormone treatments and the radiation treatments will pull you down.  I went through the mental thing as well.  Now after being off the hormone treatment (Lupron) my testosterone is back up in the middle of the normal levels.  I feel like a different person.  Thank God my wife was an is very understanding.

As to the constipation problem, My doctors told me to take Benefiber every morning.  I eat my wife's home made whole grain bread every day and lots of fruit and Veggies, and cut back on the red meat.  Still eat a little, but not like I used to.  By doing that, I was back on solid food the day after my surgery and had no problems.  In fact Dr. M insisted they take away my semi solid diet at lunch, the next day, and he made me eat a full solid meal before he would let me go home that afternoon.  I Had no BM problems.  Again---our cases are all different, So, can't tell you what to do.

As to your pain, I can't relate to that, becasue I didn't have that and never took any of the pain medication they sent home with me.  I was back on my Aleve and Arthritis Tylenol two days after (doctors orders) so I geuss that took care of any pain.  But I did not take any of the Opioids they sent home.  I had been warned about the removal of the Catheter, so I took two of those pills before I went in to have the catheter removed.  I walked in with my catheter bag in a State Liquor Store Bag and they all laughed.  I was on "the table", looked at the nurse and sadi, Let's get this over with."  She held up the catheter and it had already been removed.  I didn't feel a thing.  I was in La La Land, they had a good time, and to this day tease me about that day.

An Inch?  Yep, I understand completely.  I was warned about that.  However now that I'm coming up on 4 years post surgery, things are getting almost back to "normal" ( for me).

Best of luck

Peace and God Bless

Will