Nerve sparing and realistic results

I had robotic surgery in December 2016. I was 65 years old and I went through the same decision process and emotions as you, I am assuming. I talked to three surgeons, two at IU Health and one at Urology of Indiana. It was an easy choice to choose one at IU Health as he was very experienced and calm, confident and kind. The doctor at U of I was arrogant, negative and he didn't even bother to make sure he had my records before my appointment.

Prior to surgery, my PSA was at 17 which is very high.

My excellent surgeon was Dr. Ronald Boris.

I also talked to an urgent care doctor when I went into the facility for a different minor problem. He emphatically told me to get the surgery ASAP and save my life. His brother and dad had prostate cancer, so he knew what he was talking about!

The surgery went well, per my surgeon. I was uncomfortable after surgery, but not in much pain, because I had a tube in my throat and my face was swollen, but it all got better within hours.

My stomach had six small incisions which healed well within six weeks.

My nerve was somewhat damaged on one side. The surgeon removed some lymph nodes to make sure he got all of the cancer. My cancer was still encapsulated in the prostate. A month later the PSA test showed zero, meaning no cancer. Second PSA test showed no cancer, too.

Urinary continence returned in just two months! I was so relieved. I tried Cialis and Viagra, but neither of those drugs helped me. Today, I tried Trimix (penile shot). I got a month of shots through Custom Med Apothecary in Indianapolis. It worked perfectly! My erection lasted for several hours. Trimix costs about $95.00 per month. I can afford this, luckily. Medicare does not pay for any of these treatments. Medicare will pay for a surgical implant (I checked). I know you are younger, but I wanted older men to know if they read this post.

The shot was "not that bad" just like my surgeon had said.

If your cancer stage is similar to mine, then you may have the same results. You will have sex again. The orgasm is different, but it's okay. It's just kinda different.

My wife was really happy. She said it was worth the wait. She struggled with depression after surgery, but she went on a low dose of Paxil to help herself cope better. This illness has made a difference in our lives, but we have grown closer because of it. Before surgery, our marriage was rocky. We changed our focus and worked at getting closer again, knowing how things can change quickly when health concerns are involved.

I can't say yet whether I will need to continue with the penile shots forever or whether I will regain normal erections within a year or two. If I do not regain erections, then I will need to think about an implant. I am patient and willing to give my recovery plenty of time.

Hang in there and remain hopeful. Staying calm as much as possible will help you the most after surgery.

@Scott

It is a challenge to make the necessary choice but something needs to be done at a young age. Everything about this from what I can see is a bell curve of chance - some men fall one side, some another and most in the middle. The one thing I have learned is it is important to do the things that adjust the odds - diet, fitness, medication, kegels, meditation, whatever it takes. You either own the disease or it owns you. I flapped like an old woman but still slogged through. I've got a huge mental battle ahead of me.

@Max

You are right but as I think you said yourself the outcome is the same but the side effects are different. Being informed is key.

@JS

Sounds like a similar story to me. I had bilateral nerve sparing. My first so called boner afterwards looked like a drunk left hand turn. Yikes! I've had some luck since but I'm learning the hard way, in every way, this is a long game.

@MK

I sense your frustations from this and other posts. You aren't alone. I suspect most men at the early stage and even 9 months is early have to work bloody hard. I tried viagra yesterday and although it sort of worked mostly I just got a headache and a WTF feeling. I don't think other people sharing their experiences are bragging, they are just glad they are having success and want to share. Everyone has a different set of issues. Mine are all in my head. Yours are elsewhere. I don't think there are "lucky" PCa survivors - just people with a different story to tell. I doubt ANYONE (excuse my bluntness) is banging hookers in three day coke fuelled marathons after PCa surgery. I'm not - I intend for that to happen on my death bed I lost an inch and can't rise up on demand - it takes work. My consultant, brilliant though he was otherwise, poo pooed even the idea of penile length loss. We all get lied to. I think the trick is to focus on the positive and work out ways to attack the negative or solve problems, day by day. I have heard that one can have surgery to get back some length for example. Keep fighting.

C

For the record, MK had a TURP procedure done 6 months before the RP. Another patient in the archives had a similar experience. I am thinking there was, and should be, warning of risk during radical prostatectomy when a TURP procedure was done prior. I do not know how a prior TURP affects nerve sparring robotic surgery, but any correlation would be significant enough to warrant a biopsy prior to a TURP procedure to eliminate the possibility of PC, making the TURP procedure totally futile.

Let's face it, why should a potential PC patient have a TURP procedure done with the possibility of RP looming in the very near future? Being a skeptic, I do know that some urologist are capable of performing a TURP, but are not qualified to perform DaVinci RP.

Do you get my meaning?

My 4th urologist informed me of the TURP procedure, but also informed me of DaVinci RP as well, even though he was not qualified to perform it. He also suggested I start HT to shrink my massive prostate, or I may have to have open surgery. Fortunately the antibios knocked it down to about 200 grams in weight by the time of the surgery and I had a really good Davinci surgeon.

No we are not bragging. I joke about "Stubby" because I have to take a grateful outlook on this, because life really really SUCKED before RP. I would never say it at the time, because I was blessed with so many great people and things during that time, but there was no sex life for us as long as I had a Staph infection in my prostate. And you can't even get a woodie with those frickin catheters sticking out of your business. 

So that was my choice... No sex life with the wife at all, or the possibility of a sex life someday if all went well. And if you have prostate cancer, it CAN kill you. It killed my neighbor. What Mrs. T would give to have Mr. T back sex life or no. She just sold the house this week. They raised and raced horses together. Now someone else will take over the ranch, including the horse head bronze mailbox and the horse themed outdoor lighting. She won't own a horse again. He won't be back.

PC is not to be taken lightly. If someone needs more than Active Surveillance, consider all options carefully. Maybe someday there will be even better procedures than DaVinci RP, and CK, and RT. But for now these are what available and ALL variables have to be weighed when deciding what procedures to employ.

Hi,

As you can see by the comments most results are favorable along with a not so favorable.  There are no guarantees so be prepared for the worse, hopefully it will be the opposite.  I had my prostate removed almost three years ago and I am back about 95% on the erection scale and about where I was before surgery on the leakage scale.  Older men sometimes leak a little after they pee, that's me.  My leakage has been handled by a lite pad I change once a day and it's not soaked when I remove it.  Overall I sleep well at night knowing the cancer was removed(I hope).  All forms of treatments have side effects, some early some later on after the proceedure was done.  Good luck and keep us informed.  Your best day will be when the take the catheter out, believe me.  Livin life six months at a time.............................

Dave 3+4

Here's the conclusion... I lift my glass to toast the old geezer who is having full on erections at 70 years old within four weeks after RP!! A bigger man than I am, at least in one sense of the word. 

But my point remains... why are guys getting TURP procedures done at great expense and risk when RP could be in their future? Why get it reemed out when it could possibly be removed within a few short months? I

Why are biopsies not scheduled before TURP? Then if there is no PC, or candidate for AS, THEN a TURP could be scheduled as a solution. Instead guys are getting TURP only to have their whole prostate removed anyway. 

Am I getting this through to you guys? Am I not explaining myself coherently?

MK... Please continue to detail every bit of your experience, for the sake of the guys that read this later. And I have to say again, my "Stubby" is nothing to brag about. I will be avoiding men's locker rooms in the future cuz like Ricky says "I have a lot of splainin to do!"

 I do wonder though.. Somebody said something about the RP taking a lot longer because of the previous TURP procedure. That would throw out a red flag for me. Why would that be? If the whole enchilada is taken out, why would the previous TURP affect the removal?

If I roto rootered a pipe, then took it out a couple months later, it wouldn't make any difference in the removal. Why does it make a difference with a urethra if the whole thing is coming out anyway. 

Think about this... The TURP very possibly removed a good deal of the urethra. If the RP took out EVEN MORE, then that would be a disaster. The TURP surgeon SHOULD reem only that part of the urethra that would be taken out in event of an RP... But does an inexperienced surgeon even take that into consideration? Does the area of urethra reemed in a TURP vary from person to person, or surgeon to surgeon?

C'mon you geniuses, figure this out for me. Is MK's problem with RP, or was TURP and RP a dangerous combination?

For guys in the future who are considering TURP with the possibility of RP looming in the future, we owe it to them to figure this out.