On the fence about my treatment choice.

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  • Redsoxx1918
    Redsoxx1918 Member Posts: 14 Member
    #22

    Well, I had my Da Vinci robotic surgery Thursday. Finished up my surgery around 3:15 and they sent me home by 7:30. I'm on day four of recovery. Getting better each day. Needed the OxyContin just for the first 24 hours and then tossed the rest. Tylenol for two days after and now I'm pain medication free. Been taking the laxatives they prescribed and now having bowel movements, so that's good. I was constipated the first couple of days. My gut is still sore and this catheter bag really sucks! I have an appt this coming Thursday to see my doctor and get it removed. I'm excited about that. My surgeon said that it went well and that he feels he got it all and that he was able to do a bilateral nerve spare. So, I know it'll be a long journey but I have hope that I can recover function in time.

  • centralPA
    centralPA Member Posts: 322 Member
    #23

    Wow. Didn't even get a relaxing overnight stay being woken up every ten minutes by a nurse?

    Glad to hear the surgery is well and done, enjoy having that catheter out this week. Full speed ahead!

  • Redsoxx1918
    Redsoxx1918 Member Posts: 14 Member
    #24
    https://csn.cancer.org/discussion/comment/1711267#Comment_1711267

    Right? lol. It was a little brutal to climb into the car for the hour and a half ride down from Boston but it was nice to be in my own bed. And my wife is an excellent nurse. I guess the next thing to pray about will be my post op PSA test. Hopefully it shows as undetectable and I can go about my business healing and trying to regain all of my functions. I'm on day four and already feeling a lot better so, looking back, I don't know if this is any worse than going through 28 radiation treatments or getting radioactive seeds out in me and having to go on ADT treatments. Time will tell. I will try to keep you guys updated on my journey. Hang in there everyone. God bless all of you!

  • Old Salt
    Old Salt Member Posts: 1,505 Member
    #25

    You decided on therapy and it's looking as good as can be hoped for. Congratulations!

    I believe that the first meaningful (ultrasensitive) PSA test should be done (about) six weeks after surgery.

  • Redsoxx1918
    Redsoxx1918 Member Posts: 14 Member
    #26

    Ok....it's early morning but I decided to post and record updates on my recovery. Something pretty exciting happened during the night. I was awakened, twice, by some pain in my penis and realized, both times, that I was having partial nocturnal erections. Nothing spectacular going on but it was about twice the size it has been since surgery and semi hard. It was a little painful because I still have a catheter. There is hope for the future.

  • Old Salt
    Old Salt Member Posts: 1,505 Member
    #27

    There's hope for the future.

    Yes, there is...

  • lighterwood67
    lighterwood67 Member Posts: 393 Member
    edited December 2023 #28

    Make sure you get a copy of the post RP biopsy. In some cases, it can paint a picture of things to come or not to come. Sounds like you are doing great so far. Best of luck on your journey.

  • DaveTX
    DaveTX Member Posts: 19 Member
    #29
    https://csn.cancer.org/discussion/comment/1711270#Comment_1711270

    We're "RP Twins"; had my surgery on Thursday as well. I'm glad you posted the update, other than spending 1 night in the hospital, I'm tracking about the same as you are. I needed 1 Oxy after the first walk around the nurses station and that was it. I requested another Oxy for the ride home more as a preventative measure, and glad I did. Houston is like Boston, can't get anywhere fast. The normal 45 ride took 1:40 due to Friday rush hour traffic. Now just on stool softener and laxative and thankfully didn't experience any constipation. Been drinking lots of water Like you, I'm moving around much better now and considered the first time I was able to get out of bed by myself a major accomplishment! You beat me on the catheter removal, my pull will be on Friday.

    Do keep posting updates to this thread and I'll do the same. You'll be in my prayers.

  • Redsoxx1918
    Redsoxx1918 Member Posts: 14 Member
    #30

    Will do, brother. My prayers are with you as well.

  • Redsoxx1918
    Redsoxx1918 Member Posts: 14 Member
    #31
    https://csn.cancer.org/discussion/comment/1711342#Comment_1711342

    Ok, had the catheter out yesterday. Went pretty smoothly and I literally have zero incontinence. I'm using a thin pad in my boxers and will wear a depends for a while, at night, just in case. I think I had a couple drops yesterday on the way home but that was about it. I'm pretty happy about that. I did kegels for about a month before surgery so maybe that helped.

    They sent a prescription for Cialis to my local pharmacy that I'll be picking up in a little while. They said they want me to take half a pill twice per week. I've also read that some doctors prescribe a quarter pill daily. Regular therapeutic Cialis seems to make a big difference in reviving erectile function, from what I've read. Anyone out there have any thought on that?

    As far as my incisions...most look pretty good. The big incision above my belly button is a little swollen. It's not red or anything, just a little swollen but I'm hoping that's normal. I've been doing a lot of activity so maybe I aggravated it a little. The small incision on my left by my belt line appears to have become infected. It's right at my belt line and my pants were rubbing on it. There is some puss and there's a red ring around it. The red ring has gotten bigger since yesterday. I'm going back and forth with a nurse practitioner at the urology dept, through the patient portal, trying to get them to call in an antibiotic in case it continues to get worse over the weekend. They looked at it yesterday and said to let them know if it got worse. Well, it got worse but they are being very resistant with prescribing an antibiotic.

    Erectile function....eh....not expecting much at this point and it has been a little traumatic at how small it appears...lol. I know the penis takes a big hit with this surgery. I did get a little more nighttime nocturnal erection activity last night. Not much but a little bit of blood flow in there. That gives me hope for the future. Let's hope the Cialis treatment works over time.

    On a bright note....my urine stream is stronger than it's been in many years! No more prostate choking my urethra.

    I think I've been overdoing it a little so I'm trying to rest today. Supposed to be a nice day tomorrow so I'm planning on going for a nice long walk in the sunshine. I'm still waiting on my pathology report.

  • centralPA
    centralPA Member Posts: 322 Member
    #32

    Regarding the overdoing it, definitely patience will win the day here. Treat yourself kindly!

  • lighterwood67
    lighterwood67 Member Posts: 393 Member
    edited December 2023 #33

    Sounds like you are doing great. My surgeon had me on sildenafil (viagra) 30 to 45 days prior to my RP. He said to look at it as fertilizing the area. Anyway, best of luck on your journey.

  • Redsoxx1918
    Redsoxx1918 Member Posts: 14 Member
    #34
    https://csn.cancer.org/discussion/comment/1711331#Comment_1711331

    Just saw the post RP biopsy report. Apparently the intraductal carcinoma finding and high decipher score were correct in indicating higher grade cancer lurking. I had two biopsies, including a targeted biopsy and they didn't indicate anything higher than Gleason 6. After the RP, biopsy showed Gleason 7. It also showed focal extraprostatic extension. But....clear margins and clear lymph nodes. This worries me. I don't have my PSA test until Jan 15 and appt with my surgeon on Jan 17. I can't wait that long to talk to him. I'm going to try to have him call me before that. I'll post a screen shot of my post RP biopsy. Can focal extraprostatic extension mean it was bulging out but clear margins means he got it all???

    IMG_8102.jpeg


  • lighterwood67
    lighterwood67 Member Posts: 393 Member
    edited December 2023 #35

    Make sure you take your report with you when see your surgeon. If you like comparing stuff. Here is a copy of my biopsies performed after RP:

    Surgical Pathology Report * Final Report * 

    Final Pathologic Diagnosis 

    1. ANTERIOR BLADDER NECK MARGIN, EXCISION: 

    BENIGN BLADDER NECK TISSUE. 

    2. ANTERIOR PROSTATIC FAT, EXCISION: 

    BENIGN FIBROADIPOSE TISSUE. 

    3. LEFT OBTURATOR LYMPH NODES, EXCISION: 

    THREE LYMPH NODES NEGATIVE FOR METASTATIC CARCINOMA (0/3). 

    4. LEFT DEEP PELVIC LYMPH NODES, EXCISION: 

    TWO LYMPH NODES NEGATIVE FOR METASTATIC CARCINOMA (0/2). 

    5. RIGHT OBTURATOR LYMPH NODES, EXCISION: 

    THREE LYMPH NODES NEGATIVE FOR METASTATIC CARCINOMA (0/3). 

    6. RIGHT DEEP PELVIC LYMPH NODES, EXCISION: 

    BENIGN FIBROADIPOSE TISSUE. 

    7. URETHRAL MARGIN, EXCISION: 

    BENIGN URETHRAL/PERIURETHRAL TISSUE. 

    8. PROSTATE AND SEMINAL VESICLES, RADICAL PROSTATECTOMY: 

    ADENOCARCINOMA, GLEASON SCORE 4 + 3 = 7 (GRADE GROUP 3), WITH MUCINOUS DIFFERENTIATION. 

    PERCENT OF CARCINOMA THAT IS PATTERN 4 = 90%. 

    PATHOLOGIC STAGE (AJCC 8TH ED, 2017): pT2 pNO. SEE SYNOPTIC SUMMARY. 

    Synoptic Summary 

    PROSTATE CANCER CASE SUMMARY 

    PROCEDURE: 

    Radical prostatectomy 

    PROSTATE SIZE: 

    Size: 4.4 cm, x 3.7 cm, x 3.6 cm 

    PROSTATE WEIGHT: 

    Weight: 32 g 

    LYMPH NODE SAMPLING: 

    Pelvic lymph node dissection 

    HISTOLOGIC TYPE: 

    Adenocarcinoma (acinar, not otherwise specified) 

    HISTOLOGIC GRADE: 

    Primary Gleason Pattern: Grade 4 Secondary Gleason Pattern: Grade 3 Total Gleason Score: 7 

    TUMOR QUANTITATION: 

    Proportion (percent) of prostatic tissue involved by tumor: 15% 

    TUMOR LATERALITY: 

    Bilateral involvement 

    EXTRAPROSTATIC EXTENSION: 

    Not identified 

    SEMINAL VESICLE INVASION: 

    Not identified 

    MARGINS: 

    Margins negative for invasive carcinoma 

    TREATMENT EFFECT ON CARCINOMA: 

    History of treatment unknown 

    LYMPH-VASCULAR INVASION: 

    Not identified 

    LYMPH NODES: 

    Number of regional lymph nodes examined: 8 

    Number of regional lymph nodes involved - none identified 

    PATHOLOGIC STAGING: 

    PRIMARY TUMOR: pT2 

    REGIONAL LYMPH NODES: pNO DISTANT METASTASIS: Not applicable 

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