New Guy Reporting In

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