New Member / First Post

Dale, Their is a new surgical technique that almost eliminates incontinence especially for a small prostate. The technique which not all Surgeon’s are trained in, the Surgeon is able to spare what’s called the puboprostatic ligament during robotic prostatectomy. In essence my Surgeon said this technique keeps the continence mechanism intact and it also helps maintain urethral length. A longer urethra allows for more control in the release of urine reducing the likelihood of incontinence and also the Puboprostatic ligament provides support to the urethra in keeping it in its position. He further does Retzius sparing of the tissue between the bladder and the prostate which further helps with continence. Another benefit of sparing the Puboprostatic ligament is the less likelihood the patient will see any reduction in their penile size that many patients report by either perception of it or a slight amount as its drawn in. 

He explained that during Surgery I am certainly not upside down but he will operate through the Davinci robotic system as if I were upside down during the surgery. He said typically the surgeon operates from below in between the persons raised legs. He said in this procedure he operates from behind the persons head with the patient still basically lying flat. He also operates using the single port Davinci robotic system with just the one small incision above the belly button and faster healing with less blood loss. The multi port I believe leaves three incisions to heal under the belly button. Many surgeons are not familiar in the use of this new approach and this is how he is able to spare the ligament which he said is a significant advancement in prostate surgery.

I was immediately continent upon removal of the catheter and no loss in penile size and doing pretty darn good on the erection side with a dose of viagra beforehand.

I would certainly research this technique and try to find an experienced surgeon doing this. You don’t want a newbie.

Best of luck

Yes my penis is shorter than it used to be. And yes, you have to be aware of that when getting ready to pee and to make sure you dont get your clothes wet. It seems like it's not the automatic process that it used to be, and that you have to have heightened awareness of what you're doing to avoid making a mess.

Hi,

I had PNI when I had my Prostate removed 10 years ago. My Urologist did five small incisions, 2 on each side and one at the belly button, robotically. The Urologist was sitting at a video monitor controlling the robotic arms a short distance away. My legs were inverted above my head during surgery because I had the blisters on my shoulders to prove it. I have heard that the newer one hole incision gives you a better chance of not having incontinence/ED issues vs the 5 hole. To be honest with you I don’t really notice my member being that much shorter than before. I do wear tightly whiteys and found out if I went a size larger it gives my member a little more room to hang and not like a scared turtle. The way I see it, if I am cancer free then the shorter member length is OK with me.

Dave 3+4

Hi,

Usually if cancer is left behind it is a smaller area to radiate. Your doctor team should catch it early via PSA/imagining, I would think it would be more of a spot treatment.
Dave 3+4