My Robotic Prostatectomy Experience

whubbs
whubbs Member Posts: 77
edited March 2014 in Prostate Cancer #1
I was diagnosed back in Aug with PCa, I'm 41, healthy, Gleason score of 3+3 and 3 of 12 biopsy cores positive.
I made the decision to go with the robotic prostatectomy, mainly due to the positive outcomes of rapid return erectile function and incontinence improvements being touted by most robotic surgeons, as well as the positive Oncological results mainly being expected in cases of early detection and organ confined.
The surgeon I selected was Dr. Ash Tewari at NY Presbyterian Hospital.
His specialty is in robotic prostatectomies, and he practices his own pioneered methods of nerve sparing techniques.
It is now 2 weeks after my surgery, I have lingering continence issues, which are easily and discreetly dealt with.
Erectile function has returned in part with the help of Levitra after only a week and a half, which is a remarkable outcome if you ask me!
Each day I see improvement in each aspect.
I am back to work (desk job), however on limited time as I do remain a bit tired and incision areas are right on the belt line, which doesnt bode well with some pants.
I have to say, the worst part of the entire experience was the 3T transrectal MRI, the biopsy and the catheter.
Finding the energy to get up out of the bed in the hospital and walk, with the annoying catheter in was horrible. Otherwise, pain was not too bad once it was controlled.
One thing I would suggest to anyone going for the robotic method, is to WALK as soon as you can. In Dr. Tewari's case, he wanted me up within hrs of the surgery.
At the time I had thought it crazy, but the longer I laid there, the worse the gas pains got. It got to a point where I wasn't getting up because I was weak from not eating and the gas pains were so bad. Walking is absolutely needed to relieve this pain.
I regret that I didn't get up and fight through the gas pain. It lingered for days and set me back.
One thing to keep in mind regarding prostatectomy, is that it can not be performed if you do radiation first. Once you do radiation (seeds for example), I was told you can not do any surgical method. It was always suggested to me that seeding be a secondary method unless you are older.
I welcome any questions from anyone who is considering a robotic prostatectomy, you can email me at [email protected] (please make subject 'prostatectomy')
I certainly recommend Dr. Tewari, he is an outstanding surgeon, whose priorities are in Oncology, Erectile function and continency return in the method of his own pioneered nerve sparing techniques.
I will continue to post to this thread on my outcome, but I am very pleased so far.
Good luck to everyone with the method you chose. Be sure to educate yourself as much as you can, and make the decision with all the questions answered.
-Wayne
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Comments

  • johndeer
    johndeer Member Posts: 17
    daVinci
    Wayne,
    I am very interested to read your experience with the robot. I have a date at City of Hope in Cal. of Feb 5 for the same procedure. I am happy for you in your outcome and proud of you for being so forthcoming in your experience. I'm sure my wife will kick me out of the hospital bed if I'm not willing. I am 54, with a gleason score of 3+3 and a PSA of 2.0. I too, think I am too young for the radiation ( I am considering proton beam). Dr Kawachi at City of Hope has done 325 + procedures since '03 and will do 377 this year. He is very concerned for my quality of life issues, so he will do his best ,I believe, to ensure the best result.
    God speed your recovery!
    Rick
  • whubbs
    whubbs Member Posts: 77
    Continued improvement
    3 week update:
    I am down to 1/3 of the 800mg of Ibuprofin I was taking twice a day, and continue the stool softener and Pepcid (needed to keep Ibuprofin from eating a hole in my stomach).
    If I stop Ibuprofin cold turkey I get some sharp pain so Doc recommended staying on for some
    more time and lower dosage.
    Incisions are healing pretty well, most of the steri-strips have fallen off, with the exeption of the larger incision below my navel, that continues to feel sensitive. There may be a hernia under there from the surgery, but can't tell yet.
    Incontinence is still a pretty mild issue, improving each day slowly.
    I've been able to sleep over 6 hrs without getting up, and today for the first time I was able to sleep from 10 to 5 and could have pushed it to 6 when I usually get up, with no leaks.
    For the most part, daily activity on my feet promotes leaks, but I do change the pad often and may go through 3 or 4 per day, just to insure dryness. Could probably go with one all day.
  • gcapaz
    gcapaz Member Posts: 4
    whubbs said:

    Continued improvement
    3 week update:
    I am down to 1/3 of the 800mg of Ibuprofin I was taking twice a day, and continue the stool softener and Pepcid (needed to keep Ibuprofin from eating a hole in my stomach).
    If I stop Ibuprofin cold turkey I get some sharp pain so Doc recommended staying on for some
    more time and lower dosage.
    Incisions are healing pretty well, most of the steri-strips have fallen off, with the exeption of the larger incision below my navel, that continues to feel sensitive. There may be a hernia under there from the surgery, but can't tell yet.
    Incontinence is still a pretty mild issue, improving each day slowly.
    I've been able to sleep over 6 hrs without getting up, and today for the first time I was able to sleep from 10 to 5 and could have pushed it to 6 when I usually get up, with no leaks.
    For the most part, daily activity on my feet promotes leaks, but I do change the pad often and may go through 3 or 4 per day, just to insure dryness. Could probably go with one all day.

    RPE
    Good to hear you are doing so well.
    I'm 5 days into recovery from my RPE (12-05-08).
    My first office visit is this friday and can't
    wait to get the cather removed.
    The only problem I seem to have is not moving
    my bowls as often as I use too, but then it's
    only been 5 days. I sit there and just pass gas
    and don't dare to push..lol
  • whubbs
    whubbs Member Posts: 77
    gcapaz said:

    RPE
    Good to hear you are doing so well.
    I'm 5 days into recovery from my RPE (12-05-08).
    My first office visit is this friday and can't
    wait to get the cather removed.
    The only problem I seem to have is not moving
    my bowls as often as I use too, but then it's
    only been 5 days. I sit there and just pass gas
    and don't dare to push..lol

    Catheter removal
    Same with me that first, most difficult week.
    Your not eating as much, so BM's will be less.
    It all gets SO much better once the catheter is out.
    Just be ready for some leakage, I was surprised by the lack of continence I had at first, but it comes back quick. Don't do any kegel exercises for 48 hours after catheter removal.
    Then do them as much as you can, they do help.
    Good luck on Friday!
  • whubbs
    whubbs Member Posts: 77
    whubbs said:

    Continued improvement
    3 week update:
    I am down to 1/3 of the 800mg of Ibuprofin I was taking twice a day, and continue the stool softener and Pepcid (needed to keep Ibuprofin from eating a hole in my stomach).
    If I stop Ibuprofin cold turkey I get some sharp pain so Doc recommended staying on for some
    more time and lower dosage.
    Incisions are healing pretty well, most of the steri-strips have fallen off, with the exeption of the larger incision below my navel, that continues to feel sensitive. There may be a hernia under there from the surgery, but can't tell yet.
    Incontinence is still a pretty mild issue, improving each day slowly.
    I've been able to sleep over 6 hrs without getting up, and today for the first time I was able to sleep from 10 to 5 and could have pushed it to 6 when I usually get up, with no leaks.
    For the most part, daily activity on my feet promotes leaks, but I do change the pad often and may go through 3 or 4 per day, just to insure dryness. Could probably go with one all day.

    5 Week update
    These 5 weeks have felt like 5 months.
    I've stopped taking Ibuprofen and most all of the other Meds.
    Still experiencing a little pain, but manageable.

    I'm growing frustrated with my doctors office, as I've left some messages regarding my continued prescription of Levitra use daily, as it causes my face to flush, pronounced heartbeat and panic attacks in my sleep. So, I've stopped taking that as well until they call. Anxiously awaiting their reply to decide what to do with that.
    That function is slow to return, but luckily not like playing billiards with rope.

    Incisions are healing well, though I rested a piece of wood against my stomach in Lowes the other night and opened one up, embarrassing situation, however I did have a trail of blood to help me find my abandoned cart after sealing up the leak.

    Speaking of leaks, return of continency is slow. Granted I have been remiss in doing Kegel exercises,(it is hard to remember to do these things), it is slowly getting better.

    Feeling great, and ready for the New Year!
    Feel free to email me if you'd like more info to ease some anxieties.
    Everyone have a Happy and Healthy Holiday and New Year!
  • acslife
    acslife Member Posts: 12
    Survivor
    I had the same surgery performed in July 2007 by Dr. Scott Miller at North Side Hospital in Atlanta, GA. He's a genius. I was ready to return to work after six weeks, but did so after eight. I am an Accountant, so sitting was not a problem. No beltline incision. Mine was left side above the naval. Only lingering side effect was incontinence. I came off the pads after 13 months, so expect a slow recovery there. Get the pads that fit like a brief. Walgreens has them. They were the most comfortable.
    Erections are 70 to 80 percent of presurgery, but I am 57 and Okay with the slight loss.
    I am very thankful and feel like a new kid from the womb.

    Best of luck
  • larry59
    larry59 Member Posts: 41
    prostatectomy
    Wayne congrats and I hope you got the cure. I've heard nothing but positive about the robotic surgery and about the aftereffects being pretty minor. Hope that's your case. Let me know how you are doing! And best of luck to you.
  • sonomablue
    sonomablue Member Posts: 2
    Robotic Da Vincvi
    Congrats to all of you. I just found this site tonight. I was diagnosed in October. After consulting with my local Urologist, and after reading the book "Dr. Patrick Walsh's Guide to Surviving Prostate Cancer, 2nd Ed, I received a referral to UCSF. I am scheduled to have the Da Vinci surgery in Feb. I will continue to read these threads. Nice to hear from people who have been, or are currently going through it. thanks for your information, suggestions, thoughts, etc.
  • socky
    socky Member Posts: 4

    Robotic Da Vincvi
    Congrats to all of you. I just found this site tonight. I was diagnosed in October. After consulting with my local Urologist, and after reading the book "Dr. Patrick Walsh's Guide to Surviving Prostate Cancer, 2nd Ed, I received a referral to UCSF. I am scheduled to have the Da Vinci surgery in Feb. I will continue to read these threads. Nice to hear from people who have been, or are currently going through it. thanks for your information, suggestions, thoughts, etc.

    4 weeks and feeling great
    I had the most amazing surgeon do my Robotic Da Vinci, his name is Dr. Premal Desai here in Los Angeles at Cedars Sinai. I had the surgery on December 1st and went back to work last week. The worst part was the gas and the catheter. Once the catheter was taken out I have had no problem with incontinence. I also have had normal erections and orgasams. Strange when nothing comes out!!. I try and do the kegel exercises everyday. The past four weeks seem to be a haze. I can't beleive I had cancer and now it is gone. I am so thankful to have a wonderful partner to help me thru this and incredible friends.
  • larry59
    larry59 Member Posts: 41
    socky said:

    4 weeks and feeling great
    I had the most amazing surgeon do my Robotic Da Vinci, his name is Dr. Premal Desai here in Los Angeles at Cedars Sinai. I had the surgery on December 1st and went back to work last week. The worst part was the gas and the catheter. Once the catheter was taken out I have had no problem with incontinence. I also have had normal erections and orgasams. Strange when nothing comes out!!. I try and do the kegel exercises everyday. The past four weeks seem to be a haze. I can't beleive I had cancer and now it is gone. I am so thankful to have a wonderful partner to help me thru this and incredible friends.

    Congratulations
    The recent postings give me great hope that you guys are in good shape prostate-wise. Keep up with the program and follow the docs' instructions. And don't let the docs boss you around too much about pain meds, if you need em, take em.
    Best of luck to all of you!!!!!!!!
  • g8rb8
    g8rb8 Member Posts: 18
    thank you
    I'm sitting here doing all kinds of reading and research online after getting my diagnosis on 12/23. I just came across this board and am really encouraged by all the frank discussion goign on. I'm 45 with a 3+3 Gleason, T2a (who knew all these terms before?)

    Thank you for sharing your experiences with the robotic procedure. I'm working with a surgeon at a university who sounds like he's doing some of the same nerve-sparing techniques you describe.

    Just seeing words from someone who's been through this and is working through it so quickly helps ease some of my fears. I guess that won't completely go awawy, but information, education and prayer are critically important. We're meeting on Jan 6 to start talking through the treatment options and the robotic procedure sounds like the best option so far....

    I'm looking forward to reading and posting more on here as things progress.
  • whubbs
    whubbs Member Posts: 77
    g8rb8 said:

    thank you
    I'm sitting here doing all kinds of reading and research online after getting my diagnosis on 12/23. I just came across this board and am really encouraged by all the frank discussion goign on. I'm 45 with a 3+3 Gleason, T2a (who knew all these terms before?)

    Thank you for sharing your experiences with the robotic procedure. I'm working with a surgeon at a university who sounds like he's doing some of the same nerve-sparing techniques you describe.

    Just seeing words from someone who's been through this and is working through it so quickly helps ease some of my fears. I guess that won't completely go awawy, but information, education and prayer are critically important. We're meeting on Jan 6 to start talking through the treatment options and the robotic procedure sounds like the best option so far....

    I'm looking forward to reading and posting more on here as things progress.

    So many similar situations - 6 weeks now.
    g8rb8- Your gleason and stage are the same as mine were. Glad to hear that the biopsy suggests organ confined, these are good indicators.

    I didn't expect so many similar stories as mine, especially the age group of men in my situation, guys in their youthful forties, completely blind-sided by this.
    I'm particularly thankful for a doctor I had a few years ago, Dr. Arnold Winokur, he was my GP at the time, he was a great doctor and very pleasant and nice man. We've since lost him to his own cancer battle, however thanks to his recommendation to set my baseline PSA at the age of 38-39, I wouldn't have caught the prostate cancer when I did, at a stage when it is most treatable. He's just as responsible for saving my life as the surgeon who removed it.

    As far as recovery, after 6 weeks I'm feeling mostly back to myself again.
    I've been back to work, desk job designing aircraft, not strenuous at all, for a few weeks. Incisions are healed and no longer are irritated by the belt line.
    Though I do have a remaining hernia situation caused by the surgery that needs attention as well as a couple sutures that are actually sticking out that need to be trimmed off.

    The continency and erectile issues are tough, and if you approach it with a sense of humor, it helps ease the anxiety of such dignity-striping issues. My wife is very understanding and supportive, this alone is one of the most important aspects of recovery- a loving, supportive partner/family to get you through the tough times.


    This board is so important too. I learned a lot from it before seeing the doctors, I had the right questions to ask BEFORE I went, you're just a number to them unfortunately.
    Feel free to email me at the email address I posted earlier, I've heard from some men who have been very anxious about the surgery and I feel obligated to help by discussing it openly and honestly. Not something appropriate for the board, but I'll let you know what I experienced right down to the catheter/drain issues - continency/erectile issues.
    I know I would have felt so much better, if not so much more PREPARED, had I heard the candid experiences that someone else had.

    Good luck everyone and Happy New Year!
    May 2009 bring us all health and happiness!
  • rocky24
    rocky24 Member Posts: 1
    Tewari/Catherterless option
    Hi Whubbs ,Hope you are well..Did Dr.Tewari offer catheterless recovery option that he has tested?
  • whubbs
    whubbs Member Posts: 77
    rocky24 said:

    Tewari/Catherterless option
    Hi Whubbs ,Hope you are well..Did Dr.Tewari offer catheterless recovery option that he has tested?

    Catheter or not to catheter
    Yes, Dr. Tewari suggested that if it were possible he would.
    This was something he would determine once the surgery was underway.
    I understood it that the surgery would still involve the catheter, but may be removed after surgery if it were anatomically feasible. (meaning if the sphincter at the base of the bladder wasn't interrupted, that they could essentially remove the catheter)
    In hindsight, with all of the immediate bladder spasms, pain, etc. it helped to not have to deal with the incontinency issues until a week later.
    Week with the catheter was very uncomfortable though.
    I'm not sure which way I'd go if I truly had the choice.
  • whubbs
    whubbs Member Posts: 77
    whubbs said:

    So many similar situations - 6 weeks now.
    g8rb8- Your gleason and stage are the same as mine were. Glad to hear that the biopsy suggests organ confined, these are good indicators.

    I didn't expect so many similar stories as mine, especially the age group of men in my situation, guys in their youthful forties, completely blind-sided by this.
    I'm particularly thankful for a doctor I had a few years ago, Dr. Arnold Winokur, he was my GP at the time, he was a great doctor and very pleasant and nice man. We've since lost him to his own cancer battle, however thanks to his recommendation to set my baseline PSA at the age of 38-39, I wouldn't have caught the prostate cancer when I did, at a stage when it is most treatable. He's just as responsible for saving my life as the surgeon who removed it.

    As far as recovery, after 6 weeks I'm feeling mostly back to myself again.
    I've been back to work, desk job designing aircraft, not strenuous at all, for a few weeks. Incisions are healed and no longer are irritated by the belt line.
    Though I do have a remaining hernia situation caused by the surgery that needs attention as well as a couple sutures that are actually sticking out that need to be trimmed off.

    The continency and erectile issues are tough, and if you approach it with a sense of humor, it helps ease the anxiety of such dignity-striping issues. My wife is very understanding and supportive, this alone is one of the most important aspects of recovery- a loving, supportive partner/family to get you through the tough times.


    This board is so important too. I learned a lot from it before seeing the doctors, I had the right questions to ask BEFORE I went, you're just a number to them unfortunately.
    Feel free to email me at the email address I posted earlier, I've heard from some men who have been very anxious about the surgery and I feel obligated to help by discussing it openly and honestly. Not something appropriate for the board, but I'll let you know what I experienced right down to the catheter/drain issues - continency/erectile issues.
    I know I would have felt so much better, if not so much more PREPARED, had I heard the candid experiences that someone else had.

    Good luck everyone and Happy New Year!
    May 2009 bring us all health and happiness!

    7 Week update
    Well, I've had my PSA checked..... NON DETECTABLE... exactly what I wanted to hear!!
    Things are going pretty well, Dr. Tewari is happy with my outcome so far.
    I'll need a little fix on a herniated muscle in a couple months time, but otherwise he says I'm right on track.
    I was given a bladder control medication to help with the stress incontinence.
    We'll see how that works.
    Otherwise, I'm now off of any ED medications, mostly due to the fact that I had reactions to both. So far, so good with that. Not perfect, but working at it ;)

    A resounding PHEW! is what I experienced standing outside the hospital last night after my appointment in Manhattan. I wish that feeling to everyone here!!
    I only hope that number remains at nil.
  • whubbs
    whubbs Member Posts: 77
    whubbs said:

    Catheter or not to catheter
    Yes, Dr. Tewari suggested that if it were possible he would.
    This was something he would determine once the surgery was underway.
    I understood it that the surgery would still involve the catheter, but may be removed after surgery if it were anatomically feasible. (meaning if the sphincter at the base of the bladder wasn't interrupted, that they could essentially remove the catheter)
    In hindsight, with all of the immediate bladder spasms, pain, etc. it helped to not have to deal with the incontinency issues until a week later.
    Week with the catheter was very uncomfortable though.
    I'm not sure which way I'd go if I truly had the choice.

    7 week update
    Well, I've had my PSA checked..... NON DETECTABLE... exactly what I wanted to hear!!
    Things are going pretty well, Dr. Tewari is happy with my outcome so far.
    I'll need a little fix on a herniated muscle in a couple months time, but otherwise he says I'm right on track.
    I was given a bladder control medication to help with the stress incontinence.
    We'll see how that works.
    Otherwise, I'm now off of any ED medications, mostly due to the fact that I had reactions to both. So far, so good with that. Not perfect, but working at it ;)

    A resounding PHEW! is what I experienced standing outside the hospital last night after my appointment in Manhattan. I wish that feeling to everyone here!!
    I only hope that number remains at nil.
  • whubbs
    whubbs Member Posts: 77
    whubbs said:

    7 week update
    Well, I've had my PSA checked..... NON DETECTABLE... exactly what I wanted to hear!!
    Things are going pretty well, Dr. Tewari is happy with my outcome so far.
    I'll need a little fix on a herniated muscle in a couple months time, but otherwise he says I'm right on track.
    I was given a bladder control medication to help with the stress incontinence.
    We'll see how that works.
    Otherwise, I'm now off of any ED medications, mostly due to the fact that I had reactions to both. So far, so good with that. Not perfect, but working at it ;)

    A resounding PHEW! is what I experienced standing outside the hospital last night after my appointment in Manhattan. I wish that feeling to everyone here!!
    I only hope that number remains at nil.

    8-9 week update
    If you had asked me a month ago how I'd be feeling at 2 months, I wouldn't have expected to be reporting such improvements by now.
    Incisions feel fine now.
    I'm back to running around, wrestling with the kids and not limited in any way.
    Urinary control is inching in improvements. Now just deal with stress incontinence (when I cough, sneeze, get angry, etc. there is a small amount of leakage), without the help of the med's the doc suggested. I just couldn't bring myself to take any more pills.
    ED is a limited problem, close enough to normal and improving every day, without pills.
    Quality of life has returned to what I consider 100%.
    Occasionally a little pain from the area where the prostate was located, doc says due to nerves 'waking up', I love when they try to dumb it down for us.

    I'd be happy to share any further details if you email me @ [email protected]
    All the best to everyone, I hope your outcomes are picture perfect!
  • g8rb8
    g8rb8 Member Posts: 18
    whubbs said:

    8-9 week update
    If you had asked me a month ago how I'd be feeling at 2 months, I wouldn't have expected to be reporting such improvements by now.
    Incisions feel fine now.
    I'm back to running around, wrestling with the kids and not limited in any way.
    Urinary control is inching in improvements. Now just deal with stress incontinence (when I cough, sneeze, get angry, etc. there is a small amount of leakage), without the help of the med's the doc suggested. I just couldn't bring myself to take any more pills.
    ED is a limited problem, close enough to normal and improving every day, without pills.
    Quality of life has returned to what I consider 100%.
    Occasionally a little pain from the area where the prostate was located, doc says due to nerves 'waking up', I love when they try to dumb it down for us.

    I'd be happy to share any further details if you email me @ [email protected]
    All the best to everyone, I hope your outcomes are picture perfect!

    That's great news. Hearing
    That's great news. Hearing stories like yours and others on here has helped settle my nerves and prepare questions and get my head ready for the procedure in a couple of weeks. Hope the recovery continues as it has for you.
  • Roni123
    Roni123 Member Posts: 1

    Robotic Da Vincvi
    Congrats to all of you. I just found this site tonight. I was diagnosed in October. After consulting with my local Urologist, and after reading the book "Dr. Patrick Walsh's Guide to Surviving Prostate Cancer, 2nd Ed, I received a referral to UCSF. I am scheduled to have the Da Vinci surgery in Feb. I will continue to read these threads. Nice to hear from people who have been, or are currently going through it. thanks for your information, suggestions, thoughts, etc.

    Robotic Da Vinci ?
    Hi ,

    I wanna ask about Dr.Patrick Walsh , is he a doctor at John's Hopkins ? Does he do the Robotic Da Vinci surgery ? Can you please tell me more about the outcome of such a surgery?
    Where is UCSF at ?

    Thanks ,
  • whubbs
    whubbs Member Posts: 77
    Roni123 said:

    Robotic Da Vinci ?
    Hi ,

    I wanna ask about Dr.Patrick Walsh , is he a doctor at John's Hopkins ? Does he do the Robotic Da Vinci surgery ? Can you please tell me more about the outcome of such a surgery?
    Where is UCSF at ?

    Thanks ,

    Da Vinci
    Yes, Dr. Walsh is a world leader in robotic prostatectomies at Johns Hopkins.
    He is published on the subject and has helped pioneer the nerve sparing procedure.
    I sought the help of Dr. Ash Tewari in NYC. Easily on par with Dr. Walsh in terms of nerve sparing abilities. He performs 3 per day year round.
    Regarding the outcome of the surgery, the best I can tell you is my own story, which I've tried to document the best I could here.
    Feel free to email me at [email protected] and I'd be happy to share my experiences and issues more in depth.
    Good luck and stay positive!