Robot assisted Radical prostatectomy, My findings a month in

[ambiguous (imported)]

On the 31st of December2021 I underwent a RARP (Robot assisted radical prostatectomy) procedure under our national health service (Costs privately would have been about $20 K for those in US without insurance) after being diagnosed with localised early stage cancer,

The operation went well and I worked it out that I was out for about 3 hours.

Knowing that I would only see the surgeon the following day I wished the staff a happy new year before being knocked out

Post op probably the first 2 weeks I was a bit tender and my regular body functions so far as the bathroom went were a bit screwed up.

4 days after the procedure I was pretty badly constipated but they do provide medications to sort this out and I felt the need to pee fairly often.

This is probably due to the procedure making certain bits of me tender.

You are discharged with a catheter fitted and a leg and bedside bag to cope with the urine whilst the urethra heals up,

Expect some blood in the urine Ros'e wine coloured is OK but anything darker for prolonged periods isn't. (I had a baddish bleed that cleared up pretty quickly (about 4 days post op) due to swelling subsiding and internal scabs falling off also some blood clots may be passed, This is normal.

This is usually removed between 5 to 10 days after (Mine was removed on day 6).

Fortunately I did not suffer from the really bad bladder leak that some folks experience, (There is a YouTube of a guy who was pretty incontinent and needed a diaper for a few months after and even a year on he is about where I am now) Mileage will vary on this but I like to keep myself in pretty good shape and this might have helped a lot.

I do suffer a little from what they call Stress leakage caused when you cough or sneeze or some physical activities will cause a small amount to dribble out (Usually a few drops) but this will improve (Currently only 20 odd days since catheter removal). This is due to the fact that the sphincter in the base of your bladder is close to where all the incisions are made

The bladder leak problems will get a whole lot better and may return to normal with the passage of time, at the moment I can get through the day without wearing a pad although I wear one down the gym.

The biopsy indicated that the cancer was contained in the prostate itself so hopefully problem solved.

The good bit is I can remain on my testosterone replacement therapy (Other treatments like "Watchful waiting and some radioactive pellet procedures quite often require either going on anti androgens or in my case quitting TRT).

My dick has lost about 3/4" off its length due to the procedure sort of pulling it inside my body a bit. (This may return to normal as things settle down)

Also as the procedure quite often damages the nerves that control blood flow to the penis I have not had an erection this year. In fact it is loosing quite a bit of girth as a result.

There are treatments for this such as Cialis vacuum pumps, cock rings etc that may help but the combination of my age and being on synthetic testosterone are against me on this.

Some folks do gain functionality again but this is usually measured in months or years.

TBH I'm not all that bothered and quite like my little dinky dick, I can still get pleasure with playing with it and that's all that counts.

I hope this may have helped some folks out there and I would of course urge folks to get their PSA test done every now and then (Especially for 50+ age group)

[Cseriess (imported)]

Hi ambiguous. Glad to hear everything went so well! That's great news about the cancer being contained. As surgical techniques improve, I hope this option will be more available and more accepted. When I was just wanting the what I consider a ticking time bomb, removed, it was really presented as a last option. I think you are correct about looking after yourself. Kegels should be a daily regime .

[Valery_V (imported)]

I wish you a full recovery!

I admire the art of surgeons and modern medical technologies!

[ambiguous (imported)]

I wish you a full recovery!

I admire the art of surgeons and modern medical technologies!

Thanks

I will know a lot more on 18th Feb when I have a de-brief but a recent letter from my urologist indicates its cleared up,

Myself well I'm pretty much back to normal all the scars have healed up and and taking it steady down the gym now.

[ambiguous (imported)]

Hi ambiguous. Glad to hear everything went so well! That's great news about the cancer being contained. As surgical techniques improve, I hope this option will be more available and more accepted. When I was just wanting the what I consider a ticking time bomb, removed, it was really presented as a last option. I think you are correct about looking after yourself. Kegels should be a daily regime .

It was one of those cases where having no nuts can extend your life span.

Had I have not been on testosterone therapy I would not have had the blood test that raised the initial alarm.

Folks say that being on TRT extends your risk of prostate cancer but I am inclined to think its because our bloods are frequently monitored then more cases come to light.

The medics give you a pamphlet on pelvic floor exercises and other useful stuff to be doing pre-op.

Also you get a lot of useful stuff given to you from prostate cancer UK like pamphlets and contact details.

[Cseriess (imported)]

Because I am so high risk, I was getting psa tests every 3months. A spike resulted in biopsy. Before the last biopsy I was told they expected to find cancer with a 95% certainty. I was given information to look at about options. My urologist's nurse called saying my results were in and my urologist wanted to see me. So in I went expecting to start on the journey. When she walked in, the first thing she said was "Hi, great news". I thought that meant it was still contained in my prostate. She went on to say the biopsy showed no signs of cancer. When I asked why it had gone from 95% a sure thing to nothing. She explained they weren't really sure why psa was indicating one thing and biopsy showing nothing. That's when I asked why we didn't just take it out. Absolutely not an option! Very frustrating!

[ambiguous (imported)]

Because I am so high risk, I was getting psa tests every 3months. A spike resulted in biopsy. Before the last biopsy I was told they expected to find cancer with a 95% certainty. I was given information to look at about options. My urologist's nurse called saying my results were in and my urologist wanted to see me. So in I went expecting to start on the journey. When she walked in, the first thing she said was "Hi, great news". I thought that meant it was still contained in my prostate. She went on to say the biopsy showed no signs of cancer. When I asked why it had gone from 95% a sure thing to nothing. She explained they weren't really sure why psa was indicating one thing and biopsy showing nothing. That's when I asked why we didn't just take it out. Absolutely not an option! Very frustrating!

In my case the TRT clinic raised the alarm.

My PSA was recorded as about 4.1, The test was later repeated and it had risen to 4.7.

Initially my general partitioner was going to dismiss this as prostatitis and was quite prepared to leave it at that.

However the consultant from the TRT clinic and myself pushed for a repeat blood test 6 weeks later.

The blood test showed it had risen again to 5.4 and on the weight of that another blood test and biopsy were done.

By which time my PSA had spiked to 15.1.

Over here we do a 46 point pin matrix biopsy and in my case 7 samples were flagged 5 samples of low risk with another 2 of these 46 samples showing a moderate risk (Gleason 3 +4) of it spreading if left alone.

I hope this helps you to compare notes

[Cseriess (imported)]

My psa was steady between 4and 5 for a while, then started to climb to 18, which resulted in the 95% chance of pc prediction.

[ambiguous (imported)]

My psa was steady between 4and 5 for a while, then started to climb to 18, which resulted in the 95% chance of pc prediction.

It might be worth a repeat blood test to see where your PSA is heading 18 would put it in the suspicious range.

[depiladobcn-2 (imported)]

I was operated on in March 2020 with the Da Vinci robot. Since then I continue with blood tests every three months. At the moment everything is going well (PSA=0.04). Physical recovery went well but erectile dysfunction is still ongoing. They say to be patient but....