FrankTalk.org

Hey fellows,
One week out from non-nerve sparing Radical Robotic Prostatectomy/Catheter Out---staying drier than I expected.-- I am a 67 YO retired tooth doctor.
I had an aggressive Gleason 8 Ca with 6 of 12 biopsy cores positive. PSA Velocity >2 (3 to 5.2)
Urologist looked me in the eye and said, "if I try to save your nerves I am afraid I will leave a positive surgial margin. And I do not want to tell you when the Post-Op Patholgy Report comes back that I left some cancer"
So , I said take them.
Surgery went well/ no positive margins/ no nodes involved/ and seminal vesicles were clear.
So, "maybe" we got it all and I won't have Radiation and Hormone Therapy in my future.
I have fought ED for the past 10 years because of BP meds, but Oral ED meds were successful for me.
Am I right when I assume that oral Ed meds will not help me now with erections? I know they help to revitalize the general area.
My ED challenges will be greater than a "nerve sparing" patient I would assume.
Can I expect success with Tri-mix?
My Uro tends to take things a step at a time, which is fine, so we have not a frank discussion on this subject yet. He just said," things can be done".
I would like to be a little better informed when I meet with him in a month for my first post-op PSA,
so I will look forward to any comments.
All in all , a bad month ---except for my old school Auburn being # 1
thanks, michael

Welcome to FrankTalk Michael. You are at one of the most informative sites on the web. Lots of data to research here....and they have pictures too....lol Another good website is www.healingwell.com. They discuss all things prostate, and some very informed guys there.

You and I are in a very similar situation. I'm ten years younger, but found out in May, 2010 that I also had PCa. Mine was a gleason 9 with a psa of only 2.64. I also lost both nerves for the exact same reasons you mention. Also had negative EPE, nodes, and seminal vesicles, so I feel very blessed to have had organ contained cancer, considering where I started.

Ever since the surgery, I have been totally ED. Tried the pump, caverject shots, and most recently, trimix. Met with my oncologist this morning. He asked me how the ED was going. I told him it wasn't, and gave him a little background. He set me up with a Urological sexual specialist, who, after reviewing my stats, and doing a physical exam, told me that if he ever had a perfect candidate for an implant, I was it. I replied; "I'll bet you tell that to all the girls." After everyone stopped literally LTAO, he continued with the pro's and con's. Currently, I am scheduled for implant surgery the end of November, and I'm a tad nervous. So far, 2010 has been a wild and ugly year. But, at least I'm here to talk about it, laugh about it, and cry about it...

Sounds like you're in a good spot except for the G8. You'll be fine.

k

Thanks for the reply "k",
I guess you're post-op PSAs have been good. & Good luck on the Surgery!
My post-op Path was actually much better than expected, but I am a little "suspect" because it was a done by a local Lab and my original biopsy was by Bostwick Labs.
The local guy graded me a Gleason7 (4+3) with no mention of Gleason 8 (Gleason 8 was only 2% of one core at Bostwick) and a Tumor volume of 20% when we expected much more)
If I had known I was Gleason 7 with a 20% Tumor volume would we have attempted a "nerve sparing" surgery?? probably not with 6 of 12 positive cores---
"Second guessing" is an exercise in futility at this stage. Maybe someday better pre-surgery imaging and testing will make the decisions easier and more accurate for guys like us.

Michael

Michael:

Welcome to FT. This is a great site and you will find a lot of assistance and support here. You are so close to your surgery- Wow that you are doing this well. I am also a PCA victim, 4 yrs post surgery and had the robotic. Isn't science amazing. Glad to hear the continence is a minor issue and that should get better as you get further away from surgery. Do take the meds although they probably won't get you up for a few months at best. At this point don't worry to much about loosing the nerves. There are guys here who lost nerves doing very well with a pill and guys who's nerves were spared who are tremendously challenged. Two things we are learning- our bodies haven't read the text books and the docs still have a lot to learn.

I would recommend you consider trying the "Prelude" (see under pumps). It is not a "real" pump and can't be used for sex but it is a wonderful way to get the blood flowing again. I started using one right after I joined the site (3yrs post-op) and found it a great help. I have since moved on to a "medical" type pump and am very happy with teh results. The Prelude is not expensive and will start you going forward while you heal. They aren't expensive and come in 2 sizes as measured by your girth. The people there are very nice and will work with you and openly answer questions. I would also suggest you not begin much of a rehab until you're 3-4 weeks post-op (although a few strokes to let him know you still care are great and can lead to some nice but soft moments). Really surprised me the first time I got off then! Let everything down there heal and if you're not having any issues get going! (I'm not medically trained so talk with your doc).

So really, not too bad of a month. Surgery over, recovery started and and you've found a great place to ask questions and continuing healing. And, as I remember Auburn still ranked well.

Regards,

Dick