Radical Prostatectomy and Implant at Same Time?

[Cigar56]

Has anybody here heard of prostate surgery and penile implant at the same time? I'm currently using injections but on the clock for possible removal of my prostate. I could need prostate surgery in six months -- or six years. However, the clock is ticking. Just looking ahead, I am intrigued about the implant and the prostate surgery at the same time.

Am I out to lunch on this?

[Cigar56]

OK, I think I found my answer from PubMed.gov:

http://www.ncbi.nlm.nih.gov/pubmed/16145445

Men who chose simultaneous placement of a penile prosthesis with RP reported greater overall QOL (quality of life), erectile function and more frequent sexual contact than a comparison group of men who underwent RP alone. Placement of penile prosthesis at the time of RP may be a desirable option for men with prostate cancer in whom a nerve sparing procedure may not be ideal. These results underscore the importance of sexual function for men undergoing prostate cancer treatment.

Comments? Thoughts?

[Bionic_by_AMS]

In the 5 yrs. I've been coming here ... I have never heard of anyone having both operations at the same time.

I imagine that some Insurance companies would not authorize both ...

[OttoHS]

Although I have no reason to doubt that a simultaneous RP and implant procedure is possible, I see at least one practical issue. The surgeons who specialize in one of the procedures usually do not do the other one. So you either would have to have two different surgeons or one surgeon who was not a specialist in one of the procedures. Although my RP was performed by a well regarded surgeon, I ended up with both ED and incontinence. When I met initially with Dr Kramer I asked him whether he could do an implant and a male sling in the same operation. He said that it would be possible but that he advised against it. He thought that it would be best to stage the operations so that one was healed and any complications ruled out before doing the second one. I followed his advice and had implant surgery first and sling surgery eight weeks later. If you really are interested in having a RP and an implant done simultaneously, I would recommend that you email or talk to one of the high volume implant guys to see what they have to say.

[Cigar56]

In the 5 yrs. I've been coming here ... I have never heard of anyone having both operations at the same time.

I imagine that some Insurance companies would not authorize both ...

Thanks for your comments. I appreciate them. According to Pubmed.gov, the the dual surgeries have been performed. As for the insurance authorizations, surgery requests are generally considered on their individual merits. If a physician can make the case for a penile implant, then the insurance company may approve it. If the physician can make the case for prostate surgery, then that could be approved as well.

i have heard of insurance companies approving two knee replacements at the same time, for example, and there are many women who have undergone different hysterectomy-related surgeries at the same time. So those are a couple examples. It doesn't matter to the insurance company when you have your surgeries. You just have to meet the qualifications for approval on each diagnosis.

But I do understand your skepticism. In fact, that was my very first reaction when I learned about this. The good thing is that I am hoping not to need prostate surgery ever. I have tested positive for prostate cancer, but the cancer is so microscopic at this point that my doctor says I have a 50-50 chance of dying of other natural causes before the prostate cancer becomes a real threat. That's good to know because I'm hoping for another 20-25 years given that I'm now 60. Thanks again for your comments.

[roninhouston]

In the 5 yrs. I've been coming here ... I have never heard of anyone having both operations at the same time.

I posted this on FT yesterday's "Surgeon Reviews" .....

- Dr. Cornell studied at the Scott Urology school where the IPP was developed by Dr. Scott in the Houston's Texas Medical Center. The patent is now held by AMS. Dr. Scott was one of founders of AMS.

- if you need to have a artifical urinary sphincter (AUS) to control bladder leakage he can put in both with one incision, one OP. BTW it was developed by Dr. Scott.

Dr. Cornell does these two operations at the same time but don't know if he has done what you are looking to do. Since I don't have a prostate problem have never discussed it with him. His is a urology surgeon and he might say he does them all the time, I just don't know. He did say the healing time for the dual AUS and IPP was extended.

I did talk to one of his patients with a dual AUS and IPP. He thought it was great, just has to be careful of which pump you squeeze. I asked him if it was getting a little crowed down there. He said it was not too bad as the AUS pump is small, but he does have the equivalent of four balls.