RALP after TURP

Chris, 

Thanks for your prompt response. I needed that and it is really encouraging. It's all a bit distressing and a bit of a shock at the moment. 

99% day 4, you must have been mightily pleased with that.

Once more. Thanks.

Peter

I didn't have a lot of control on day 1 and in the early days as soon as I got tired I lost control.

I'd give it a few weeks before getting concerned

I’d recommend a couple of sessions with a physiotherapist as they can get the technique nailed down fairly quickly.

Just watched a video on UCLH website. Explained clearly to me that the long 'hold fart' PF exercise is separate to the short 'stop peeing' PF exercise. Not one immediately after the other in the same count as I had previously understood. They recommend 3 sets of 10 for each exercise 5 times daily. Won't leave much time for anything else!

I will see a physio if necessary but far too early yet. Have an appointment to see the surgeon in four weeks so I will persevere and  try and be patient until then and hopefully improve in the meantime. Only Day 2 after catheter removal at the moment.

Just received the surgeon's letter to my GP. Confirmed I had a clear margin and that both sets of nerves were saved. I'm a lucky guy.  Also that I had an anterior bladder neck reconstruction. Is that a normal procedure during RALP? I understand it helps continence.

As an aside; I don't suppose direct commercial mentions are permitted in this forum, but I have found some cheaper pads and pants I have tried to be more comfortable, easier to remove and just as absorbant and retaining as a notable brand always being advertised on TV.

Off to see my surgeon for te 6 week post op. review next Saturday. I suppose that  we will be discussing my pathology results (assuming the intra op. Neurosafe analysis was not the final analysis) , how I am doing and plan ongoing etc.
Can anyone put forward any killer questions that may not be obvious to me, or that they may have wished they had asked on a post op. review?

Thanks, Peter

Progress report.
Saw the surgeon today for my 6 week post op review. Very positive outcome. He said that the margins were definitely clear and that all cancer had been removed. Definitely. The tumour was quite large but he was confident that I am cured. Yes. he actually used that terminology. I was so pleased that I dropped several of my pre-prepared questions. They just didn't seem important at the time.
My continence is nowhere near where I would I like it, although I don't think it is unusually poor at 6 weeks, but he said (after discussing my daily exercise regime) this is probably due to me overdoing things and I have been ordered to slow down. He said this is one of the drawbacks of robotic surgery in that the small exterior wounds heal quickly and give a false impression of what is really going on inside. Also, my previous TURP doesn't help continence because of the additional scarring. That said and if I take things slowly, do my PF sets daily, he is confident I will see significant improvement by the time I see him again in February, following my first post op PSA test. So, largely, with no adverse medical indications, it is up to me now.

Onward and upward.

Peter

So now I have just received a copy of my surgeon's letter to my GP.

My final pathology confirms Gleason 3+4=7 as expected, tumour volume of 2.19ml which Mr Google tells me is on the larger side of average, a staging of pT3a and clear margins.

I am surprised at the staging of pT3a (locally advanced) as I was advised pre-op that my cancer was contained within the prostate and whilst I welcome the confirmation of clear margins, I do not understand what that means if the cancer had broken through the capsule. Can anyone explain this to me?

Peter

Thanks Upkeep. I'm still fighting the incontinence, but live in hope as it is still early days. Surgeon called it moderate stress incontinence. I'm OK at night, but 5 pads during the day with leakage at any time. Is that a fair description?

Edited by member 10 Jan 2022 at 13:29  | Reason: rephrase

Cheers
Upkeep

Urgency might also be influenced by the stimulating caffiene. Might be worth trying a proper, de-caffienated coffee at breakfast. Once i made the switch i rarely go back. I guess a lot of it's in the mind.   

I'm now 6 weeks from surgery and have noticed small amounts of blood in my pee occasionally. Did you get advice that this is normal as the healing inside takes longer that the outside. If internal scabs are dislodged then I suppose there would be some blood in these small amounts.

I can now get by on two pads a day and it seems progress is not linear with some days better than others. I can retain urine whilst sitting or lying down at night but getting up from sitting down still involves leakage.

People I've talked to that have had the same op reckon it was 3 to 4 months before they could discard the pads.

Thanks for that it's only been very small amounts of very light red blood on occasions so far so probably the internal scabs coming off.  Still early for me six weeks in after the operation so hopefully by mid-summer things will be approaching normal again.  I feel physically fit enough to resume all activities but in view of the slower healing of the internal bits maybe golf and cricket can wait another couple of months.  My next consultation is in early April when I have my first PSA test after the op so will know more by then.