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daVinci vs TURP

User
Posted 16 Apr 2015 at 10:11

Hi, all.

We've got the scores on the doors so far: Gleason 7 (now down to 3+4 rather than 4+3 after the second opinion team), no bone or other involvement and it's contained in the capsule on one side, 3 out of 7 cores. OH was galloping into choosing a TURP over the daVinci but after a "whoa there, folks - take your time," from others on the site, we need to find out what's in the choice. It's all written down in a cool, calm and collected way in the blurb, but what about real people?

From what I'd read of the posts on here, the daVinci guys seem to have fewer problems afterwards with pain, ED and incontinence but that doesn't seem to be correct according to someone in the know on here and I might be selectively remembering what I've read. I've tried trawling the posts for info, but I'm finding it hard to compare all the different strings and anyway, if I can get a few answers in one place then my OH might look at what's here so I just want to ask a simple question.

If you've had a radical prostatectomy through either TURP or  daVinci, how do you find your recovery? do you think that it's true that there is less blood loss, incontinence and ED after daVinci or do you reckon it's manufacturer's blurb or NHS blurb for "cheaper to do"?

Any replies would be gratefully read. Thanks. 

User
Posted 16 Apr 2015 at 17:22

Hi,sorry to add to the confusion but Da Vinci was shown on BBC2  programme called inside Harley Street earlier this week,Monday 13th. It should also be available on the BBC player online.  My OH was also Gleason 3+4 ,offered op.RT. or Brachytherapy.  He chose the last as least invasive solution after we were told outcomes for all 3 were virtually the same.  No regrets ,so far, 9 months after treatment.  ps his case was considered by a team at Clatterbridge -oncologist,RT guy and Brachy guy.  Seems like a better way forward tho it did take longer. Good luck,El.

User
Posted 26 Apr 2015 at 21:11
Enjoyed reading your post, made me smile ⛳️😀

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User
Posted 16 Apr 2015 at 17:22

Hi,sorry to add to the confusion but Da Vinci was shown on BBC2  programme called inside Harley Street earlier this week,Monday 13th. It should also be available on the BBC player online.  My OH was also Gleason 3+4 ,offered op.RT. or Brachytherapy.  He chose the last as least invasive solution after we were told outcomes for all 3 were virtually the same.  No regrets ,so far, 9 months after treatment.  ps his case was considered by a team at Clatterbridge -oncologist,RT guy and Brachy guy.  Seems like a better way forward tho it did take longer. Good luck,El.

User
Posted 16 Apr 2015 at 17:50

Bit confused by your post as a turp is not a radical prostectomy.

If you mean an open op v the robot then the stats show that potential blood loss is less with the robot. Recovery time is usually quicker..hospital stay is less...wound sites are smaller..

Regarding longer term results from the robot it is relatively early days but the current results do seem to state that outcomes for removal of PCA and side effects are similar

Bri

User
Posted 16 Apr 2015 at 18:11

Hi Steph,

A simple question but unfortunately not a simple answer.

There are many variables to consider, not least as to whether he would like to end up with one, three or five holes in his abdomen!

What worked for me (Da Vinci - my choice) may not be the best choice for your OH. What does your urologist advise?

What won me over for Da Vinci was how precise the robot could be under the control of a SKILLED surgeon (by SKILLED I mean a surgeon who has undertaken the procedure hundreds if not thousands of times).Then, hopefully, nerve damage will be minimised and complications reduced. There are of course many skilled surgeons who prefer the 'open' method as it allows them to have direct contact with the prostate and the surrounding nerves.

With Robot / keyhole vs "open", I understand that blood loss is less with the former (100ml in my case) and the recovery time is shorter (again for me a couple of days).

I would try not to over-analyse things too much, the aim is to get the blighter out (PCa hopefully as well!)

flexi

 

 

 

 

 

 

 

 

 

 

 

User
Posted 16 Apr 2015 at 19:18

Hi again Steph,

As you probably know by now ( looking at my profile ) I had da Vinci surgery..

Recovery from my surgery was very quick with just less than 24 hours in hospital...

I didn't need a drain in my wounds and was discharged with just a spare set of clear dressings to change when / if needed...

My wounds were closed using dissolving stitches and I never needed a visit from a nurse or any aftercare for 2 weeks until my catheter was removed at my local hospital...

There is no doubt in my mind that da Vinci surgery is proving to be more cost effective for the NHS if my history is anything to go by.....
Does that make it any better for the patient? .....Maybe, if the initial recovery is quicker...

As to side effects following da Vinci surgery, they are individual to every person, but as far as I can see they are no better or worse whatever procedure you choose...

On a personal level my incontinence after 10 months is not as good as I was hoping for....but I'm reassured by the medics who are supposed to know that it will improve further in time..
My ED is also now improving slowly ( I only have 50% of nerves spared )  but still nowhere near achieving a usable erection unaided....

I don't regret my decision to have surgery and within approx 7 to 8 weeks I had a full histology report which fortunately informed me that 'things' went well and I was able to concentrate on getting on with my 'new life' without a prostate...

I hope this helps you and your hubby in some way in seeing my personal take on this subject...

PS..... I think you may be getting confused with TURP and a Laparoscopic Prostatectomy ?

Best Wishes 
Luther

 

User
Posted 16 Apr 2015 at 22:14

TURP or Da Vinci? 

TURP will not deal with the cancer. 

The Robot is generally supposed to have some advantages with regard to recovery time from the operation itself, reduced blood loss, and less time in hospital.   

Open surgery allows the surgeon to get their hands in there and may be the only surgical option if the patient is overweight has a beer belly.

There is a lot of information available here and elsewhere about the pros and cons of each procedure.

dave

 

edited to make it to the point

 

Edited by member 17 Apr 2015 at 06:04  | Reason: Not specified

User
Posted 17 Apr 2015 at 01:28

Hi Steph, don't worry about it - I guess they said LARP or LRP rather than TURP which is an easy thing to mishear I think. In terms of difference between LRP and da vinci, the research data says there is no difference to blood loss, duration of operation, length of stay in hospital, recurrence rates or risk of incontinence / ED. And far from DV being a cheaper option, I think it is actually more expensive at least in the early years which is why not all hospitals have bought the machine.

Both LRP and DV have advantages over open surgery in terms of blood loss and length of stay in hospital but the open surgery means a shorter time under general anaesthetic. Some people with heart problems can't have LRP/DV because you get tipped head down feet up on the operating table which puts too much pressure on a damaged heart. Open RP means less problems with wind afterwards but a longer time off work because the wound is more extensive.

Wait to see the surgeon who will presumably talk you both through all these things.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Apr 2015 at 08:12

Thank you all for your replies. El - I'm going to try and get it on iplayer. I have, of course, ballsed-up - Lyn you got it, it was LARP not TURP. Not even sure what TURP is - must have skimmed it somewhere. The surgeon Gray will be referred to will be either for the laparoscopy at Preston or a different surgeon for the daVinci in Manchester (a wait of 12 weeks from referral - but they're not guaranteeing that!). We've not been offered any pre-surgeon consultation with regard to choice, but are being pigeonholed first since Gray jumped at the LARP (the laparoscopy, incase I'm ballsing-up again). But Gray has put a hold on the referral for the laparoscopy until he's spoken to the urology nurse - no point in speaking to the silent smiling man urologist who said but 4 sentences. But from what i read, there is totally conflicting advice and reactions from every corner, so I guess it's a lottery.

I do thank you for your replies, each. I'm not going to return to the site because it's too much for me, but I appreciate all your advice and kindnesses and the time you have all taken to try to answer questions and help - you have managed it!

God bless.

Edited by member 17 Apr 2015 at 08:13  | Reason: Not specified

User
Posted 17 Apr 2015 at 09:22

One year on, loving life after da Vinci surgery. Nearly continent, sildenafil (viagra) having some effect, but not enough for intercourse, but am as content as I've ever been, and playing the best golf of my life at 62!

However, ask as many questions and find as much info as you can to help make your own decision.

Paul

Stay Calm And Carry On.
User
Posted 26 Apr 2015 at 21:11
Enjoyed reading your post, made me smile ⛳️😀

 
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