Retzius-Sparing Laparoscopic Radical Prostatectomy

Cheers

Bill

Another Great result John, long may it continue.

Ange

Hi Bernster 

I checked it out after a few of the lovely folks on here and in a local support group mentioned it. The Retzius approach is gaining traction with urologists globally which is great news. Fundamentally it generally needs a more technically competent surgeon as the prostate is accessed through a very small area known as the cave of Retzius. The approach means the nerves associated with bladder control and bladder itself aren’t messed around with as much as the regular approach which means continence  rates post op are significantly better. Some quote as high as 98%+ 

Certainly for me it was a no brainer as once I decided to go down the surgical route I wanted to ensure the best outcome I could in terms of cancer control plus urinary continence. The approach I believe doesn’t really impact the stats for ED...that’s more about surgeon skills and fair dose of luck and dependant on how extensive the cancer plus how much nerve sparing can be done.

During  my Retzius sparing RARP I also had NeuroSafe which is often part of the package....this is essentially a pathologist on standby live who will immediately take frozen sections of the prostate before the surgeons close up to check the margins etc so if more tissue needs to be taken they can do it there and then.

Hope that adds some useful info. Please shout if you need more :-)

Simon

Edited by member 16 Jan 2021 at 18:23  | Reason: Not specified

Hi Bernster

Very welcome. I was down that way yesterday in Boscombe having urgent wisdom tooth surgery. Grew up in the area. Definitely worth asking the consultant as he should know it as been around ~4-5years now. Key thing is to use a high volume surgeon who does >100 procedures a year and check their stats.

The surgeon I used is based out Guildford(NHS) and London Bridge Guys (Private). I went up to London Bridge which was an hour or so on the train. Not as ideal as my local hospital but the surgeons volumes and outcomes were very impressive and I good continence from catheter removal and didnt need pads after week 5. The odd occasional stress drip maybe once a month but improving all the time. ED outcome was better than expected and can have penetrative sex without viagra/tadalafil if not tired or pop a pill for a booster and feel like a youngster again.

Yes the main data for Retzius is speed of recovery but long term data is also strong v a procedure where more disturbance of the urinary control nerves are disturbed. My consultant said a normal RARP would maybe yield 80% continence after a year whereas Retzius takes that number nearer to 98% with a skilled pair of hands.

Ultimately I suspect you'd have to be willing to travel to London. Fairly direct from where you are...2hrs. Through NHS choices you can select hospital and consultant. Privately self pay you would be looking at about ~£22k.

PM'd you as we cant share on the discussion group unfortunately. Yeah Covid is a curve ball.

Thats cool.  Yes, I think there is a timeout as was an issue for me. Please also check out my thread if you've not seen it as plenty of info there. Just shout if you need anything as happy to help where I can like the folks helped me during this journey.

Thanking TechGuy and Bollinge. I read about this Professor and his work and location around Christmas time, when I started my research shortly after my diagnosis on 14/12/20 (carved into my brain!).

I haven't contacted him yet, but I can imagine he gives preference to private patients, or there will be a long wait under NHS, if he in fact services the latter. I do wonder what is happening with the rollout of his technique.

That’s great news John.  ‘Happy Days’ indeed!!

Angex