My RALP

Just received the bad news this week, doctor said RALP is probably my best option. So I though I do some research, see what the road ahead looks like. 

Thanks Kev for starting this post.

Craig

kev

Search for shopping in the search facility, it will be come up with a relevant conversation and within is a link to a similar conversation.  My top tips avoid constipation and get some instilagel or hydrocaine to lubricate the catheter. If you are having the retzius version of the  op you will not need it. 

Hope all goes well.

Thanks Chris

Best of luck with your recuperation.

Cheers, John.

Kev

A few days after my RARP I also suffered an excruciating pain in the abdominal area that resulted in paramedics, 30 mg ?  of morphine and a ride to hospital in an ambulance. After a few hours I was given the option of going to the urology ward at a different hospital or going home, I chose to go home. We decided it was constipation,  my bladder spasms are uncomfortable but only lasts for a minute or so and are usually or accompanied with leaking urine. Painkillers can   cause constipation. 

Thanks Chris

Hi Craig,
My decision for RALP was unanimous between my oncologist, surgeon and myself with backing from my partner.

I'd consider the following:
Nerve sparing.. (no guarantee of course).
Penis: may be a bit shorter after.
There'll be pain and discomfort but I was quite comfortable by day 2.
The catheter can be uncomfortable and cumbersome, you need to keep an eye on the bag! I needed help with emptying as it's strapped to my calf (may be an issue if you're single).
On a busy ward, it helps to have a partner to fight your corner sometimes.
There'll be a wait for final pathology so it'll be a bit like the biopsy one I guess.

Prep:
I'm no athlete but do use a gym, so bearing in mind comments about shoulder pain, I used the arm bike(?) machine a lot. As well as using gym equipment I went running. I figured I needed to be in the best shape possible. I think this focussed my mind and cleared my head and gave me a positive attitude, so by the day of the op, I can honestly say that I was ready.

Apart from that, others have listed useful stuff like mattress protector, icopads etc.. as theres bound to be the odd drip when changing night bag etc..

I have no regrets (well too late now anyway)

I hope this helps in some way and best of luck.
Kev.

Edited by member 14 Nov 2019 at 14:10  | Reason: Typo

Hi Kev

Sounds like you are making steady progress. Due for my Retzius sparing RARP + neurosafe in just over a week. One pre-op yesterday the nurse mentioned about scrotal swelling and said to be prepared for significant swelling as the bruising comes out. She said although from outside the surgery looks minor inside it’s quite a different story and takes quite a while to settle. Defo get it checked out for reassurance but sound like you are on a good road to recovery. Will start a thread too when things kick off.

best of luck and keep those tips and updates coming as they are invaluable.

TG

Hope you don't get any more spasms. May be worth getting some Buscopan or equivalent. Check out my post from 9th September.

Very best wishes for your recovery,

Chris

Hi John

Ah yes forgot that. Epidural is also the path for me I believe via the pre-op staff. 

Seems to be favoured as less load on heart/lungs/immune system apparently. I wonder if it will cure me of my fear of needles. Had so many now the bloods on Thursday I didn’t even break into a sweat 😲

cheers

TG

Kev

Looks like you’re making steady progress.

Good luck for the meeting on the 24th and may you enjoy feet up a bit with a tipple over the festive period with friends and family.

TG

Good to hear your progress . All the best to you.  

Hi Kev

It was good to read your post although when I read all the tough stuff you have had to go through I feel incredibly lucky that my RAPR seems to have gone remarkably well with very limited SE.

I had my PR removed at London Bridge hospital less than 2 weeks ago. Apart from shoulder pain, particularly the right shoulder - linked as others have mentioned to diaphragm pushing down during op and CO2 - some general tenderness around the wounds etc I was able to stop all paracetamol and ibuprofen a week after the operation.  I had none of the swollen scrotum, bowel, catheter and peeing issues you have described.

Like you sleep in hospital was at best fitful as the nursing staff did regular checks throughout the night, particularly the first night; my operation was late evening and I was only back in my room at 20:30.  Ice-cream and yoghurt only for supper after having had nothing to eat all day!

I had no abdominal drain post op and my 6 wounds were all closed with what looks like a clear plastic adhesive; no redness, all flat and no staples.  There was some bruising and tenderness around the big 2inch cut above my belly button.

The hospital physio had me up and doing a corridor walk on the morning after the operation.  I could walk ‘tall’, take steps - no shuffling - and could sit up and get out of bed relatively easily.  I coud bend down although obviously coughing was sore. I was able to shower on day 2 after the operation.

I was in the hospital for 3 nights and then got train from London Bridge - we missed the terrorist incident there by 15 minutes; we were on a 13:45 train and the incident kicked off at 14:00 - to Gatwick for flight to Jersey late Friday afternoon flight.  All went fine and assistance at Gatwick was great.  

It was good to get home and I slept in a spare bedroom; sleep was fitful as I was suffering from severe headaches which were linked to very high blood pressure.  My GP prescribed medication to control this last Monday and apart from BP falling a bit I feel a lot better.

I had my catheter - I had the penile catheter rather than the supra pelvic one - removed last Thursday - 9 days after surgery - and this was a big relief.  I am delighted I am completely dry and in control.  No leaks or need for pads, waterproof mattress cover etc.

It turns out that RP was the right call as during the RP surgery the surgeon established that the cancer had spread outside the capsule - something that was not evident from MRI scan etc - and he took out some margin. I am now in the holding pattern of monitoring PSA results in 4 weeks time and quarterly thereafter to establish if in fact the surgeon got it all. Apparently Brachy would not have been an option if it had been established that my cancer had spread outside the capsule.

And then last night was delighted to wake up during the night with a strong hard nocturnal erection!

So all good right now and I am feeling fine and strong.  I have been for walks on the beach, and been into town for Christmas market and even attended a Christmas drinks party on Saturday night.

So I feel very fortunate and hope your recovery continues to improve each day.

Cheers

Grant60

Good to hear Kev. 

Made the same mistake a few years back with a case of Bollinger. Got handed down from my father. Think he won it randomly on a credit card competition mid 80s. When opened it tasted like sherry 😬 Such a waste of the 8 bottles left 😒

Cheers

Bill

Kev T

Great news .

Thanks Chris

Third PSA post-op result is <0.03 undetectable.

I emailed PALS after having difficulty contacting the hospital and having appointments cancelled due to covid. The result being a PSA test form, and a new ED appointment next week replacing the one they cancelled. Result!

ED wise, things are definitely improving. Nowhere near pre-OP standards, but I can manage penetration now which is a huge psychological boost. I owe a big thanks to all those on this site who have posted some fantastic advice on the subject.

To everyone else still struggling, try not to be disheartened, don't give up but keep trying. 

I might even have a celebratory beer tonight.. and I will raise my glass to everyone on here.

Cheers and good luck. 

Kev.